The Brief Pain Inventory asks how bad pain is and how much it gets in the way of daily life. The short form rates worst, least, average, and current pain, and interference with seven activities, each from 0 to 10, with a body map and how much treatment helps. See how to score severity and interference, what the numbers mean, how much change matters, and record the result with the free template.
BPI result template
FreeBRIEF PAIN INVENTORY RESULT Date: [Date] Patient: [Name or ID, age] Pain problem: [Diagnosis and main pain site] Form: [Short form or long form, licensed copy; language] How completed: [Self-completed on paper or tablet, or read aloud in an interview; interpreter if used] SEVERITY, EACH 0 TO 10 Worst, last 24 hours: [Rating] Least, last 24 hours: [Rating] Average: [Rating] Right now: [Rating] Mean severity: [Mean of the four, one decimal] Worst pain band: [No pain, mild, moderate, or severe] INTERFERENCE, EACH 0 TO 10 General activity: [Rating] Mood: [Rating] Walking ability: [Rating] Work, in or outside the home: [Rating] Relations with other people: [Rating] Sleep: [Rating] Enjoyment of life: [Rating] Mean interference: [Mean of the items answered, one decimal; needs 4 of 7] BODY MAP AND TREATMENT Areas shaded: [Sites, and where it hurts most] Treatments now: [Medicines with doses and how often taken, and non-drug treatment] Relief from treatment: [Percent, 0 to 100, over the last 24 hours] CHANGE SINCE LAST BPI Earlier results: [Date, worst pain, mean severity, mean interference] Change: [Points and percent for each] Meaningful: [Yes or no, and the threshold used] ASSESSMENT Function now: [What the patient can and cannot do, in their words] Impression: [Cause of the pain, and what the scores add] PLAN Pain treatment: [Continue, adjust, start, or stop, with doses] Activity and work: [Goals, pacing, and any limits] Repeat BPI: [Date or interval] Clinician: [Name, credentials]
Use it for
The patient completes the licensed form on paper or a tablet, or answers it aloud in an interview. The short form takes about 5 minutes and asks mostly about the last 24 hours.
Avoid: Making your own version or changing the recall period. The form may not be altered, and a changed form no longer matches the published data.
There is no single total: score severity and interference separately, each from 0 to 10.
Avoid: Adding severity and interference into one number. They measure different things and move at different speeds.
Worst pain gives the severity band; the interference ratings show which parts of life pain is taking over.
Avoid: Escalating opioids on the severity score alone. Look at function, relief, and side effects first.
The patient shades where it hurts and marks the worst spot, then gives the relief treatment has brought as a percentage.
Repeat the BPI at set points, such as before and after a treatment, and compare each score with its own baseline.
Avoid: Calling a fall in pain a response when the analgesic dose went up to get it.
Each one follows the recording template. Use them to judge how much to write.
Radiation oncology follow-up clinic, short form completed on paper in the waiting room
Worst 3, least 0, average 2, now 1. Mean severity 1.5. Worst pain band: mild.
General activity 2, mood 1, walking 3, work 2, relations with others 0, sleep 1, enjoyment of life 1. Mean interference 1.4, all seven answered.
Shading over the right buttock and back of the hip, worst at the right sacroiliac joint, the treated site. Oxycodone 5 mg as needed, now about once a day, down from four times; acetaminophen 1 g three times a day. Relief from treatment 80%, up from 40%.
October 6, before radiation: worst 8, severe; mean severity 5.8; mean interference 6.4. Worst pain down 5 points. Mean interference down 5.0, a 78% fall. Daily opioid use down by three quarters.
59-year-old woman with metastatic breast cancer and a painful right iliac metastasis, treated with a single 8 Gy fraction on October 9. A pain flare in the first 3 days settled. She walks to the mailbox and back without her cane and sleeps through most nights. No new pain sites, leg weakness, or numbness. Partial response by the bone metastasis consensus rules: worst pain down 2 points or more with less analgesic. Not complete, as worst pain is above 0.
Oxycodone as needed only, and stop it once unused for a week. Continue acetaminophen. Repeat the BPI at 2 and 3 months after radiation, sooner with new or returning pain; re-treating this site is an option if the pain comes back.
Interdisciplinary pain program, week 6 discharge review, short form done on the program tablet
Worst 7, least 3, average 5, now 4. Mean severity 4.8. Worst pain band: severe.
General activity 3, mood 3, walking 2, work 4, relations with others 2, sleep 4, enjoyment of life 3. Mean interference 3.0.
Shading across the lower back, worst just left of the midline, nothing below the knees. Naproxen 500 mg twice a day on bad days, about two days a week. Daily graded exercise and a pacing plan. Relief from treatment 30%.
Intake in week 1: worst 8, mean severity 6.0, mean interference 6.7. Mean severity down 1.2, 20%: short of the 2-point or 30% mark. Mean interference down 3.7, 55%: well past the 1 to 2 points that count as real change.
47-year-old dental hygienist with nonspecific low back pain for 2 years, off work for 5 months. Six weeks of daily physical therapy, cognitive behavioral therapy for pain, and occupational therapy. She now sits for 40 minutes, walks for 30, lifts a 10 kg box from waist height, and sleeps about 6 hours. Pain intensity has barely moved, but function has: the gain the program aims for. The severe worst-pain rating is no reason to add opioids.
Discharge to the home program: exercise 5 days a week and the written flare-up plan. Graded return to work: 4-hour shifts with patients spaced out for 2 weeks, then 6 hours, then full days by week 6. No new medicines. Repeat the BPI at the 3-month follow-up; goal: mean interference held at 3 or below, back at full hours.
There is no BPI total. A combined number hides which score moved, and the two often move at different speeds.
Mild, moderate, and severe were set for worst pain. If you apply them to the interference mean, say so, and rely on change over time instead.
A patient can report the same worst pain while walking, working, and sleeping far better. Without the interference ratings, that gain never reaches the chart.
Less pain on twice the opioid dose is not the same as less pain on half. Record medicines and doses next to every BPI.
Rewording items or changing 24 hours to a week breaks the link to the published data, and the BPI may not be altered. Use the licensed copy.
Vero Scribe records the BPI result in your template from the visit, with the patient’s consent, or from your dictation: the four severity ratings, the seven interference ratings, both means, relief from treatment, and the plan. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
The BPI is a pain questionnaire developed by Charles Cleeland, first for cancer pain and now used for chronic and acute pain of all kinds, from arthritis and low back pain to pain after surgery. It measures two things: how bad the pain is, and how much it interferes with daily life. IMMPACT recommends its interference ratings as a measure of physical function in chronic pain trials.
There is no total. Severity is the worst pain rating on its own, or the mean of the four severity ratings: worst, least, average, and now. Interference is the mean of the seven interference ratings, scored when at least four are answered. Each runs from 0 to 10. The body map and the relief percentage are recorded, not scored.
For worst pain, the most cited bands are 1 to 4 mild, 5 to 6 moderate, and 7 to 10 severe, from a 1995 study of cancer pain; other studies draw the lines a little differently. Interference has no agreed bands: higher means pain gets in the way of more of daily life, and the change from the patient’s own baseline is what matters most.
For pain severity, a fall of about 2 points or 30% is the usual mark of a clinically important improvement. For the interference mean, 1 point is IMMPACT’s provisional minimum, and some studies put it nearer 2. After radiation for bone metastases, a 2-point fall in worst pain without more analgesic counts as a partial response.
The short form covers severity, interference, a body map, treatments, and relief, and takes about 5 minutes; it’s the version used in most trials and translations, and the one MD Anderson recommends for its brevity and ease of use. The long form adds questions such as what the pain feels like, burning or tingling for example, and takes up to 10 minutes. There are also versions for diabetic neuropathy and for shingles.
The PEG is three questions adapted from the BPI: average pain, interference with enjoyment of life, and interference with general activity, averaged into one score. It suits a quick check at every visit. The BPI adds the other severity ratings, five more areas of interference, a body map, and relief from treatment, so it shows where pain is worst and which parts of life it affects.
Patients usually complete it themselves on paper or a screen, and any member of the care team can hand it out or read it aloud as an interview. No special training is needed; the clinician reads the scores and acts on them. It’s validated in adults with cancer and non-cancer pain.
Not automatically. The BPI is copyrighted by Charles Cleeland and licensed through MD Anderson Cancer Center: every use, including clinical practice, is ordered through MD Anderson’s online form under a license agreement, and fees depend on the use, the setting, and the sponsor. The recording template on this page is free to copy or download.
Patient-reported measures of symptoms and function, scored as T-scores with 50 as the average: short forms, CATs, and the PROMIS-29.
Six basic self-care activities rated independent or dependent, scored 0 to 6, for function and care needs in older adults.
Eight independent living tasks, from shopping to finances, each scored 0 or 1: a total from 0, dependent, to 8, independent.
Eleven questions on arm, shoulder, and hand function over the past week, scored 0 to 100: the higher, the more disability.
Twenty everyday activities rated for difficulty: lower limb function scored 0 to 80, higher is better, and 9 points is a real change.
Goals, targets, and a flare-up plan for long-term conditions, chronic pain included.
Visit notes, care documents, and follow-up in one clinical workspace.
Notes from complex conversations, clear care plans, and follow-up.
Every tool, by area, with what its scores mean.
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