Advanced Physical Therapy self-checks / Pain and function check

Pain and function check

Rate your pain, how it affects you, and check for warning signs. About 2 minutes. No sign-up; your answers are not stored.

Think about the pain that bothers you most (back, neck, shoulder, knee or elsewhere).

Pain right now (0 = none, 10 = worst imaginable)

Average pain over the last week (0-10)

How much has pain interfered with enjoying life? (0-10)

How much has pain interfered with work and daily activity? (0-10)

How long have you had this pain?

Less than 6 weeks6 to 12 weeksMore than 3 months

Numbness around your private parts or buttocks, or new problems controlling your bladder or bowel?

YesNo

New weakness in your legs or arms that is getting worse?

YesNo

Fever or feeling very unwell together with the pain?

YesNo

Did the pain start after a serious fall, accident or injury?

YesNo

Unexplained weight loss, or a history of cancer?

YesNo

Chest pain, or pain spreading to your arm, jaw or back with sweating or shortness of breath?

YesNo

Source: Numeric pain rating (0-10), PEG-style interference items (Krebs et al.) and standard red-flag questions. Screening only.

This information is for general health awareness only and is not medical advice, diagnosis or treatment. Always consult a registered healthcare practitioner; in an emergency call 10177 (ambulance) or 112 from a mobile phone, or the SADAG Suicide Crisis Helpline on 0800 567 567.