When to refer: bleeding requires assessment, symptoms severe or lasting for (cid:859) weeks or more, recurrent vomiting with constipation may indicate intestinal blockage urgent, severe abdominal pain with fever. Electric, cutting, throbbing, pulsing, flickering, flashing, shooting, prickling, stabbing, cutting, pressing, crushing, cramping, pulling, wrenching, hot, scalding, searing, tingling, itchy, stinging, dull, ache, heavy, tender, taut, crystalline, exhausting, nauseating, suffocating, blinding, radiating, penetrating, piercing, tight, numb, cold. Superficial: skin, subcutaneous tissue, mucosa: eg burns, lacerations. Deep: bones, joints, muscles, tendons, ligaments, organ capsules: eg muscular, oa. Visceral: organs, deep tumour masses, lymph nodes: eg apendicitis, am), endometriosis. Generally: hot, sharp, stinging, dull, aching, throbbing, deep. Eg herpes zoster (shingles), postherpetic neuralgia, diabetic neuropathy, (cid:494)phantom pain(cid:495), spinal cord injury or compression, sciatica, (cid:494)nerve pain(cid:495) Generally: pins and needles, tingling, burning, stinging, shooting, radiating. Breakthrough and incident pain describe pattern of pain: Breakthrough occurs between regular doses of analgesic, from occasional fluctuation in pain, or inadequate baseline analgesia.