Pain assessment · Updated October 2026
Pain scale 0 to 10: pain assessment tool
Rate pain on the Numeric Rating Scale (NRS), the most widely used pain assessment scale. Record where it hurts and what it feels like, check for warning signs, and build a simple pain chart to track pain over time.
For guidance only. This pain assessment tool does not replace advice from a doctor, nurse or pharmacist. Nothing you enter is saved or sent anywhere.
What is a pain scale?
A pain scale, or pain assessment scale, is a simple way to measure how much pain someone is in. Because pain cannot be seen or tested, it relies on what the person tells you, or what you observe when they cannot tell you. Using the same pain scale every time makes it easier to see whether pain is getting better or worse, and whether pain relief is working.
The Numeric Rating Scale (NRS) is the most common pain scale for adults. The person rates their pain from 0 (no pain) to 10 (the worst pain imaginable).
Free download
Pain assessment tool (PDF)
A printable pain assessment form to complete on paper and keep in the person’s care records.
How to use the pain assessment tool
- 1Ask for a number“On a scale of 0 to 10, where 0 is no pain and 10 is the worst pain you can imagine, how bad is your pain now?”
- 2Check movement and the last 24 hoursPain is often worse when moving. Asking about the worst pain gives a fuller picture.
- 3Describe the painRecord where it is, what it feels like, how long it has lasted and what it is affecting.
- 4Act and reassessFollow the care plan, then rate the pain again 30 to 60 minutes after pain relief and add it to the chart.
Pain scale chart: what the numbers mean
| Score | Pain level | What it usually means |
|---|---|---|
| 0 | No pain | No pain at all. |
| 1–3 | Mild pain | Noticeable and annoying, but does not get in the way of most daily activities. |
| 4–6 | Moderate pain | Interferes with concentration, sleep or daily tasks. The person may need pain relief. |
| 7–10 | Severe pain | Stops the person doing normal activities. Needs prompt attention. |
Pain is personal, so the score is whatever the person says it is. Don’t compare one person’s score with another’s. Look at how each person’s pain changes over time.
Alternative types of pain scales
The NRS works well for adults who can understand and use numbers. Other pain scales are better for children, people with dementia, and people who cannot speak or communicate easily.
| Pain scale | Best for | How it works | Score range |
|---|---|---|---|
| Numeric Rating Scale (NRS) | Adults and children over about 8 who can use numbers | The person rates pain from 0 (no pain) to 10 (worst pain imaginable) | 0–10 |
| Visual Analogue Scale (VAS) | Adults, research and clinics | The person marks a point on a 10 cm line from “no pain” to “worst pain” | 0–100 mm |
| Verbal Rating Scale (VRS) | Older adults, people who find numbers hard | The person picks a word: none, mild, moderate or severe | 4 or 5 words |
| Faces Pain Scale – Revised (FPS-R) | Children aged about 4 to 12 | The child points to one of six faces showing increasing pain | 0–10 |
| Wong-Baker FACES | Children aged 3 and over | Six cartoon faces from smiling to crying | 0–10 |
| FLACC | Babies, young children and non-verbal people | Staff score Face, Legs, Activity, Cry and Consolability | 0–10 |
| Abbey Pain Scale | People with dementia who cannot say they are in pain | Staff score vocalisation, facial expression, body language, behaviour, physical and physiological changes | 0–18 |
| PAINAD | People with advanced dementia | Staff score breathing, vocalisation, facial expression, body language and consolability | 0–10 |
| Brief Pain Inventory (BPI) | Long-term and cancer pain | Rates pain severity and how much pain interferes with daily life | 0–10 for each item |
| McGill Pain Questionnaire | Long-term pain, specialist clinics | The person chooses words that describe the quality of their pain | Word-based score |
Self-report scales
NRS, VAS, VRS and faces scales. The person rates their own pain. Always the first choice when someone can communicate.
Observational scales
FLACC, Abbey and PAINAD. Staff score signs of pain when the person cannot tell you.
Multidimensional tools
Brief Pain Inventory and McGill. Used for long-term pain to look at how pain affects daily life.
Pain assessment in dementia and non-verbal people
People living with dementia, learning disabilities or communication difficulties may not be able to say they are in pain. Watch for changes from their usual behaviour, and use an observational pain assessment scale such as the Abbey Pain Scale or PAINAD.
- Facial expressions such as frowning, grimacing or looking frightened.
- Moaning, calling out, crying or unusual quietness.
- Guarding part of the body, rocking, restlessness or refusing to move.
- Changes in sleep, appetite or mood, or new aggression or withdrawal.
- Faster breathing, sweating or a change in colour.
Family and staff who know the person well are often the first to notice. Record what you see and share it with the nurse or GP.
Using SOCRATES for a full pain assessment
A pain score tells you how bad pain is. SOCRATES helps you find out more about it.
Site and radiation
Where is the pain, and does it spread anywhere else?
Onset and time course
When did it start, was it sudden, and does it come and go?
Character
Is it aching, sharp, burning, throbbing or shooting?
Associated symptoms
Is there sickness, fever, breathlessness or dizziness too?
Exacerbating and relieving factors
What makes it worse, and what helps?
Severity
How bad is it, using a pain scale such as the NRS?
Acute pain and chronic pain
Acute pain
Short-term pain with a clear cause, such as an injury, surgery or infection. It usually improves as the body heals.
Chronic pain
Pain that lasts more than 3 months. It can affect sleep, mood and daily life, so assessment looks at function as well as the pain score.
Pain assessment best practice
- Believe the person’s report of their pain. Pain is whatever they say it is.
- Use the same pain scale each time, and record which one you used.
- Ask about pain at rest and when moving.
- Reassess after every pain relief or change in care, and record the result.
- Never ignore new, sudden or severe pain, especially after a fall.
About this pain scale tool
- Pain levels follow the commonly used NRS bands: 0 none, 1–3 mild, 4–6 moderate, 7–10 severe.
- Suggested next steps are general guidance. Always follow the person’s care plan and prescriber’s instructions.
- The pain chart keeps up to 12 readings for this visit only. It is cleared when you leave the page.
- This tool does not give medical advice or diagnose the cause of pain.
Frequently asked questions about pain scales
What is a pain scale?
A pain scale is a tool for measuring how much pain someone is in. The most common is the Numeric Rating Scale, where the person rates their pain from 0 (no pain) to 10 (the worst pain imaginable).
What is the 0 to 10 pain scale?
The 0 to 10 pain scale is the Numeric Rating Scale (NRS). A score of 0 is no pain, 1 to 3 is mild pain, 4 to 6 is moderate pain and 7 to 10 is severe pain.
What is the most common pain assessment tool?
The Numeric Rating Scale is the most widely used pain assessment tool for adults who can communicate. Other common tools include the Visual Analogue Scale, the Verbal Rating Scale and faces scales for children.
Which pain scale is used for people with dementia?
The Abbey Pain Scale and PAINAD are commonly used for people with dementia who cannot say they are in pain. Staff observe signs such as facial expression, body language and behaviour.
Which pain scale is used for children?
The Faces Pain Scale – Revised and Wong-Baker FACES are used for children aged about 3 to 12. FLACC is used for babies and young children who cannot describe their pain.
Is there a free printable pain assessment form?
Yes. You can download the free pain assessment tool (PDF) to print and complete on paper.
How often should pain be assessed?
Assess pain regularly as part of routine care, whenever the person says they are in pain or seems distressed, and 30 to 60 minutes after giving pain relief to check it has worked.
What does SOCRATES stand for in pain assessment?
SOCRATES is a way to ask about pain: Site, Onset, Character, Radiation, Associated symptoms, Time course, Exacerbating and relieving factors, and Severity.
When is pain an emergency?
Call 999 for chest pain, pain with breathlessness or collapse, a sudden severe headache, or severe pain after a serious injury. For other worrying pain, call NHS 111 or the GP.
Is my information saved?
No. Everything you enter stays in your browser and is cleared when you leave the page.