Daily Pain Score

 

 

What is the level of your discomfort today?

 

 

KEY:                  

 

NONE              MILD            MEDIUM               SEVERE

 

      0           1            2                 3                4               5

 

Please fill in your score with the corresponding day of the month.

 

Pain Score

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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How to score pain.

 

MILD PAIN: Pain that occurs occasionally and does not limit your mobility or the
way you do things. Pain that can be relieved by drugs like panadol.

 

MEDIUM PAIN: Pain that occurs on a daily basis. May include joint stiffness and
soreness after getting out of bed in the morning, persistent pain throughout the day,
and pain that increases with physical activity. A drug that helps this patient is an
anti-inflammatory.

 

SEVERE PAIN: Chronic, constant pain that can be debilitating over time. Severe
pain negatively impacts a person’s quality of life, activity tends to increase the
intensity of the pain.