Pain Assessment Tools

In order to identify how pain is assessed and interpreted currently,  I have gathered different pain assessment tools used in medical settings now. Some of these examples are from the U.K., and they do not seem to be utilized in the U.S. yet. In this way, I will be able to discover possible pain points of the LEP patients in pain communication.

McGill Pain Index


What is working?

This pain index contextualizes pain for others. Even though not everyone has experienced or will experience labor pain, by showing organizing different pain in a 0 to 50 scale, one can compare different pain and estimate the level of pain his or her pain.

What is missing?

This focuses on the magnitude or level of the pain rather than the individuality of different of pains, which means that one cannot express what kind of pain one feels.

McGill Pain Questionnaires

McGillForm  SF-MPQ2McGillPainChart

What is working?

McGill Pain Questionnaire sorted different pain descriptors and categorized and arranged them into different of hierarchies.

What is missing?

This assessment tool cannot be used if you do not speak English. It is translated into some languages.  But, I doubt the availability of these forms in different languages at the provider’s offices in the U.S. For LEP patient, these subtle differences are not easily communicative and comprehensible.

VAS Scale

What is working?

One of the most common tools used around the world. Some visual elements (smiling or frowning face), portray the pain along with the numbers.

What is missing?

Again, this only deals with the magnitude of the pain. A patient can only determine the intensity of the pain based on their past experiences. So, pain magnitude is individualistic. A provider cannot determine if one patient’s 7 and other patient’s 7 are the same.

Pain Scale


What is working?

Even though there is no smiley and frowny faces, this pain scale gives more context to the scale by having explanations and examples of pain level next to the number.

What is missing?

Again, this only deals with the magnitude of the pain, not what kind of the pain, one feels. Other than the color and numerical portion, this scale relies on language proficiency of the patient. Plus, this can be most useful when the patient and provider are language concordant.




What is working?

Pain-QuILT a Web-Based Visual Pain Assessment Tool in Adults With Chronic Pain. This method allows patients to quickly describe, log and track what kind of pain they feel, where the pain is as well as the magnitude. The best part of this method is the metaphors. Not only descriptors are visual but also easy to understand, which means that patient is not required to understand the words to comprehend the meaning.

What is missing?

This focuses on chronic pain, therefore, it does not ask the patient about other relevant pain information such as the duration, frequency, aggravators, relievers and etc.

Show Me Where


What is working?

Having something tangible and visual to communicate with the provider enhances the overall quality of the face to face communication between the patient and provider. The app version offers 12 other languages other than English. Plus, it has two different versions one for the Adult and one for Child. The visual language is simple yet factual.

What is missing?

Personally, I feel like the location of the pain is easier to communicate than the kind and description of the pain. Even when there is a language barrier, one can point and show the location of the pain. But, how and what kind of pain one feels is very difficult to explain without proper language skills.



What is working?

Used with the intensity scale, OLDCART can help identify basic factual information about the pain. The beginning, location, duration, characteristics, aggravators, and relievers, as well as the treatment type, can be distinguished.

What is missing?

Neither verbal nor written communication help LEP patients. Without knowing the English words, one cannot communicate any of information OLDCART can help identify. I wonder if there is a list of pain characteristics or descriptors they use.

PQRST Pain Assessment Method

P = Provocation/Palliation

What were you doing when the pain started? What caused it? What makes it better or worse? What seems to trigger it? Stress? Position? Certain activities?

What relieves it? Medications, massage, heat/cold, changing position, being active, resting?

What aggravates it? Movement, bending, lying down, walking, standing?

Q = Quality/Quantity

What does it feel like? Use words to describe the pain such as sharp, dull, stabbing, burning, crushing, throbbing, nauseating, shooting, twisting or stretching.

R = Region/Radiation

Where is the pain located? Does the pain radiate? Where? Does it feel like it travels/moves around? Did it start elsewhere and is now localized to one spot?

S = Severity Scale

How severe is the pain on a scale of 0 to 10, with zero being no pain and 10 being the worst pain ever? Does it interfere with activities? How bad is it at its worst? Does it force you to sit down, lie down, slow down? How long does an episode last?

T = Timing

When/at what time did the pain start? How long did it last? How often does it occur: hourly? daily? weekly? monthly? Is it sudden or gradual? What were you doing when you first experienced it? When do you usually experience it: daytime? night? early morning? Are you ever awakened by it? Does it lead to anything else? Is it accompanied by other signs and symptoms? Does it ever occur before, during or after meals? Does it occur seasonally?


What is working?

Very detailed set of questions which can gather important factual information of the pain. This method affirms that the severity of the pain is not the only thing to be determined from a patient in order to accurately diagnosis the pain.

What is missing?

This method still relies on verbal communication, which is difficult for the LEP patient. But I can make sure to incorporate some of these indicators to my project.