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Neurobehavioral Medicine Consultants
Pain Profile


Pain Profile

Pain is a complex phenomenon, with both medical and psychological components. The cause of the pain, its severity and the time elapsed since its onset are all important, along with the individual's response to the pain. Although medication is likely to play a central role in the management of pain, factors such as stress and depression can also influence a patient's adaptation to pain.

Even the best medical pain management program may not be as effective as possible if associated psychological conditions are not thoroughly addressed. It is these psychological aspects that the clinical psychologist deals with when assessing a patient's pain and making recommendations for intervention. Although this profile is not intended as a substitute for a detailed evaluation by a trained and licensed clinician, it may help you gain insight into some of the important characteristics of pain.

The Olive Trees, Van Gogh

The questions which ask about the perception of pain use a simplified five-step scale from the first step, no pain, to the fifth step, corresponding to the worst pain imaginable, pain sufficiently intense that it results in complete incapacitation. The second step corresponds to mild pain, which can be ignored, at least for some reasonable interval of time. The third step, moderate pain, corresponds to pain sufficiently severe that the person's ability to complete tasks is compromised. The pain corresponding to the fourth step is sufficiently severe to interfere with concentration and may interfere with the patient's ability to meet his or her basic needs.

Please answer each of the following questions as honestly as possible. Pick the answer which most accurately describes your situation. Then go to the summary, which will include a listing of your answers to the questions. If you have provided sufficient information about your pain, it will also give you a brief discussion about some of the characteristics of your pain and their implications for intervention.

1.

Where is your pain located? Check each location that applies:

Head

Neck

Shoulders

Upper Extremities

Chest or Abdomen

Upper Back

Lower Back

Lower Extremities


less than 1 week

How long have you had your current pain problem?

1 week to 1 month

2.

more than 1 month

more than 1 year

more than 5 years


none

During the last 3 months, or since your pain began, whichever is less, how much of your work have you missed because of the pain?

less than 20%

3.

20% to 50%

more than 50%

100% (on disability)


strenuous

Is your work strenuous or sedentary?

mostly physical work

4.

equal mix of each

mostly sedentary

completely sedentary


stimulating

Is your work stimulating or boring?

mostly stimulating

5.

somewhat stimulating

mostly boring

boring


no pain

How would you rate the pain that you have had during the past week?

mild pain

6.

moderate pain

severe pain

worst pain imaginable


no pain

On average, how bad was your pain during the last 3 months or since its onset, if you have had it for less than 3 months?

mild pain

7.

moderate pain

severe pain

worst pain imaginable


once

During the last 3 months or since the pain's onset, if less than 3 months ago, how often have you experienced episodes of pain?

about once a week

8.

several each week

every day

continuously


no pain

What level of pain could you tolerate and still get on with your life?

mild pain

9.

moderate pain

severe pain

worst pain imaginable


eliminate it

Using whatever coping skills you have developed, how much are you able to decrease your level of pain during the day?

almost eliminate it

10.

moderate

a little

none


highly unlikely

In your view, how high is the risk that your current pain may become more persistent?

somewhat unlikely

11.

possible

moderately likely

highly likely


no stress

How much stress have you felt in the last week?

For additional guidance in answering this question, see the Stress Profile.

a little stress

12.

moderate stress

high degree of stress

constant stress


none

How often have you felt depressed during the last week?

For additional guidance in answering this question, see the Depression Profile.

infrequently

13.

some of the time

often

continuously


no pain

What was your highest level of pain during the last month (or since its onset, if less than a month ago)?

mild pain

14.

moderate pain

severe pain

worst pain imaginable


no pain

What was your lowest level of pain during the last month (or since its onset, if less than a month ago)?

mild pain

15.

moderate pain

severe pain

worst pain imaginable


no pain

What is your overall level of pain right now?

mild pain

16.

moderate pain

severe pain

worst pain imaginable


For each of the following questions, please choose the answer which best describes how much difficulty is caused by the pain as you engage in that activity.


no problem

Walking for an hour.

fairly easy

17.

moderately difficult

very difficult

impossible


no problem

Performing light work for an hour.

fairly easy

18.

moderately difficult

very difficult

impossible


no problem

Doing ordinary housework for an hour.

fairly easy

19.

moderately difficult

very difficult

impossible


no problem

Shopping.

fairly easy

20.

moderately difficult

very difficult

impossible


no problem

Sleeping at night.

fairly easy

21.

moderately difficult

very difficult

impossible

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