• This questionnaire has been designed to help you assess the severity of your back pain and give your health provider information as to how your back pain can affect your ability to manage everyday life. Please answer each question and select only the ONE statement that applies to you.

  • Answer these questions to find out if you are suffering from chronic pain. Section A 1. Do you feel as if you are a prisoner to your pain? yes    no 2. Do you have increasing need for pain medication with little or no relief? yes    no 3.

  • A headache tracker is an important tool in the management of headaches: it is a way of ''measuring'' your headaches, just as someone with high blood pressure would measure and record their blood pressure readings.

  • Use this form to keep a record of your pain levels and times. You can print the form and complete it at your leisure.

  • Print and complete this quiz to test your knowledge about morphine. The answers are either true or false.   True False 1. If morphine is prescribed too soon, then nothing else is left to relieve the pain at the end.     2. The use of morphine signals that the patient's prognosis for survival is hopeless and the doctors have given up.

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