What does OPQRST stand for?

OPQRST stands for Onset, Provocation or Palliation, Quality, Region and Radiation, Severity, and Time. It is a mnemonic for the questions to ask about pain and is widely used in the United States, especially in emergency care.

What does OLDCARTS stand for?

OLDCARTS stands for Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing and Severity. It works for any symptom, not only pain, and is common in US medical and nursing schools.

What does SOCRATES stand for?

SOCRATES stands for Site, Onset, Character, Radiation, Associated symptoms, Time course, Exacerbating and relieving factors, and Severity. It is the standard pain mnemonic in UK medical schools and the OSCE.

Which pain mnemonic should I use?

They cover the same ground, so use the one your school or exam expects and use it consistently. SOCRATES has the advantage of prompting for associated symptoms explicitly; whichever you use, remember to ask about associated symptoms.

Updated November 10, 2026

OPQRST, OLDCARTS and SOCRATES: taking a pain history

Pain is one of the most common reasons patients seek care, and its character often points to the cause. Three mnemonics cover much the same ground: OPQRST and OLDCARTS, common in the US, and SOCRATES, used widely in the UK. Use whichever you remember under pressure.

OPQRST

Onset: When it started and what the patient was doing.
Provocation and palliation: What makes it worse and what makes it better.
Quality: What it feels like, in the patient's words.
Region and radiation: Where it is and where it spreads.
Severity: How bad it is, on a scale of 0 to 10.
Timing: Constant or intermittent, how long it lasts, and how it has changed.

OPQRST does not have a letter for associated symptoms, so remember to ask about them separately.

OLDCARTS

Onset: "When did it start, and what were you doing?"
Location: "Where is the pain? Show me where."
Duration: "How long does each episode last? How long has this been going on?"
Character: "What does it feel like?" Sharp, dull, burning, crushing or cramping.
Aggravating and alleviating factors: "What makes it worse? What makes it better?" Include what the patient has already tried.
Radiation: "Does the pain move or spread anywhere?"
Timing: "Is it constant, or does it come and go? Is it worse at a particular time of day?"
Severity: "How bad is it, from 0 to 10?" Ask how it affects sleep, work and daily life.

OLDCARTS works for any symptom, not only pain: it serves as well for a cough or a rash as for a headache.

SOCRATES

Site: "Where exactly is the pain? Can you point to it?" Pain the patient can point to with one finger suggests somatic pain, from the body wall or a joint; a vague, diffuse area suggests visceral pain, from an organ.
Onset: "When did it start? Did it come on suddenly or gradually?" A pain that is at its worst within seconds needs urgent attention.
Character: "How would you describe it?" Crushing, sharp, burning, colicky and tearing each suggest different causes.
Radiation: "Does it spread anywhere?" To the arm or jaw, through to the back, or from flank to groin.
Associations: "Have you noticed anything else with it?" Nausea, sweating, fever, shortness of breath or a change in bowel habit.
Time course: "Is it there all the time, or does it come and go? Has it changed since it started?"
Exacerbating and relieving factors: "Does anything make it better or worse?" Exertion, eating, breathing in, position or rest.
Severity: "On a scale of 0 to 10, where 10 is the worst pain imaginable, how bad is it?" Ask how it compares with pain they have had before.

Beyond the mnemonic

A mnemonic tells you what to ask about the pain, not what the pain means. Once you have the character of the pain, think about which conditions could cause it and ask the questions that separate them. Chest pain that is worse on exertion and eases with rest raises different questions from chest pain that is worse on breathing in. Ask about previous episodes, what the patient has already tried, and how the pain affects their daily life.

Frequently asked questions

What does OPQRST stand for?: OPQRST stands for Onset, Provocation or Palliation, Quality, Region and Radiation, Severity, and Time. It is a mnemonic for the questions to ask about pain and is widely used in the United States, especially in emergency care.
What does OLDCARTS stand for?: OLDCARTS stands for Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing and Severity. It works for any symptom, not only pain, and is common in US medical and nursing schools.
What does SOCRATES stand for?: SOCRATES stands for Site, Onset, Character, Radiation, Associated symptoms, Time course, Exacerbating and relieving factors, and Severity. It is the standard pain mnemonic in UK medical schools and the OSCE.
Which pain mnemonic should I use?: They cover the same ground, so use the one your school or exam expects and use it consistently. SOCRATES has the advantage of prompting for associated symptoms explicitly; whichever you use, remember to ask about associated symptoms.