CRPS Screening pain Self-Check CRPS Screening clinically supported pain self-check module. Step 1 of 4 25% Is your pain associated with an injury from any of the following?* skin (e.g. burn) muscle injury bone injury or break joint sprain nerve damage or injury surgery stroke none of the above What is the average level of your pain over the past 24 hours?*012345678910What is the average level of your pain over the past week?*012345678910What is the average level of your pain over the past 4 weeks?*012345678910 Is your pain out of proportion to the initial injury? (ie more severe than makes sense for the severity of the injury)*YesNoHave you been given pain Medications for your CRPS*YesNo Are you currently experiencing any of the following OR have you experienced any of the following?* ‘Burning’ pain Temperature asymmetry (one warm side/one cold) Color changes (red/blue/white) Sweating changes (more sweaty or dry) Swelling or feeling of swelling Nails brittle or flaking Hair (thicker or darker on the skin compared with the other side) Skin (dry, discoloured) Weakness Shaking Joint stiffness Difficulty coordinating your movements Reduced movements Things that used to hurt now hurt more (eg hitting myself on something) Things that didn’t hurt before, now hurt (eg touch, movement, pressure) None of the above This iframe contains the logic required to handle AJAX powered Gravity Forms.
