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OPQRST

OPQRST is a framework for assessing a patient's pain. It involves questions about: 1. Onset (O) - When the pain started and what prompted it. 2. Provocation/palliation (P) - What makes the pain better or worse, such as activity, position, medication. 3. Quality (Q) - How the patient describes the pain, such as throbbing, dull, or sharp. 4. Region/radiation (R) - Where the pain is located and if it radiates to other areas. 5. Severity (S) - The intensity of pain on a scale of 0-10. 6. Timing (

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Harsah Bahtiar
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2K views2 pages

OPQRST

OPQRST is a framework for assessing a patient's pain. It involves questions about: 1. Onset (O) - When the pain started and what prompted it. 2. Provocation/palliation (P) - What makes the pain better or worse, such as activity, position, medication. 3. Quality (Q) - How the patient describes the pain, such as throbbing, dull, or sharp. 4. Region/radiation (R) - Where the pain is located and if it radiates to other areas. 5. Severity (S) - The intensity of pain on a scale of 0-10. 6. Timing (

Uploaded by

Harsah Bahtiar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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OPQRST

O Onset of  • What was the patient doing when it started? Were they active, inactive, and or stressed?
event • Did that specific activity prompt or start the onset of pain?  
• Was onset of pain sudden, gradual or part of an ongoing chronic problem
P Provocation  • Is the pain better or worse with:
and  • Activity. Does walking, standing, lifting, twisting, reading, etc… have any effect of the pain?
palliation of  • Position. Which position causes or relieves pain? Provide examples to the patient‐‐ sitting, 
symptoms   standing, supine, lateral, etc… 
• Adjuvant. Which type of medication relieves the pain (Tylenol, Ibuprofen, etc.. )? Does the use of 
heat or ice packs alleviate pain? What type of alternative therapy (massage, acupuncture) have 
you used before?
• Does any movement, pressure (such as palpation) or other external factor make the problem 
better or worse? This can also include whether the symptoms relieve with rest.
Q Quality   • Ask the patient to describe the quality of pain – is it throbbing, dull, aching, burning, sharp, 
crushing, shooting, etc…?
• Questions can be open ended "Can you describe it for me?" or leading
• Ideally, this will elicit descriptions of the patient's pain: whether it is sharp, dull, crushing, 
burning, tearing, or some other feeling, along with the pattern, such as intermittent, 
constant, or throbbing.  1
OPQRST
R Region and  • Where pain is on the body and whether it radiates (extends) or moves to any other area? Referred 
radiation pain can provide clues to underlying medical causes.
• Location: body diagrams may help patients illustrate the distribution of their pain. 
• Dermatome map – may help determine the relationship between sensory location of pain and spinal 
nerve segment (see figure next slide).
• Referred vs Localized: referred pain (also known as reflective pain) is feeling pain in a location other 
than the original site of the painful stimulus. Localized pain is when pain typically stays in one location 
and does not spread.
S Severity • Ask the patient to describe the intensity of pain at baseline and during acute exacerbations. 
• The pain score (usually on a scale of 0 to 10) where 0 is no pain and 10 is the worst possible pain. This 
can be comparative (such as "... compared to the worst pain you have ever experienced") or 
imaginative ("... compared to having your arm ripped off by a bear"). If the pain is compared to a prior 
event, the nature of that event may be a follow‐up question. 
T Timing • Identify when the pain started, under what circumstances, duration, onset (sudden/gradual), 
frequency, whether acute/chronic. 
• How long the condition has been going on and how it has changed since onset (better, worse, 
different symptoms)?
• Whether it has ever happened before, and how it may have changed since onset, and when the pain 
stopped if it is no longer currently being felt?
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