Pain Assessment Scales

The National Initiative on Pain Control™ (NIPC™) has provided these diagnostic tools to assist you in assessing the severity and quality of pain experienced by your patients. We suggest that you produce multiple photocopies so that you may obtain written feedback to place in the patient’s history file.

Client's Full Name

Wong-Baker FACES Pain Rating Scale

Explain to the person that each face is for a person who feels happy because he has no pain (hurt) or sad because he has some or a l ot of pain. Face 0 i s very happy because he doesn’t hurt at all. Face 1 hurts just a little bit. Face 2 hurts a little more. F ace 3 hurts even more. Face 4 hurts a whole lot. Face 5 hurts as much as you can i mage, although you don’t have to be crying to feel this bad. Ask the person to choose the face that best describes how he is feeling.

Rating scale is recommended for persons age 3 years and older.

Brief word instructions: Point to each face using the words to describe the pain i ntensity. Ask the child to choose face that best describes own pain and record the appropriate number.

From Wong DL, Hockenberry-Eaton M, Wilson D, Winkelstein ML, Sch wartz P: Wong’s Essentials of Pediatric Nursing, 6/e, St. Louis, 2001, P. 1301. Copyrighted by Mosby, Inc. Reprinted by permission.

0–10 Numeric Pain Rating Scale

No pain Worst possible pain

Where is Your Pain?

Please mark, on the drawings below, the areas where you feel pain. Write “E” if external or “I” if internal near the areas which you mark. Write “EI” if both external and internal.

Reprinted from Pain, Vol 1, Melzack R, The McGill Pain Questionnaire: major properties and scoring methods, 277-299, Copyright 1975, with permission from the International Association for the Study of Pain.

Selected Areas

Pain Quality Assessment Scale© (PQAS©)

Instructions: There are different aspects and types of pain that patients experience and that we are interested in measuring. Pain can feel sharp, hot, cold, dull, and achy. Some pains may feel like they are very superficial (at skin-level), or they may feel like they are from deep inside your body. Pain can be described as unpleasant and also can have different time qualities.

The Pain Quality Assessment Scale helps us measure these and other different aspects of your pain. For one patient, a pain might feel extremely hot and burning, but not at all dull, while another patient may not experience any burning pain, but feel like their pain is very dull and achy. Therefore, we expect you to rate very high on some of the scales below and very low on others.

Please use the 20 upcoming rating scales to rate how much of each different pain quality and type you may or may not have felt over the past week, on average.

1. Please use the scale below to tell us how intense your pain has been over the past week, on average.

No pain The most intense
pain sensation
imaginable

2. Please use the scale below to tell us how sharp your pain has felt over the past week. Words used to describe sharp feelings include “like a knife,” “like a spike,” or “piercing.”

No pain The most sharp
sensation imaginable
(“like a knife”)

3. Please use the scale below to tell us how hot your pain has felt over the past week. Words used to describe very hot pain include “burning” and “on fire.”

Not hot The most hot
sensation imaginable
(“burning”)

4. Please use the scale below to tell us how dull your pain has felt over the past week.

Not dull The most dull
sensation imaginable

5. Please use the scale below to tell us how cold your pain has felt over the past week. Words used to describe very cold pain include “like ice” and “freezing.”

Not cold The most cold
sensation imaginable
(“freezing”)

6. Please use the scale below to tell us how sensitive your skin has been to light touch or clothing rubbing against it over the past week. Words used to describe sensitive skin include “like sunburned skin” and “raw skin.”

Not sensitive The most sensitive
sensation imaginable
(“raw skin”)

7. Please use the scale below to tell us how tender your pain is when something has pressed against it over the past week. Another word used to describe tender pain is “like a bruise.”

Not tender The most tender
sensation imaginable
(“like a bruise”)

8. Please use the scale below to tell us how itchy your pain has felt over the past week. Words used to describe itchy pain include “like poison ivy” and “like a mosquito bite.”

Not itchy The most itchy
sensation imaginable
(“like poison ivy”)

9. Please use the scale below to tell us how much your pain has felt like it has been shooting over the past week. Another word used to describe shooting pain is “zapping.”

Not shooting The most shooting
sensation imaginable
(“zapping”)

10. Please use the scale below to tell us how numb your pain has felt over the past week. A phrase that can be used to describe numb pain is "like it is asleep."

Not numb The most numb
sensation imaginable
(“asleep”)

11 .Please use the scale below to tell us how much your pain sensations have felt electrical over the past week. Words used to describe electrical pain include “shocks,” “lightning,” and “sparking.”

Not electrical The most electrical
sensation imaginable
(“shocks”)

12. Please use the scale below to tell us how tingling your pain has felt over the past week. Words used to describe tingling pain include “like pins and needles” and “prickling.”

Not tingling The most tingling
sensation imaginable
(“pins and needles”)

13. Please use the scale below to tell us how cramping your pain has felt over the past week. Words used to describe cramping pain include “squeezing” and “tight.”

Not cramping The most cramping
sensation imaginable
(“squeezing”)

14. Please use the scale below to tell us how radiating your pain has felt over the past week. Another word used to describe radiating pain is “spreading.”

Not radiating The most radiating
sensation imaginable
(“spreading”)

15. Please use the scale below to tell us how throbbing your pain has felt over the past week. Another word used to describe throbbing pain is “pounding.”

Not throbbing The most throbbing
sensation imaginable
(“pounding”)

16. Please use the scale below to tell us how aching your pain has felt over the past week. Another word used to describe aching pain is “like a toothache.”

Not aching The most aching
sensation imaginable
(“like a toothache”)

17. Please use the scale below to tell us how heavy your pain has felt over the past week. Other words used to describe heavy pain are “pressure” and “weighted down.”

Not heavy The most heavy
sensation imaginable
(“weighted down”)

18. Now that you have told us the different types of pain sensations you have felt, we want you to tell us overall how unpleasant your pain has been to you over the past week. Words used to describe very unpleasant pain include “annoying,” “bothersome,” “miserable,” and “intolerable.” Remember, pain can have a low intensity but still feel extremely unpleasant, and some kinds of pain can have a high intensity but be very tolerable. With this scale, please tell us how unpleasant your pain feels.

Not unpleasant The most unpleasant
sensation imaginable
(“intolerable”)

19. We want you to give us an estimate of the severity of your deep versus surface pain over the past week. We want you to rate each location of pain separately. We realize that it can be difficult to make these estimates, and most likely it will be a “best guess,” but please give us your best estimate.

How intense is your deep pain?

Not deep pain The most intense deep
pain sensation imaginable

How intense is your surface pain?

Not surface pain The most intense surface
pain sensation imaginable

20. Pain can also have different time qualities. For some people, the pain comes and goes and so they have some moments that are completely without pain; in other words the pain “comes and goes”. This is called intermittent pain. Others are never pain free, but their pain types and pain severity can vary from one moment to the next. This is called variable pain. For these people, the increases can be severe, so that they feel they have moments of very intense pain (“breakthrough” pain), but at other times they can feel lower levels of pain (“background” pain). Still, they are never pain free. Other people have pain that really does not change that much from one moment to another. This is called stable pain. Which of these best describes the time pattern of your pain:

I have intermittent pain (I feel pain sometimes but I am pain-free at other times). i have variable pain (“background” pain all the time, but also moments of more pain, or even severe “breakthrough pain or varying types of pain). I have stable pain (constant pain that does not change very much from one moment to another, and no pain-free periods).