Where it hurts, when it started and what changes it.
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Pain Relief Institute of AmericaDescription of Pain
Where is your pain?
Check every area that hurts, and circle the main one on the line below.
When did it start?
What does it feel like?
How often?
What makes it worse or better?
What have you tried?
Other symptoms
Weakness in an arm or leg?
Loss of bladder or bowel control?
Fever, chills or unexplained weight loss?
If you have sudden weakness, loss of bladder or bowel control, or severe new pain, call 911 or go to the nearest emergency room instead of waiting for your visit.
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