The Chronic Pain Questionnaire

 
 
 

1. Gets Detailed Information about Your Pain

 

Pain Location: The part (or parts) of the body affected.

 

Worst Pain: The worst point within a painful area. The worst area if you have several painful body areas.

 

Pain Severity and Duration:  How severe and how long.

 

Pain Quality: Pain may be described in many different ways – sharp, dull, throbbing, burning, numb, aching, etc.

 

What makes Pain Better or Worse: Pain may vary according to the time of day, physical activity, certain movements, touching the area, medications, or your emotional state.

 

Associated Symptoms: Such as stiffness or swelling.

 

Limitation of Activity: Pain may make it difficult for you to walk, or to do housework or gardening.

 

Mood Changes: Chronic pain can be debilitating and upsetting, and some people are better able to tolerate pain than others.

2. Confirms you can Take Part in the Study

We ask some questions to make sure you are eligible for the study.

3. Gets Contact Information for us to email your Personal Pain Report & to Analyze Group Data

We take all legal means available to us to protect your confidentiality and prevent unsolicited contacts.

 

To return to the More Information page, click:

More Information

 

 
 
Copyright © 2004 & 2005, Taylor MicroTechnology, Inc. All rights reserved.
 

 

 

Hit Counter