Pain Management Tools

These practice tools are available to help healthcare professionals diagnose and treat pain more effectively in their patients.

Pain Management Tools

View Page Table of Contents

General Safety Information on Opioid Analgesics

Assessment Forms

  • Documentation is essential for supporting the patient evaluation, the overall pain management plan, any consultations received, and periodic review of the status of the patient. The essential tools for evaluating the use of controlled substances for pain management include an evaluation of the patient, a treatment plan, an informed consent and treatment agreement, a periodic review, consultation and medical records.
  • Patient History

    Patient History

    24k PDF file

    A two-page form covering a general health overview, including surgical history (related to and unrelated to pain), current medications and allergies, as well as substance use.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Initial Pain Assessment

    Initial Pain Assessment

    41k PDF file

    This short yet comprehensive form provides step-by-step guidelines for assessing the type and intensity of the pain, the patient's psychosocial health, instructions on performing a physical and neurologic examination, and a diagnostic evaluation.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Initial Pain Assessment Tool

    Initial Pain Assessment Tool

    140k PDF file

    This important tool helps healthcare professionals assess pain level and develop an understanding of its cause, intensity, and contributing factors. It includes multiple full-body diagrams to highlight the areas of the body where a patient experiences pain.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Checklist for Long-term Opioid Therapy

    Checklist for Long-term Opioid Therapy

    667k PDF file

    This one-page form is indispensable for healthcare professionals monitoring the effects of opioid therapy on a patient. The healthcare professional can record the date and outcome for a variety of parameters, including complete physical examination, risks and benefits communicated, monitoring compliance, and more.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

Pain Assessment Scales

  • Pain assessment scales are useful for eliciting responses from patients about their comfort or discomfort, for enhancing clarity in communications, and for supporting an individualized pain management program. Here, a choice of scales is presented for your use in talking with your patients.
  • Patient Comfort Assessment

    Patient Comfort Assessment

    103k PDF file

    Included here is a downloadable assessment form that doctors often use to help create a more complete picture of a patient's pain, including questions regarding the effectiveness of pain medications they've taken, side effects of these medications, and the effect pain has had on their mood, general activity, and other parts of their life. Patients might find it helpful to complete the assessment form and take it along to their next doctor's visit.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Visual Analog Scale

    Visual Analog Scale

    14k PDF file

    This easy-to-use scale allows patients to mark on a straight, continuous line where they think their pain is, starting with "no pain" and ending at "worst pain" and is effective for healthcare professionals in getting a basic, early indication of a patient's pain level.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Multiple-Language Pain Assessment Scales

    Multiple-Language Pain Assessment Scales

    292k PDF file

    An easy-to-use scale from 0 to 10 your patients can use to describe their pain, with 0 representing no pain and 10 representing terrible pain. Downloadable scales are provided in several languages, including English, Chinese, French, German, Italian, and Japanese.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Wong-Baker FACES Pain Rating Scale

    Wong-Baker FACES Pain Rating Scale

    48k PDF file

    This scale features a series of faces your patient can choose from that graphically depict his or her pain. The first face shows no pain (0) and the last face shows the most severe pain (10).

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Numeric Pain Intensity and Pain Distress Scales

    Numeric Pain Intensity and Pain Distress Scales

    25k PDF file

    Two separate but similar scales, the numeric pain intensity and pain distress scales enable your patient to gauge pain intensity and distress on a scale of 0 (no pain) to 10 (worst pain imaginable/unbearable pain).

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Brief Pain Inventory

    Brief Pain Inventory

    105k PDF file

    This short yet thorough form lets your patients rate how pain affects various aspects of daily life, such as sleep, mood, enjoyment of life, relationships, normal work, and more.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Memorial Pain Assessment Scale

    Memorial Pain Assessment Scale

    20k PDF file

    This assessment card allows your patients to rate their pain on four scales: mood, pain description, pain severity and relief.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

Drug Abuse Screening Tools

  • Behaviors that are suggestive of drug abuse exist on a continuum, and pain relief seeking behavior can be mistaken for drug-seeking behavior. The following tools will help the healthcare professional monitor patient behavior for evidence of addiction and drug abuse.
  • Screening Techniques

    Screening Techniques

    17k PDF file

    This single-page list of guidelines will help you determine the possibility of drug abuse in a patient, such as using open-ended and probing questions, observing client behavior during the interview, asking the client to mention all substances and alcohol use, confronting avoidance and discrepancies, and more.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

Aberrant Drug-Related Behaviors

  • These guidelines will help you determine if a patient's behavior is more suggestive of an addiction disorder, such as selling prescription drugs, prescription forgery, and concurrent abuse of alcohol or illicit drugs. Some examples of behaviors less suggestive of an addiction disorder include requesting specific drugs and aggressive complaining about the need for more of the drug.
  • The CAGE and CAGE-AID Questionnaires

    The CAGE and CAGE-AID Questionnaires

    43k PDF file

    These questionnaires are designed to obtain information about a patient's opinion of his or her alcohol/drug use, such as if the patient believed he or she drank too much, if they were annoyed by what others thought of their drinking, or if they had any feelings of guilt about their drinking.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • The Brief MAST

    The Brief MAST

    280k PDF file

    This questionnaire comprises 10 questions regarding a patient's behavior/habits related to alcohol consumption, in which a score of 6 or more indicates a probable diagnosis of alcoholism.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Opioid Risk Tool

    Opioid Risk Tool

    66k PDF file

    This brief assessment tool asks important questions about family/personal history of substance abuse, age, and psychological disease to help determine if a patient may be at risk for opioid abuse.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Addiction Behaviors Checklist

    Addiction Behaviors Checklist

    40k PDF file

    This checklist is designed to track behaviors and characteristics of addiction related to prescription opioid medications in chronic pain patients. Items are focused on observable behaviors noted both during and between visits. The checklist is focused on longitudinal assessment and tracking of problematic behaviors.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

Pain Treatment Forms

Pain Diaries

  • In this section, you will find tools that help patients track their pain, which can be useful when they discuss their pain with you.
  • Records for Keeping Track of Your Care

    Records for Keeping Track of Your Care

    207k PDF file

    Keeping records of a pain control plan makes it easier for others to tell if the plan is working. Records can also help prevent confusion about medicine schedules. Included in the downloadable document are a list of medicines and side-effects form, pain and relief records, and a pain assessment form. Choose the form(s) that is most appropriate for your practice.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Pain Management Log

    Pain Management Log

    13k PDF file

    This handy self-assessment log is helpful when keeping track of when your patients experience pain, how long they've had it, the medication they took to relieve the pain, the severity of pain after taking medication, and the activity they were involved in when the pain occurred.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

  • Daily Pain Diary

    Daily Pain Diary

    78k PDF file

    The Daily Pain Diary is an effective record-keeping tool that enables you to keep detailed records of when your patients experienced pain throughout the day, medications and other methods used for relieving pain, and the medication's side effects. It also includes a body diagram to identify where they experienced pain, the effect of pain on their sleep, and more. The Daily Pain Diary should be taken to their next doctor's visit.

    DOWNLOAD >
    Get Adobe® PDF Reader®

    Rate this tool:

    User Rating

    Your Rating

Clinical Follow-Up

Healthcare
Professional
Communication Guide

This Hands On Approach for Pain Management Communication Guide offers healthcare professionals 'road maps'  for establishing and maintaining productive, two-way exchanges.

DOWNLOAD >

close  x