Since your first evaluation [2 or 4 weeks ago], has there been any change in the function of your treated hand or forearm?
A very great deal worse
A great deal worse
A good deal worse
Moderately worse
Somewhat worse
A little worse
Almost the same, hardly any worse
No change
Almost the same, hardly any better at all
A little better
Somewhat better
Moderately better
A good deal better
A great deal better
A very great deal better
Since your first evaluation [2 or 4 weeks ago], has there been any change in the pain of your treated hand or forearm?
A very great deal worse
A great deal worse
A good deal worse
Moderately worse
Somewhat worse
A little worse
Almost the same, hardly any worse
No change
Almost the same, hardly any better at all
A little better
Somewhat better
Moderately better
A good deal better
A great deal better
A very great deal better
Since your first evaluation [2 or 4 weeks ago], please rate your response to treatment
None – no good at all, ineffective treatment
Poor – some effect but unsatisfactory
Good – satisfactory effect with occasional episodes of pain or stiffness
Excellent – ideal response, virtually pain-free
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