Graded Chronic Pain Scale (GCPS)

1. How would you rate your facial pain on a 0 to 10 scale at the present time, that is right now, where 0 is no pain and 10 is pain as bad as could be? No pain 0 1 2 3 4 5 6 7 8 9 Pain as bad as could be 10

2. In the past six months, how intense was your worst pain, rated on a 0 to 10 scale where 0 is no pain and 10 is pain as bad as could be? No pain 0 1 2 3 4 5 6 7 8 9 Pain as bad as could be 10

3. In the past six months, on the average, how intense was your pain rated on a 0-10 scale where 0 is no pain and 10 is pain as bad as could be? (That is you usual pain at times you were experiencing pain).) No pain 0 1 2 3 4 5 6 7 8 9 Pain as bad as could be 10

4. In the past six months, how much has facial pain interfered with your daily activities rated on a 0 to 10 scale where 0 is no interference and 10 is unable to carry on any activities? No interference 0 1 2 3 4 5 6 7 8 Unable to carry on any activities 9 10

5. In the past six months, how much has facial pain changed your ability to take part in recreational, social and family activities where 0 is no change and 10 is extreme change? No change 0 1 2 3 4 5 6 7 8 9 Extreme change 10

6. In the past six months, how much has facial pain changed your ability to work (including housework) where 0 is no change and 10 is extreme change? No change 0 1 2 3 4 5 6 7 8 9 Extreme change 10

7. About how many days in the last six months have you been kept from your usual activities (work, school or housework) because of facial pain? _____________ Days

Scoring Criteria for Grading Chronic Pain Severity

Characteristic Pain Intensity is a 0 to 100 score derived from Questions 1 through 3: Mean (Pain Right Now, Worst Pain, Average Pain) X 10 Disability Score is 0 to 100 score derived from Questions 4 through 6: Mean (Daily Activities, Social Activities, Work Activities) X 10 Disability Points: Add the indicated points for Disability Days (Question 7) and for Disability Score. Disability Points Disability Days (0-180 Days) 0-6 Days 7-14 Days 15-30 Days 31+ Days 0 Points 1 Point 2 Points 3 Points Disability Score (0-100) 0-29 30-49 50-69 70+ 0 Points 1 Point 2 Points 3 Points

Classification
Grade 0 Grade 1 Low Intensity Low Disability Grade II High Intensity Low Disability Grade III High Disability Moderately Limiting Grade IV High Disability Severely Limiting No TMD pain in prior 6 months

Characteristic Pain Intensity< 50 < 3 Disability Point

Characteristic Pain Intensity > 50 < 3 Disability Points

3 to 4 Disability Points (Regardless of Characteristic Pain Intensity) 5 to 6 Disability Points (Regardless of Characteristic Pain Intensity)

Von Korff M, Ormel J, Keefe FJ et al. Grading the severity of chronic pain. Pain 1992; 50:133-149.