Numerical Rating Scale

On the scale above, the number 0 represents “no pain” and the number 10 represents the “worst imaginable pain”.  Choose a number between 0 and 10 that best represents the level of pain you feel.

Faces Rating Scale

On the scale above, each face is for a person that feels happy because he has no pain or sad because he has some or a lot of pain.  Choose a face that best shows how you feel when you have pain.

You may find it helpful to keep a record or a diary to track your pain and what works to relieve your pain.  A pain control diary is one way to keep this record.  Be sure to share your diary with your nurse and doctor.  Some items you may want to include in this diary are:

• The date
• The times you take your pain medicine
• The name and dose of the pain medicine you take
• The number from the pain rating scale at the time you take your medicine (Be sure to note what scale you used)
• The number from the pain rating scale about 1 to 2 hours after you take your medicine (Be sure to note what scale you used and the length of time)
• Any pain-relief methods other than medicine you used such as rest, relaxation techniques, distraction, skin stimulation or imagery
• Any side effects that may occur

You may want to include in the comments section of your diary:

• Any activity that seems to increase the pain or decrease the pain
• Words to describe how the pain feels (sharp, burning, aching, etc.)
• Where the pain is located
• How long the pain lasts
• How long your medicine works
• How pain interferes with your normal activities, such as sleeping, eating or working
  

Click here to download a pdf of a pain control diary.