The Brief Pain Inventory (BPI)



The Brief Pain Inventory (BPI) is available in two formats: the BPI short form, which is used for clinical trials and is the version used for the foreign-language translations; and the BPI long form, which contains additional descriptive items that may be clinically useful (for example, items that expand the possible descriptors of pain, such as burning, tingling, etc.). For brevity’s sake and for the patient’s ease of use, however, we recommend the short form of the BPI.

In response to the US Food and Drug Administration (FDA) guidance for the pharmaceutical industry on the use of patient-reported outcome measures in medical product development to support labeling claims, we have prepared a BPI User's Guide to provide documentation of the BPI's development and psychometric properties. The information offered therein addresses the recommendations in the FDA guidance and establishes the BPI's adequacy as a measure to support medical product claims.

BPI Features

  • Purpose: To assess the severity of pain and the impact of pain on daily functions
  • Population: Patients with pain from chronic diseases or conditions such as cancer, osteoarthritis and low back pain, or with pain from acute conditions such as postoperative pain
  • Assessment areas: Severity of pain, impact of pain on daily function, location of pain, pain medications and amount of pain relief in the past 24 hours or the past week
  • Responsiveness: Responds to both behavioral and pharmacological pain interventions
  • Method: Self-report or interview
  • Time required: Five minutes (short form), 10 minutes (long form)
  • Scoring: No scoring algorithm, but "worst pain" or the arithmetic mean of the four severity items can be used as measures of pain severity; the arithmetic mean of the seven interference items can be used as a measure of pain interference
  • Reliability: Cronbach alpha reliability ranges from 0.77 to 0.91

BPI Versions

BPI Language Versions

The BPI is available in the languages shown below. Click on a linked language to view a sample in PDF format.

Psychometrically and Linguistically ValidatedLinguistically Validated
Chinese (Simplified)
Chinese (Traditional)
Spanish (Spain)
Portuguese (Brazil)
Portuguese (Portugal)

* A linguistically validated version of the BPI Long Form (PDF) is available in this language.

Future Validation Studies: We would like to collaborate with other investigators to develop and validate new language versions of the BPI. Contact us at for more information. NOTE: The BPI may not be modified or translated into another language without the express written consent of the copyright holder (see Notice of Copyright below).


To Order the BPI

To use the BPI in a publication or clinical or research trial, you must obtain permission by filling out our order form and you must comply with the copyright. Fees may apply: 

Type of UseFirst Language Version (Per Project)Additional Language Versions (Per Project)
Non-funded academic researchNo chargeNo charge
Individual clinical practiceNo chargeNo charge
Funded academic research$300$150
Commercial research$2,000$1,200

The BPI will be e-mailed to you as a PDF file within 7 to 10 business days. If your request is urgent or the language version you seek is not shown,  contact us to make special arrangements:

The Department of Symptom Research
Attn: Assessment Tools
The University of Texas MD Anderson Cancer Center
1515 Holcombe Boulevard, Unit 1450
Houston, Texas 77030 

If applicable, an invoice will be e-mailed to you. Reference the invoice number on your payment and include on the memo line, "MD Anderson Assessment Tool Distribution."

Notice of Copyright

The Brief Pain Inventory (BPI) copyright is held by Dr. Charles S. Cleeland (1991). The copyright applies to the BPI and all its derivatives in any language. 

The BPI may not be used or reproduced without permission from Charles S. Cleeland, PhD, or his designee. Fees for use may apply (see above).

The BPI may not be modified or translated into another language without the express written consent of the copyright holder. Failure to comply may result in legal action. Contact us via e-mail at or at the address shown above to obtain permission to alter or translate the instrument.

Selected References


Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore 23(2): 129-138, 1994.

Cleeland CS. Measurement of pain by subjective report. In: Chapman CR, Loeser JD, editors. Advances in Pain Research and Therapy, Volume 12: Issues in Pain Measurement. New York: Raven Press; 1989. pp. 391-403.

Atkinson TM, Rosenfeld BD, Sit L, Mendoza TR, Fruscione M, Lavene D, Shaw M, Li Y, Hay J, Cleeland CS, Scher HI, Breitbart WS, Basch E. Using confirmatory factor analysis to evaluate construct validity of the Brief Pain Inventory (BPI). J Pain Symptom Manage 41(3): 558-565, 2011.

Ferreira KA, Teixeira MJ, Mendoza TR, Cleeland CS. Validation of Brief Pain Inventory to Brazilian patients with pain. Support Care Cancer 19(4): 505-511, 2011.

Kalyadina SA, Ionova TI, Ivanova MO, Uspenskaya OS, Kishtovich AV, Mendoza TR, Guo H, Novik A, Cleeland CS, Wang XS. Russian Brief Pain Inventory: validation and application in cancer pain. J Pain Symptom Manage 35(1): 95-102, 2008.

Mendoza TR, Mayne T, Rublee D, Cleeland CS. Reliability and validity of a modified Brief Pain Inventory short form in patients with osteoarthritis. Eur J Pain 10(4): 353-361, 2006.

Mendoza TR, Chen C, Brugger A, Hubbard R, Snabes M, Palmer SN, Zhang Q, Cleeland CS. The utility and validity of the modified Brief Pain Inventory in a multiple-dose postoperative analgesic trial. Clin J Pain 20(5): 357-362, 2004.

Keller S, Bann CM, Dodd SL, Schein J, Mendoza TR, Cleeland CS. Validity of the Brief Pain Inventory for use in documenting the outcomes of patients with noncancer pain. Clin J Pain 20(5): 309-318, 2004.

Yun YH, Mendoza TR, Heo DS, Yoo T, Heo BY, Park HA, Shin HC, Wang XS, Cleeland CS. Development of a cancer pain assessment tool in Korea: A validation study of a Korean version of the Brief Pain Inventory. Oncology 66(6): 439-444, 2004.

Badia X, Muriel C, Gracia A, Nunez-Olarte JM, Perulero N, Galvez R, Carulla J, Cleeland CS. Validation of the Spanish version of the Brief Pain Inventory in patients with oncological pain [in Spanish]. Med Clin (Barc) 2003; 120(2):52-59.

Klepstad P, Loge JH, Borchgrevink PC, Mendoza TR, Cleeland CS, Kaasa S. The Norwegian Brief Pain Inventory questionnaire: Translation and validation in cancer pain patients. J Pain Symptom Manage 24(5): 517-525, 2002.

Laudico AV, Mendoza TR, Siguan SS, Cleeland CS. Measuring cancer pain intensity and its effect on daily functioning: validation of the Cebuano version of the Brief Pain Inventory (BPI-Ce). Philipp J Surg Spec 57(3): 94-99, 2002.

Mystakidou K, Mendoza T, Tsilika E, Befon S, Parpa E, Bellos G, Vlahos L, Cleeland C. Greek Brief Pain Inventory: validation and utility in cancer pain. Oncology 60(1): 35-42, 2001.

Ger LP, Ho ST, Sun WZ, Wang MS, Cleeland CS. Validation of the Brief Pain Inventory in a Taiwanese population. J Pain Symptom Manage 18(5): 316-322, 1999.

Radbruch L, Loick G, Kiencke P, Lindena G, Sabatowski R, Grond S, Lehmann KA, Cleeland CS. Validation of the German version of the Brief Pain Inventory. J Pain Symptom Manage 18(3): 180-187, 1999.

Saxena A, Mendoza T, Cleeland CS. The assessment of cancer pain in north India: the validation of the Hindi Brief Pain Inventory--BPI-H. J Pain Symptom Manage 17(1): 27-41, 1999.

Uki J, Mendoza T, Cleeland CS, Nakamura Y, Takeda F. A brief cancer pain assessment tool in Japanese: the utility of the Japanese Brief Pain Inventory--BPI-J. J Pain Symptom Manage 16(6): 364-373, 1998.

Caraceni A, Mendoza TR, Mencaglia E, Baratella C, Edwards K, Forjaz MJ, Martini C, Serlin RC, De Conno F, Cleeland CS. A validation study of an Italian version of the Brief Pain Inventory (Breve Questionario per la Valutazione del Dolore). Pain 65(1): 87-92, 1996.

Wang XS, Mendoza TR, Gao SZ, Cleeland CS. The Chinese version of the Brief Pain Inventory (BPI-C): its development and use in a study of cancer pain. Pain 67(2-3): 407-416, 1996.

Larue F, Carlier AM, Brasseur L, Colleau SM, Cleeland CS. Assessing the prevalence and severity of cancer pain in France:  The French Brief Pain Inventory [abstract]. American Pain Society 10th Annual Scientific Meeting, New Orleans LA, Nov 7-10, 1991.

Clinical Application

Wang XS, Rhines LD, Shiu AS, Yang JN, Selek U, Gning I, Liu P, Allen PK, Azeem SS, Brown PD, Sharp HJ, Weksberg DC, Cleeland CS, Chang EL. Stereotactic body radiation therapy for management of spinal metastases in patients without spinal cord compression: a phase 1-2 trial. Lancet Oncol 13(4): 395-402, 2012.

Mendoza TR, Koyyalagunta D, Burton AW, Thomas SK, Phan MH, Giralt SA, Shah JJ, Cleeland CS. Changes in pain and other symptoms in patients with painful multiple myeloma-related vertebral fracture treated with kyphoplasty or vertebroplasty. J Pain 13(6): 564-570, 2012.

Vadhan-Raj S, von Moos R, Fallowfield LJ, Patrick DL, Goldwasser F, Cleeland CS, Henry DH, Novello S, Hungria V, Qian Y, Feng A, Yeh H, Chung K. Clinical benefit in patients with metastatic bone disease: results of a phase 3 study of denosumab versus zoledronic acid. Ann Oncol: e-pub ahead of print, 2012.

Shi Q, Wang XS, Mendoza TR, Pandya KJ, Cleeland CS. Assessing persistent cancer pain: a comparison of current pain ratings and pain recalled from the past week. J Pain Symptom Manage 37(2): 168-174, 2009.

Atkinson TM, Mendoza TR, Sit L, Passik S, Scher HI, Cleeland C, Basch E. The Brief Pain Inventory and its "pain at its worst in the last 24 hours" item: clinical trial endpoint considerations. Pain Med 11: 337-346, 2010.

Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar JT, Haythornthwaite JA, Jensen MP, Kerns RD, Ader DN, Brandenburg N, Burke LB, Cella D, Chandler J, Cowan P, Dimitrova R, Dionne R, Hertz S, Jadad AR, Katz NP, Kehlet H, Kramer LD, Manning DC, McCormick C, McDermott MP, McQuay HJ, Patel S, Porter L, Quessy S, Rappaport BA, Rauschkolb C, Revicki DA, Rothman M, Schmader KE, Stacey BR, Stauffer JW, von ST, White RE, Witter J, Zavisic S. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain 9(2): 105-121, 2008.

Cleeland CS. The measurement of pain from metastatic bone disease: capturing the patient's experience. Clin Cancer Res 12(20 Part 2): 6236s-6242s, 2006.

Cleeland CS, Nakamura Y, Mendoza TR, Edwards KR, Douglas J, Serlin RC. Dimensions of the impact of cancer pain in a four country sample: new information from multidimensional scaling. Pain 1996;67:267-273.

Serlin RC, Mendoza TR, Nakamura Y, Edwards KR, Cleeland CS. When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function. Pain 1995;61:277-284.

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