| I have had widespread pain for at least 3 months | ||
| I have pain on the right and left sides of my body | ||
| I have very tender spots on my body, mainly around my neck, shoulders, hips and knees | ||
| I have pain above and below my waist | ||
| I have pain in my neck, back or shoulders | ||
| I have problems sleeping | ||
| I feel fatigued during the day | ||
| I wake up feeling stiff and tired | ||
| I have trouble carrying out everyday activities |
By using the scales below, you can assess your level of pain and the difficulty you experience sleeping and carrying out common daily activities.
These scales allow you to rate your level of pain, difficulty sleeping and carrying out your daily activities by circling a number from 0 to 10. Once you’ve filled out all three scales, you can show them to your doctor with the completed questionnaire.
