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Pain Meter | Lumov
Email ID?
*
1. Where is your pain located?
*
1. Where is your pain located?
A
Lower back
B
Foot & Ankle
C
Elbow & Wrist
D
Knee
2. How did the pain originate?
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2. How did the pain originate?
A
Gradual onset
B
Injury / Accident
C
Post-operation
D
Do not know
3. How would you describe the intensity of your pain?
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3. How would you describe the intensity of your pain?
0
1
2
3
4
5
6
7
8
9
10
Mild
Moderate
Unbearable
4. How does the pain impact your daily activities?
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4. How does the pain impact your daily activities?
A
Difficulty walking or standing for long periods
B
Difficulty sitting for long periods
C
Difficulty sleeping due to pain
D
Difficulty performing work-related tasks
E
Difficulty with self-care (e.g., dressing, bathing)
F
Difficulty exercising or participating in sports
5. What does your pain feel like?
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5. What does your pain feel like?
A
Dull ache
B
Sharp
C
Throbbing
D
Burning
E
Tingling
6. How long have you been experiencing this pain?
*
6. How long have you been experiencing this pain?
Less than a week
Week to month
More than 3 months
Submit
