2. What the clinician must assess

A complete assessment addresses each of the following each visit, scaled to the patient's diagnosis and stability:

• Location(s) and radiation; the number of distinct pain sites.
• Intensity using a scale matched to the patient — a 0–10 numeric or verbal scale, the Wong-Baker FACES scale, or an observational scale (for example PAINAD) for nonverbal or advanced-dementia patients.
• Quality — sharp, dull, burning, aching, cramping, or shooting (neuropathic features).
• Onset, duration, and pattern — constant versus intermittent, and breakthrough pain.
• Aggravating and relieving factors, including position and activity.
• Functional impact — effect on ambulation, activities of daily living, sleep, appetite, and mood.
• Analgesic regimen — around-the-clock and as-needed medications: adherence, effect, and adverse effects (constipation, sedation, nausea, and respiratory-depression risk with opioids).
• Nonpharmacologic measures and their effect; the patient's pain goal.