1. Use the scale to rate how much pain you feel in both the left and right side of your body.

Put a number from 0 to 10 in each box on the chart below:

Pain Area Left Side Right Side
Neck    
Shoulder    
Chest    
Elbow    
Hand/Wrist    
Hip/Thigh    
Knee    
Lower leg    
Ankle/Foot    
Other area    
Total    
  1. Add the numbers. If the total of the left side and the right side is more than 20, you should get help. Tell your doctor about your pain.