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Objective This study investigated the benefits of adding a new measurement tool, the Functional Activity Score to a validated measurement tool, the Numeric Rating Scale. Design Prospective cohort comparing cases (with intervention) to controls (usual care). Setting Inpatients from a Chinese Mainland teaching hospital. Subjects Eighty three postoperative patients of mixed gender and Chinese ethnicity. Interventions Adding Functional Activity score, a subjective observer assessed pain measurement tool, to usual postoperative pain intensity assessment. Main outcome measures Median 24 hour dynamic pain rating intensity. Episodes of moderate to severe pain. Results Median 24 hour dynamic numeric rating pain postoperative pain intensity rating with cough 3 [2.25, 3.75] versus 6 [5, 7] (p< 0.001), and at rest 0 [0,0] versus 2 [0,3] (p < 0.001) were both significantly lower in the intervention group versus the control group. The intervention group also experienced significantly less episodes of moderate to severe pain (p=0.02) and reported significantly less cough related interference with pain (p=0.003). Conclusion Functional activity score is easy to teach and apply, complements existing objective pain assessment after surgery and is beneficial for patient care. [ABSTRACT FROM AUTHOR]