Pain Impact Score

Please write down your score in order for it to be compared to when you do this questionnaire again in 6-12 weeks.

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The purpose of this questionnaire is to help us understand how much pain is impacting your life.

BASED ON THE PAST 7 DAYS, please check the best response for each of the 13 statements below.

What is your Pain Impact score? Please write it down somewhere.

A reduction of of 7 or more in score is considered to be a significant improvement.

Please write down your score in order for it to be compared to when you do this questionnaire again in 6-12 weeks.

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