I. Pain area (choose all that apply)
4. Flank pain (between the ribs and the hip)
5. Epigastric pain (slightly under the xiphoid process)
8. Tenderness on the spine?
II. Pain timing & conditions (choose all that apply)
1. How long ago did the pain start?
3. What happens when you press on the pain spot?
4. What happens when you apply hot or cold compress on the pain area?
1. Distending pain (a combination of swelling and pain)
2. Stabbing pain (feel like being pricked by a needle or cut by a knife)
3. Cold pain (a combined feeling of cold and pain)
5. Heavy pain (body feels heavy, and hard to raise hands or feet)
6. Soreness (uncomfortable but not obvious)
7. Extreme pain (as if wringing by a knife inside the body)
8. Empty pain (feels empty in the lower abdomen)
9. Dull pain (mild and happens from time to time)
12. Pulling pain (the pain spot feels like pulled by another part of body)