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PainSolv User Clinical Research Questionnaire
1.
Can you please tell us your gender?
Female
Male
2.
Can you please tell us your age group (or that of the person you bought the device for)?
Under 16
17-24
25-34
35-44
45-54
55-64
65-74
75 and over
3.

Please tell us what type of condition(s) you suffer from. Choose as many as appropriate.

Unspecified aches and pains/ME/MS
Aching Muscles/Rheumatism/Po-
lymyalgic Rheumatica
Back Pain/Sciatica
Burns/Scalds
Carpal Tunnel Syndrome
Cellulitis/Pemphigus Vulgaris/Bullous Pemphigoid
Complex Regional Pain Syndrome
Crohn's Disease/Irritable Bowel Syndrome/Ulcerative Colitis
Plantar Fasciitis
Fibromyalgia/Diabetic Neuropathy
Headache/Migraine
Joint Pain/Repetitive Strain Injury/Tennis Elbow/Housemaid's Knee/Golfer's Elbow
Leg or Heel Ulcers (including diabetic)/Post-herpet-
ic neuralgia (Shingles), Cold Sores
Muscle Spasm/Calf Pain
Period Pain
Sports Injury/Fracture/Broke-
n Bone
Stress/Tension/Sleep problems
Varicose Veins
Veterinary
4.
Can we now ask you about medications you have or are using to treat your pain? Please indicate which of the following you use or have used to help with your symptoms.
Aspirin (or derivative)
Codeine (or derivative)
Ibuprofen/Nurofen/Pan-
adol/Paracetemol
Prescription Drugs (any)
5.
Please indicate the degree to which you have suffered side-effects or contraindications as a result of medications you have previously used or currently use.
 None Mild Tolerable Worrying Bad 
Allergies/Sore Throat
Blood Pressure problems
Breathing Difficulty/Asthma
Constipation/Anal Bleeding
Drowsiness/Tiredness
Headache/Ringing in the ears/Impaired Vision
Liver or Kidney Problems
Loss of libido/Irritability
Skin Irritation/Sweating
Stomach Inflammation/Nausea
6.
Have you ever felt you (or the person you purchased the device for) may have been over-medicated and under-treated for your condition?
Yes
No
7.

Can you tell us if you have tried any of the following therapies to help with your condition?

Aromatherapy
Homeopathy
Bowen or Alexander Technique/Reiki
Chiropracty
Magnet Therapy
Osteopathy
Physiotherapy
Bodyshift
Acupuncture
8.
How would you describe the worst level of pain you have experienced with your condition?
None
Mild
Manageable
Tolerable
Distressing
Intense
Excruciating
Unbearable
Other  
9.
Please describe the level of pain you have experienced with your condition since using PainSolv at least twice a day over a period of time?
None
Occasional between use
Mild
Manageable
Tolerable
Distressing
Intense
Excruciating
Unbearable
Other  
10.
Could you please tell us approximately how many days you used PainSolv before noticing a reduction in the level of pain you suffer?
Same day
Between 2 and 4 days
Between 5 and 10 days
Within 2 weeks
Within 3 weeks
Within 1 month
Other  
11.
How likely are you to recommend PainSolv to a friend, or have you already recommended it to a friend or family member?
Very likely
Somewhat likely
Already recommended
Somewhat unlikely
Very unlikely
12.
Are there additional attributes that you feel would improve the PainSolv product?
 

  • 350 characters left.
13.
Can you tell us how you first found out about PainSolv?
Recommended by a Friend/Therapist
Advertisement
Direct Mail
Instore
Internet Search (Google etc)
Other