Examiner Asks/Rationale Initial Pain Assessment 1. O: onset • When did the pain start? To identify onset of pain (when active, or resting) or whether pain is acute/chronic. 2. P: provocative/palliative • Does your pain increase with movement or activity? • Are the symptoms relieved with rest? • Were any previous treatments effective? To identify quality of pain and differentiate between nociceptive and neuropathic pain mechanisms. To identify alleviating and aggravating factors. To evaluate effectiveness of current treatment. Any history of head injury etc. 3. Q: quality of the pain • What does your pain feel like? To identify mechanism of pain (terms such as “throbbing,” “aching,” “shooting,” and “dull” may provide clues). • What words describe your pain? 4. R: region of the body/radiation • Where is your pain? To identify one or more areas of the body that are affected by pain, inasmuch as there may be several. • Does the pain radiate, or move to other areas? 5. S: severity of pain • How would you rate your pain on an intensity scale? To identify intensity (refer to various intensity scales). To identify degree of impairment and effect on quality of life or ability to perform activities of daily living (ADLs). 6. T: treatment/timing • What treatments have worked for you in the past? • Is it a constant, dull, or intermittent pain? What changed since the onset that has caused you to seek care? To identify treatments which have been successful in the past. To identify the timing of the pain so that treatment can be focused on spikes in pain. 7. U: Understanding of pain To understand patient history of pain. • What do you believe is causing the pain? To be able to set achievable pain and function goals when reviewing the plan of care. 8. V: values • What is your acceptable level for this pain? • Is there anything else that you would like to say about your pain? • Are there any other symptoms related to the pain? To understand and discuss other stressors, spiritual pain.

Rational Pain Assessment

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