The PEG asks three questions about the past week: average pain, and how much pain has got in the way of enjoying life and of general activity. Each is rated 0 to 10, and the mean of the three, from 0 to 10, tracks chronic pain treatment over time. See how to score it, what a score and a change in score mean, and record the result with the free template. The official wording is in the 2009 paper.
PEG result template
FreePEG PAIN SCALE RESULT Date: [Date] Patient: [Name or ID, age] Pain condition: [Main pain diagnosis, site, and how long it has lasted] Reason for PEG: [Baseline, routine review, opioid therapy review, dose change, or program check-in] How given: [Paper, patient portal, clinic tablet, or asked aloud; interpreter if used] PEG SCORE Average pain, past week: [0 to 10] Interference with enjoyment of life: [0 to 10] Interference with general activity: [0 to 10] Mean of the three: [Sum divided by 3, to one decimal place] Descriptive level: [None to mild, moderate, or severe] COMPARED WITH BASELINE Baseline PEG: [Date and score, and what treatment started then] Previous PEG: [Date and score] Change from baseline: [Points and percent; a fall of 30% or more counts as meaningful] FUNCTION GOALS Goals agreed: [One to three activities the patient wants back, each with a target] Progress: [Met, partly met, or not met for each goal, in the patient's words] TREATMENT AND PLAN Current pain treatment: [Medicines with doses, physical therapy, exercise, self-management] Safety review: [For opioid therapy: dose, side effects, monitoring checks, naloxone] Decision: [Continue, adjust, taper, add or stop a treatment, or refer] Next PEG: [Date or interval] Clinician: [Name, credentials]
Use it for
The patient answers three questions about the past week, on paper, on a tablet or portal, or aloud. It takes under a minute.
Avoid: Asking “How is your pain today?” and recording the answer as the first item. The PEG asks about average pain over the past week.
Add the three ratings and divide by 3, for a score from 0 to 10.
Avoid: Reporting the sum, from 0 to 30, as the score. A sum of 18 is a PEG of 6.0, and a chart that mixes the two makes the trend meaningless.
Higher means worse. There are no official cutoffs, so read it against the patient’s own baseline and goals.
Avoid: Treating the descriptive level as a decision. A 6.0 that was 8.7 at baseline is a success; a 6.0 that was 6.3 isn’t.
Take a baseline before a new treatment starts, then repeat the PEG at every review of that treatment.
The PEG gives a number for the benefit side of the review, to weigh against side effects and risks.
Avoid: Judging benefit on the pain rating alone. If pain is lower but enjoyment and activity haven’t moved, the treatment hasn’t met its goal.
Each one follows the recording template. Use them to judge how much to write.
Family practice, scheduled review 3 months after starting a buprenorphine patch
61-year-old man with osteoarthritis of both knees, worse on the right, for 6 years. Asked aloud at the visit. Average pain 7, enjoyment of life 7, general activity 7. Sum 21 ÷ 3 = 7.0, severe.
Baseline 8.0 on August 4, the day the patch started: pain 8, enjoyment 7, activity 9. At the 4-week check, 6.3. Now 7.0: down 1.0 point, 12.5% from baseline, well short of the 30% mark. The early gain at 4 weeks didn’t last.
Goals set in August: walk the dog around the block, about 20 minutes, and stand at his workbench for an hour. Now he walks 10 minutes with two stops, and manages 20 minutes at the bench. Neither met. In his words: “It takes the edge off, but I’m not doing any more than before.”
Buprenorphine patch 10 micrograms an hour, changed weekly, with acetaminophen 1 g three times a day and diclofenac gel. Oral anti-inflammatories stopped in the spring for kidney function, eGFR 48. Safety review: constipation, eased with senna; no drowsiness; prescription monitoring check matches; naloxone at home. Decision: no meaningful benefit in pain or function at 3 months, so we agreed to stop the patch: 5 micrograms an hour for 2 weeks, then off. Physical therapy for a knee strengthening program, and referral to orthopedics to discuss a right knee replacement. Next PEG at the 2-week taper check, then in 3 months.
Outpatient pain self-management program, intake before 8 weekly group sessions
44-year-old woman with fibromyalgia, diagnosed 3 years ago; works full time as an office manager. Completed on a clinic tablet. Average pain 5, enjoyment of life 6, general activity 4. Sum 15 ÷ 3 = 5.0, moderate. Enjoyment of life is her highest rating: she has dropped her choir and most weekends with friends.
Today is the baseline; her family physician has no earlier PEG on file. Target for the end of the program: 3.5 or lower, a 30% fall. A fall of 1 point, to 4.0, would be the first change worth noting.
Agreed with her: walk 20 minutes on 4 days a week, up from 5 minutes twice a week now; go back to choir on Thursday evenings; get through a workday without lying down at lunch. Progress to be checked at session 4.
Duloxetine 60 mg daily for a year; no other medicines for pain, and no opioids. PHQ-9 today 8, mild. Sleeps about 5 hours, broken. Plan: 8 weekly group sessions on pacing, graded walking, sleep, and coping skills, with a home walking log. No medicine changes during the program, so a change in the PEG reflects the program. Next PEG at sessions 4 and 8, then 3 months after the program ends.
Ratings of 6, 7 and 5 add up to 18, but the PEG is 6.0. Record the mean, so every visit is on the same 0 to 10 scale.
The first item asks about average pain over the past week. A rating of the pain in the exam room is a different number, and often a higher one.
Enjoyment of life and general activity are the function half of the PEG. A lower pain rating with no change in either isn’t a meaningful benefit.
Without a PEG before a new opioid, injection, or program, the 3-month review has nothing to compare with. Take it at the first visit.
The PEG has no official bands. A move from 8.7 to 6.0 is a 31% fall and a good result, even though both scores sit above 4.
Vero Scribe records the PEG result in your template from the visit, with the patient’s consent, or from your dictation: the three ratings, the mean, the change from baseline, the function goals, and the plan. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
Rate each of the three items from 0 to 10: average pain over the past week, interference with enjoyment of life, and interference with general activity. Add the three and divide by 3. Ratings of 6, 7 and 5 give 18 ÷ 3 = 6.0. Some forms round to the nearest whole number; whichever you use, use it every time.
Higher means worse pain and more interference with daily life. The developers set no cutoffs. This page uses a common descriptive split for 0 to 10 pain ratings: 0 to 3.9 none to mild, 4 to 6.9 moderate, and 7 to 10 severe. The patient’s own baseline matters more than the level.
A fall of 30% or more from baseline is the usual mark. The CDC’s 2022 opioid guideline defines clinically meaningful improvement as 30% in both pain and function, and chronic pain research uses 30% for a moderate, meaningful improvement. In points, a 2024 analysis of six trials put the smallest meaningful change at about 1 point, with 2 as an upper bound.
The PEG takes three items from the Brief Pain Inventory: average pain and two of its interference items, enjoyment of life and general activity. The full inventory asks about pain at several points, interference in more areas of life, where the pain is, and relief from treatment. The PEG takes under a minute; in the 2009 study it tracked the inventory’s interference scale closely, with correlations of 0.89 and 0.95 in two groups of patients. Use the inventory for detail and the PEG for quick, repeated tracking.
Take a PEG and agree on function goals before starting an opioid. Repeat it within 1 to 4 weeks of starting or raising the dose, then about every 3 months or more often. If pain and function haven’t improved by about 30%, or harms outweigh the benefit, talk through tapering, other treatments, or both.
Anyone on the team. The patient answers on paper, on a tablet or portal, or aloud to a nurse, medical assistant, therapist, or clinician, and a clinician reads the result with them. It was developed in adults with chronic back, hip, or knee pain in primary care, and checked in a second group of veterans with chronic pain.
Yes. It was published in an open-access paper in 2009, and public health agency guides reproduce it free of charge and describe it as public domain, asking users to cite the paper. Its items are adapted from the Brief Pain Inventory with Dr. Charles Cleeland’s permission. Get the official wording from the 2009 paper. 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, monitoring, and safe use, agreed before long-term opioid therapy.
Goals, treatments, and follow-up for long-term conditions, chronic pain among them.
Follow-ups, opioid reviews, and procedure notes.
Every tool, by area, with what its scores mean.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
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