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Assess My Pain

 

You may know that you have pain, but you may not know what's causing your pain. It's sometimes even hard to describe the pain you're feeling.

The Pain Assessment Checklist has been designed to help you and your doctor decide if the pain you're feeling is nerve pain.

Check Out Your Pain

Take a moment now to complete the Pain Assessment Checklist. Simply answer the questions below and share your answers with your doctor.

* Indicates required field

Please answer the following question:
1. I would describe my pain as: (Check all that apply.)
Pins and needles
Stabbing/shooting
Burning
Aching/throbbing
Numb
Sharp
2. My pain worsens: (Check all that apply.)
In the morning
In the afternoon
In the evening
While sleeping
3. I would rate my pain as: (Use scale below 0=no pain, 10=most pain)*
0 1 2 3 4 5 6 7 8 9 10
4. My pain interferes with my ability to: (Check all that apply.)
Go up or down stairs
Get in or out of a car
Get in or out of bed
Play with kids/grandkids
Perform heavy chores
Sleep
Perform daily activities such as shopping
5. I am taking or have taken medication for my pain:*
Yes
No
6. If yes, the medicine(s):
Help(s) me with my pain
Do(es) not help me with my pain
Help(s) for a time, then wears off too soon
7. I have been diagnosed with:*
Diabetes
Shingles
Neither

These steps may help your doctor better understand what you’re feeling and the kind of pain you are having.

Use This Guide to Make the Most Out of Your Next Visit

The following guide can help you discuss what you’re feeling with your doctor.

___ Why am I feeling this pain?

___ What do I need to do to help control my pain?

___ How will doing this help?

___ Is LYRICA right for me?

 

1. I would describe my pain as: (Check all that apply.)
2. My pain worsens: (Check all that apply.)
3. I would rate my pain as: (Use scale below 0=no pain, 10=most pain)
4. My pain interferes with my ability to: (Check all that apply.)
5. I am taking or have taken medication for my pain:
6. If yes, the medicine(s):
7. I have been diagnosed with:
Take Again

LYRICA is indicated to treat Diabetic Nerve Pain, Pain after Shingles, and Fibromyalgia. LYRICA is also indicated to treat Partial Onset Seizures in adults with epilepsy who take 1 or more drugs for seizures.

Important Safety Information

LYRICA is not for everyone. LYRICA may cause serious, even life threatening, allergic reactions. Stop taking LYRICA and call your doctor right away if you have any signs of a serious allergic reaction. Some signs are swelling of your face, mouth, lips, gums, tongue, throat or neck or if you have any trouble breathing, or have a rash, hives or blisters.

Drugs used to treat seizures increase the risk of suicidal thoughts or behavior. LYRICA may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Call your doctor right away if you have new or worsening depression, suicidal thoughts or actions, or unusual changes in mood or behavior. If you have suicidal thoughts or actions, do not stop LYRICA without first talking to your doctor.

LYRICA may cause swelling of your hands, legs and feet, which can be serious for people with heart problems. LYRICA may cause dizziness and sleepiness. You should not drive or work with machines until you know how LYRICA affects you. Also, tell your doctor right away about muscle pain or problems along with feeling sick and feverish, or any changes in your eyesight including blurry vision or if you have any kidney problems or get dialysis.

Some of the most common side effects of LYRICA are dizziness, blurry vision, weight gain, sleepiness, trouble concentrating, swelling of your hands and feet, dry mouth, and feeling "high". If you have diabetes, tell your doctor about any skin sores.

You may have a higher chance for swelling and hives if you are also taking angiotensin converting enzyme (ACE) inhibitors so tell your doctor if you are taking these medications. You may have a higher chance of swelling of your hands or feet or gaining weight if you are also taking certain diabetes medicines. Do not drink alcohol while on LYRICA. You may have a higher chance for dizziness and sleepiness if you take LYRICA with alcohol, narcotic pain medicines, or medicines for anxiety.

Before you start LYRICA, tell your doctor if you are planning to father a child, or if you are pregnant, plan to become pregnant, or are breast-feeding. If you have had a drug or alcohol problem, you may be more likely to misuse LYRICA.

In studies, a specific type of blood vessel tumor was seen in mice, but not in rats. The meaning of these findings in humans is not known.

Do not stop taking LYRICA without talking to your doctor. If you stop suddenly you may have headaches, nausea, diarrhea or trouble sleeping and if you have epilepsy, you may have seizures more often.

View the Medication Guide.

View the Full Prescribing Information.

Pfizer LYRICA Call Center for DPN and PHN Patients 1-866-4-LYRICA (1-866-459-7422)
Pfizer LYRICA Call Center for Fibromyalgia Patients 1-888-5-LYRICA (1-888-559-7422)
Home PageTreating Painful DPNTreating PHN
Managing Fibromyalgia
Add-On Treatment For Seizures in AdultsGlossary

This product information provided is intended only for residents of the United States.

The health information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient.

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