Pain Assessment Resources for Professionals

General Pain Attributes

These measures assess attributes associated with a person’s pain, such as pain intensity, interference, and quality, regardless of the specific pain condition.

Condition-Specific Pain Attributes

These measures assess attributes associated with specific pain conditions, such as arthritis, fibromyalgia, and sickle cell disease.

Quality of Life

Quality of life measures assess the degree to which an individual is healthy, comfortable, and able to participate in or enjoy life events.

Physical Function and Disability

Although a person’s level of physical function and activity does not reflect their level of pain, pain can impact physical function, and physical activity can impact pain. These measures, either through self-report or observer rating, assess the degree to which individuals can perform certain activities requiring physical actions.

Mental Health Status

Pain can negatively impact mental health and unmanaged mental health symptoms can exacerbate pain. Mental health assessment during a pain care visit might unintentionally invalidate a person’s pain experience if not done with care. A provider’s empathy and humility can help create a trustworthy space for a person to discuss their mental health concerns. The measures below assess mental health symptoms and their severity.

Sleep and Fatigue

Pain can interfere with sleep, and poor sleep can exacerbate pain. The measures below assess aspects of fatigue (experience of extreme tiredness), sleepiness (difficulty staying awake/alert), and sleep (quality of sleep or presence/severity of insomnia symptoms).

Cognitive and Affective Pain and Treatment Factors

Assessing cognitive and affective factors related to pain and treatment can help identify a person’s beliefs, expectations, and concerns related to pain and treatment that might influence treatment responses. Further, it can help identify areas of coping and resilience to leverage a person’s strengths in treatment.

Social Contributors to Health

The burden of pain is inequitably distributed so that individuals from minoritized and marginalized groups tend to experience higher impact chronic pain yet poorer treatment in pain care. Understanding social contributors to pain and health can characterize additional areas for intervention, such as coping with discrimination, leveraging social supports, and addressing resource needs.

Medication and Substance Use

Chronic pain is not a unique risk factor for concerning substance use. In primary care settings, people with and without chronic pain are similarly at risk for concerning substance use. Further, studies have shown that most people with co-occurring chronic pain and substance use disorder experienced concerning substance use prior to the onset of their chronic pain. Yet, many people with chronic pain alone experience stigma based on perceived substance use disorder. It is important that clinicians use a high level of intentionality and humility in assessing substance use to avoid stigmatizing people with chronic pain.

Explanation of Collections:

PROMIS Measures

PROMIS is a set of brief questionnaires that helps evaluate and monitor an individual’s physical, mental, and social health. There are many validated PROMIS measures available, and more information about PROMIS measures can be found on the PROMIS website . PROMIS questionnaires relevant to pain and its comorbidities are available to measure pain intensity, pain interference, pain quality, pain behaviors, physical function, self-efficacy for managing symptoms or medications, anxiety, depression, fatigue, and sleep disturbance.

NIH Toolbox

The NIH Toolbox contains comprehensive 30-minute batteries to assess cognitive, emotional, sensory and motor functions. It is appropriate for use in general population, people with chronic conditions and people of all ages. Within the sensation measures battery, this toolbox assesses two pain related domains – Pain Interference and Pain Intensity. These pain measures are stand-alone measures but are included in the toolbox as part of a battery of measures meant to assess sensation.

NIDA Clinical Trials Network Common Data Elements

The National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) has a set of standardized, measures that make up their common data elements (CDEs). These measures make up a consensus-based set of CDEs that can be used for the screening and initial assessment of substance use disorders (SUDs) that can be use in research and general medical settings. These measures are used by all trials supported by the NIDA CTN. Though these CDEs are designed for SUD research they assess two pain-specific domains.

NIH HEAL® Core Common Data Elements

NIH staff, in collaboration with NIH HEAL® Initiative investigators and other pain research experts, went through a comprehensive process to identify nine core pain domains that should be assessed in HEAL studies and the questionnaires that should be used to measure each domain. Questionnaires were identified for the nine pain domains: pain intensity; pain interference; physical functioning/quality of life; sleep; pain catastrophizing; depression; anxiety; global satisfaction with treatment; and substance use. For more information, visit the NIH HEAL Initiative common data elements web page . Beyond the core CDEs, the NIH HEAL Initiative investigators are using hundreds of other questionnaires in their studies and these make up the HEAL CDE supplemental questionnaire collection.

Chronic Overlapping Pain Conditions Screener (COPCS)

The COPCS is an assessment tool that helps in the identification of different COPCs that may co-exist within a given individual. The COPCS site provides a video demo of the COPCS in use, a downloadable user's guide, access to a working demo version of the COPCS, and a link for obtaining a license to acquire an executable version for use with REDCap. Conditions of use may be found on the COPCS website : Students, physicians, clinical practice, and not-funded academic users may access the questionnaire and/or its available translations directly. Funded academic users, healthcare organizations, and commercial users & IT companies may have fees that apply to their project and can submit a request.

ASCQ-Me® Adult Sickle Cell Quality of Life Measurement Information System

ASCQ-Me is a set of self-report measures for use with adults with sickle cell disease that was developed through a collaboration between the National Heart, Lung, and Blood Institute (NHLBI) and the American Institutes for Research (AIR). Measures assess physical, mental, and social health as well as information about the severity of one’s disease. Information related to the development of this measure can be found;

• Adult sickle cell quality-of-life measurement information system (ASCQ-Me): conceptual model based on review of the literature and formative research
• Patient reports of health outcome for adults living with sickle cell disease: development and testing of the ASCQ-Me item banks