Brief Pain Inventory :: Midlands Partnership University NHS Foundation Trust

The Brief Pain Inventory (BPI) is a self-administered assessment tool used in pain management. The basic aim of the BPI is to record information on the intensity of pain, along with the degree to which the pain interferes with the everyday functioning of life.

The BPI is copyright (1991) Charles S. Cleeland, PhD, Pain Research Group.

Please enter your name Required

Please enter your date of birth Required

Throughout most of our lives we have had pain from time to time (such as minor headache, sprains, toothache). Have you had pain, other than these everyday kinds of pain during the last week? Required

Yes

Please rate your pain by selecting the number that best describes your pain at its worst in the last 24 hours. 0 is no pain at all. 10 is the worst pain you can imagine. Required

Please rate your pain by selecting the number that best describes your pain at its least in the last 24 hours. 0 is no pain at all. 10 is the worst pain you can imagine. Required

Please rate your pain by selecting the number that best describes your pain on the average. 0 is no pain at all. 10 is the worst pain you can imagine. Required

Please rate your pain by selecting the number that best describes your pain right now. 0 is no pain at all. 10 is the worst pain you can imagine. Required

What treatments or medications are you receiving for your pain?

In the past week, how much relief have pain treatments or medications provided? Please select the number that most shows how much relief you have received? 0 is no relief. 10 is complete relief. Required

Please select the number that describes how, during the past week, pain has interfered with your:

General activity. 0 means it does not interfere, 10 means completely interferes. Required

Mood. 0 means it does not interfere, 10 means completely interferes. Required

Walking ability. 0 means it does not interfere, 10 means completely interferes. Required

Normal work (including outside the home and housework). 0 means it does not interfere, 10 means completely interferes. Required

Relationships with other people. 0 means it does not interfere, 10 means completely interferes. Required

Sleep. 0 means it does not interfere, 10 means completely interferes. Required

Enjoyment of life. 0 means it does not interfere, 10 means completely interferes. Required

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