Pain Relief Assessment Guide

Start the Assessment

Please rate how often each statement feels true for you.
(1 = Never 2 = Rarely 3 = Sometimes 4 = Often 5 = Always)

01. My scan or MRI shows some disc bulge, herniation, or nerve compression, yet my pain feels far more intense than expected. *

1

2

3

4

5

02. My pain changes in intensity depending on my stress, mood, or rest level. *

1

2

3

4

5

03. My pain sometimes moves or shifts to a different part of my body. *

1

2

3

4

5

04. When I’m distracted, relaxed, or on vacation, the pain reduces. *

1

2

3

4

5

05. Physical treatments (physio, exercise, massage) help briefly, but the pain returns. *

1

2

3

4

5

06. My doctor says my spine looks fine or should have healed by now, yet the pain persists. *

1

2

3

4

5

07. I tend to overthink, worry, or analyze situations a lot. *

1

2

3

4

5

08. I set high expectations for myself and push through even when exhausted. *

1

2

3

4

5

09. I find it hard to express anger, frustration, or sadness openly. *

1

2

3

4

5

10. I often feel tense, braced, or tight even when resting. *

1

2

3

4

5

11. My pain began during or after a period of stress or emotional strain. *

1

2

3

4

5

12. I avoid certain movements because of fear, even when doctors said they’re safe. *

1

2

3

4

5

13. I monitor my pain constantly or check how bad it is many times a day. *

1

2

3

4

5

14. Even after multiple treatments, scans, or medicines, I’ve not found lasting relief. *

1

2

3

4

5

15. Deep down, I feel my pain has something to do with stress, emotions, or how my brain is wired. *

1

2

3

4

5

16. When I feel calm and safe, my pain tends to ease or fade away. *

1

2

3

4

5

17. I’ve noticed other symptoms (fatigue, digestive issues, anxiety, sleep problems) along with my pain. *

1

2

3

4

5

18. I’ve had previous unexplained issues (acidity, headaches, dizziness) that improved on their own. *

1

2

3

4

5