Pain Quality Assessment Scale

Instructions

There are different aspects and types of pain that people experience and that we are interested in measuring. Pain can feel sharp, hot, cold, dull, and achy. Some pains may feel like they are very superficial (at skin-level), or they may feel like they are from deep inside your body. Pain can be described as unpleasant and also can have different time qualities.

The Pain Quality Assessment Scale helps us measure these and other different aspects of your pain. For one person, a pain might feel extremely hot and burning, but not at all dull, while another patient may not experience any burning pain, but feel like their pain is very dull and achy. Therefore, we expect you to rate very high on some of the scales below and very low on others.

Please use the 20 rating scales below to rate how much of each different pain quality and type you may or may not have felt over the past week on average.

Name*

E-mail

1. How intense has your pain been over the past week, on average.

0 - No Pain
1
2
3
4
5
6
7
8
9
10 - The most intense pain imaginable

2. How sharp has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most sharp sensation imaginable

3. How hot has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most hot sensation imaginable

4. How dull has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most dull pain imaginable

5. How cold has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most cold pain imaginable

6. How sensitive has your skin been to light touch or clothing rubbing against it over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most sensitive sensation imaginable

7. How tender has your pain been when something has pressed against it over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most tender sensation imaginable

8. How itchy has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most itchy sensation imaginable

9. How much has your pain felt like it has been shooting over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most shooting sensation imaginable

10. How numb has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most numb sensation imaginable

11. How much has your pain sensations felt eletrical over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most electrical sensation imaginable

12. How tingling has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most tingling pain imaginable

13. How cramping has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most cramping sensation imaginable

14. How radiating has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most radiating sensation imaginable

15. How throbbing has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most throbbing sensation imaginable

16. How aching has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most aching sensation imaginable

17. How heavy has your pain felt over the past week?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most heavy sensation imaginable

18. How unpleasant has your pain felt?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most unpleasant sensation imaginable

19. We want you to give us an estimate of the severity of your deep versus surface pain over the past week. We want you to rate each location of pain separately. We realize that it can be difficult to make these estimates, and most likely it will be a "best guess" but please give us your best estimate.

How intense is your deep pain?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most intense deep pain imaginable

How intense is your surface pain?

0 - No pain
1
2
3
4
5
6
7
8
9
10 - The most intense surface pain imaginable

20. Pain can also have different time qualities. For some people, the pain comes and goes and so they have some moments that are completely without pain; in other words the pain "comes and goes." This is called intermittent pain. Others are never pain free, but their pain types and pain severity can vary from one moment to the next. This is called variable pain. For these people the increases can be severe, so that they feel they have moments of very intense pain("breakthrough" pain), but at other times they can feel lower levels of pain ("background" pain). Still, they are never pain free. Other people have pain that really does not change that much from one moment to another. This is called stable pain.

Which of these best describes the time pattern of your pain?

I have intermittent pain
I have variable pain
I have stable pain

< Back to Keto Feasibility Study Home Page