PQRST is a mnemonic for structuring a pain history: provocation and palliation, quality, region and radiation, severity, and timing. It exists because pain assessed by open question alone tends to capture severity and little else, and severity on its own rarely tells you what is causing the pain.
The tool below walks through each letter with the questions that belong to it, and assembles your answers into a structured note. The point is not the mnemonic — it is that the same five dimensions get captured every time, so today's assessment can be compared with the last one.
Zdrovia — https://www.zdrovia.ca/resources/pqrst-pain-assessment/
Assessment Framework
PQRST Pain Assessment Builder
Work through each letter and assemble a structured pain note you can paste into a chart.
What makes it worse?
What relieves it?
Neuropathic descriptors
Nociceptive descriptors
Record the patient's own words where they differ from these.
Severity
Range 2–8 over the assessed period. A wide range is itself a finding — it suggests the pain is strongly triggered rather than steady.
Assessment note
P — Provocation/palliation: no aggravating factors identified; no relieving factors identified. Q — Quality: not described. R — Region/radiation: low back; no radiation. S — Severity (NRS 0–10): current 5, best 2, worst 8. T — Timing: gradual onset, present 1–4 weeks, intermittent.
These results are estimates based on published clinical data and are for informational purposes only. They do not constitute medical advice, a diagnosis, or a treatment recommendation. Consult a licensed aesthetic practitioner before beginning any treatment. Individual results vary.
Zdrovia's smart blocks turn PQRST into structured note fields, so pain assessments read the same way across everyone on the team. See how smart blocks work →
Chart a full PQRST in one block
Zdrovia's smart blocks turn PQRST into structured note fields, so pain assessments read the same way across everyone on the team.
What each letter asks
P — provocation and palliation: what brings it on, what makes it worse, and what relieves it. Movement-related aggravation points somewhere quite different from pain that is worst at rest or at night.
Q — quality: the patient's own description. Burning, shooting, and electric descriptors suggest neuropathic pain; aching, throbbing, and gnawing suggest nociceptive. Record the words they use rather than translating them into your own.
R — region and radiation: where it is, and where it travels. Radiation along a dermatome or a peripheral nerve territory is one of the more useful discriminators available at the bedside.
S — severity: a numeric rating from 0 to 10 is the usual approach, and it is worth capturing current, best, and worst over a defined period rather than a single number. Someone whose pain ranges from 2 to 9 is having a different experience than someone steady at 5.
T — timing: when it started, whether it is constant or intermittent, how long episodes last, and whether it follows a pattern through the day. Onset in particular is often the most diagnostically loaded answer in the whole assessment.
PQRST, OPQRST, and SOCRATES
OPQRST adds a separate letter for onset at the front, splitting it out from timing. SOCRATES — site, onset, character, radiation, associated symptoms, time course, exacerbating and relieving factors, severity — covers the same ground with an explicit slot for associated symptoms.
The frameworks are interchangeable in practice and the choice between them matters far less than using one consistently. What produces comparable assessments over time is asking the same questions in the same order, not which mnemonic you learned.
Why severity alone is not enough
A number out of ten is easy to record and easy to trend, which is why it often becomes the only thing captured. But it is also the dimension most affected by mood, expectation, fatigue, and what the patient thinks the number will be used for — and it says nothing about mechanism.
Two patients reporting 7 out of 10 with entirely different quality, radiation, and timing have different problems and need different management. Capturing the other four dimensions is what turns a pain score into a pain assessment.