This version was machine-translated from German and has not been medically reviewed. The authoritative version is the German version.

FLACC pain scale

Face, Legs, Activity, Cry, Consolability – observer-rated pain, 0–10 points

Face

no particular expression or smile (no particular expression or smile) 0 occasional grimace/frown, withdrawn or disinterested (occasional grimace/frown, withdrawn or disinterested) 1 frequent to constant quivering chin, clenched jaw (frequent/constant quivering chin, clenched jaw) 2

Legs

normal position or relaxed 0 uneasy, restless, tense 1 kicking or legs drawn up 2

Activity (Activity)

lies quietly, normal position, moves easily (lying quietly, normal position, moves easily) 0 squirming, shifting back and forth, tense 1 arched, rigid or jerking 2

Crying (Cry)

no crying (no cry) 0 moans or whimpers, occasional complaint 1 crying steadily, screams or sobs, frequent complaints 2

Consolability

content and relaxed 0 reassured by occasional touching, hugging or being talked to, distractable (reassured by occasional touching, hugging or being talked to, distractable) 1 difficult to console or comfort 2

Coding of the sum

Total	Designation according to source
0–3	mild pain
4–6	moderate pain
7–10	severe pain

Voepel-Lewis 2002, results: “Pain scores were coded as mild (0–3), moderate (4–6), and severe (7–10) for further comparisons.” The grading is a coding used in that paper; the instrument by 1997 itself does not define any levels.

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Sources

The Reliability and Validity of the Face, Legs, Activity, Cry, Consolability Observational Tool as a Measure of Pain in Children with Cognitive Impairment (Anesth Analg 95:1224–1229) – Table 1: FLACC Behavioral Pain Assessment Tool Voepel-Lewis T, Merkel S, Tait AR, Trzcinka A, Malviya S, 2002. Original paper (freely accessible via McGill University, full text read)
The FLACC: a behavioral scale for scoring postoperative pain in young children (Pediatr Nurs 23:293–297) Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S, 1997. Original publication of the scale (not freely accessible – wording via VOEPEL-LEWIS-2002)

Scientific basis last reviewed: September 2026.

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Note

Calculation aid for healthcare professionals. Percentiles and z-scores describe the position of a measured value in the reference population; clinical assessment remains with the treating physician.