Instrument template · PainUpdated September 28, 2026

Numeric pain rating scale template, 0 to 10

Eleven numbered boxes and two anchors. The NRS is the most common pain intensity measure in clinical trials because everyone understands it, including over the phone. This template runs it as a daily diary.

  • 11-point scale
  • Daily or visit-based
  • Rescue medication on the same entry

Free sandbox · No credit card · 21 CFR Part 11 aligned

Evening pain diary

Day 5 · Baseline week

Rate your average pain over the last 24 hours

0 no pain · 10 worst pain imaginable

012345678910

Rate your worst pain over the last 24 hours

012345678910
Same wording every evening

At a glance

  • An 11-point scale from 0 (no pain) to 10 (worst pain imaginable), answered by choosing a number.
  • Common cut-points: 1 to 3 mild, 4 to 6 moderate, 7 to 10 severe, though they vary by condition.
  • Trials usually ask for average and worst pain over a fixed recall period, commonly the last 24 hours, and average daily scores over a week.
  • A reduction of about 2 points or 30% is commonly cited as clinically important in chronic pain; 50% as substantial.
  • Easier for many participants than a visual analogue scale, and it works when read aloud. It is a generic format, free to use.

Use in trials

Why pain trials default to the NRS

The numeric rating scale wins on practicality. Participants understand it without training, it works on paper, phones and telephone interviews, and it produces a number that needs no measuring. Consensus recommendations for chronic pain trials list the 0 to 10 NRS as a core measure of pain intensity, and regulators are familiar with it as a primary endpoint.

What makes NRS data good or bad is everything around the number: the exact wording, the recall period, when it is collected, and whether daily entries are complete. Fix the wording ("average pain over the last 24 hours"), collect it at the same time each day, and track compliance so weekly averages rest on enough days.

Average, worst and current pain

Average pain over 24 hours is the most common primary measure in chronic pain. Worst pain is often a secondary measure and is sensitive in conditions with flares. Current pain ("right now") suits acute pain studies with frequent assessments after a procedure. Do not mix them in one analysis.

Weekly average NRS · Subject 008-0031

Week 6 average

4 / 10

Moderate
0-0 None1-3 Mild4-6 Moderate7-10 Severe
Baseline week6.6
Week 35.1
Week 64.0

In Capture

A daily diary with a proper completion window

The NRS runs as a recurring diary in the participant's phone browser with an evening completion window, so entries describe the day they refer to rather than being filled in later. Reminders go out when due, the next day and before the window closes, and compliance is visible on the dashboard.

  • Recurring daily schedule with a completion window.
  • Rescue medication question on the same entry.
  • At-risk participants highlighted.
EDC for chronic pain trials
ePRO compliance by site
Site 0194%
Site 0281%
Site 0358%

At-risk participants

03-0073 diary entries missedReminder delivered
03-011Week 4 questionnaire overdueEmail bounced

Try a pain diary on your phone

Build an NRS diary in the sandbox and complete tonight's entry.

Use the NRS template free

Administration

Visits, phone calls and children

The NRS works in almost any mode: on paper, on a phone, or read aloud during a telephone follow-up. Keep the mode consistent within a study, because a number chosen on a screen and a number spoken to a nurse are not always the same. Where site staff record a participant's verbal rating on a visit form, record that it was verbal.

For young children, numeric scales are replaced by faces scales or observational scales, and for people who cannot self-report, by observer measures. Keep the adult NRS for participants who can use numbers reliably, typically from late childhood.

Interpreting change

How much change on the NRS matters?

Reduction from baselineCommonly described asTypical use
About 10 to 20%Minimally importantSensitivity analyses
About 30%, or about 2 pointsModerately importantCommon responder definition in chronic pain trials
50% or moreSubstantialStringent responder definition

Benchmarks come from consensus recommendations for chronic pain trials (IMMPACT). Pre-specify the responder definition in the analysis plan, and consider baseline severity.

Before go-live

NRS setup checklist

Wording fixed

Average, worst or current pain, with the recall period.

Anchors fixed

Same end labels everywhere.

Mode consistent

Diary, visit form or phone, not mixed.

Daily window

Same time each day with reminders.

Rescue medication

Captured on the same entry.

Responder thresholds

Pre-specified in the analysis plan.

FAQ

Questions about this template

Something not covered here? Ask us directly.

Is the NRS 0 to 10 or 0 to 100?

The 11-point 0 to 10 version is by far the most common in trials. Use the same version throughout a study.

Can the NRS be collected by phone?

Yes. It works read aloud. Record the mode and keep it consistent within the study.

What is the numeric pain rating scale?

An 11-point scale from 0 (no pain) to 10 (worst pain imaginable) on which participants choose a number.

What NRS scores are mild, moderate and severe?

Commonly 1 to 3 mild, 4 to 6 moderate and 7 to 10 severe, though cut-points vary by condition.

NRS or VAS?

Both are accepted. The NRS is easier for many participants and works when read aloud; the VAS offers finer resolution.

What change is clinically important?

About 2 points or 30% is commonly cited for chronic pain, with 50% considered substantial.

Is the NRS free?

Yes. It is a generic format.

Pain scores you can average with confidence

Daily NRS diaries with windows and reminders. Free sandbox.

Use the NRS template free