Most new patients I consult with are interested in not only pain relief, but also a deeper understanding of what their problem is. They want to know why they are sore, how it started, and how to prevent it from happening again. Whenever I do a consultation with a new patient, there are several questions I ask, starting with the more obvious, then moving towards the less common. Let’s say your lower back hurts. I start the questions like:
When did it start?
How did it start? Did it come suddenly from a fall, or other injury, or did it come on gradually, like from a repetitive strain?
Have you noticed it before? What was that like, what made it better, and what made it worse?
The pain may not show up to, or until 48 hours after some stress to the back, so if it’s difficult to figure it out, think back to what you did 2 days before the pain started. Have you done any heavy lifting lately or anything that you don’t normally do such as fall raking or snow shovelling?
Have you overdone it with some type of exercise or task which you haven’t done lately?
Were you sitting on a different chair, or different bed, with poor support lately?
Have you missed out on some things that normally help you avoid back pain, like regular walking or core exercises?
Perhaps you were under the weather for a few days and spent a few days in bed or sleeping on the couch. Your back could easily be sore once you get back to normal activity again.
These questions usually give us some idea about how, when, and why it started. Then we can ask more specific things like what type of pain it is – dull throbbing or sharp? Is it worse in the morning, or after you’ve been active? What aggravates it and what helps it? Are there other symptoms like stiffness, tingling, numbness, or weakness?
Finally, are there any other conditions you’ve noticed since the lower back pain started? Perhaps your stomach feels upset. You may have heartburn or leg pain.
With all these questions answered we usually proceed to the examination to determine exactly which tissues are causing the pain, in what directions, what areas are stiff, and what areas are overstretched. We see how the posture is affected helping us determine what else could be compensating or sore. Then we can come up with a treatment plan to help correct the cause of the problem and help prevent it from happening again.
Before seeing any doctor, ask yourself some of these questions and be prepared to answer them. This will not only speed up the process but help us get to a deeper understanding of your condition and ultimately a quicker, more painless recovery. Sometimes people need a lot of treatments and a long series of rehabilitation exercises, but other times conditions are quite simple and quick to get under control. The more accurately you can help define the problem, the sooner we can get started on correcting it.