Here is a list of the signs and symptoms that were nominated by our previous participants. These are symptoms that might be reported by the patient, or are signs that might be assessed by the clinician during the assessment.
For context, they have given a clarifying question that might be asked of the patient to gain the information during the assessment. They have also nominated a method of measurement.
For context, they have given a clarifying question that might be asked of the patient to gain the information during the assessment. They have also nominated a method of measurement.
Name |
What would you ask the patient to gain this information? |
How would this be measured? |
Severity of pain |
What is the patient’s pain score between the last rib and gluteal fold? |
Visual analogie scale |
Irritability of pain |
Does the patient get severe symptoms that last for more than 30 minutes? |
Yes/no |
Nature of pain |
How would the pain be described? |
Ache, sharp, stabbing, burning |
Referred pain |
Does the patient have referred pain? |
Yes/no |
Widespread pain |
Does the patient have widespread pain [pain in at least 2 sections of 2 contralateral limbs and in the axial skeleton and be present for at least 3 months]? |
Yes/no |
Pain response to medication |
How have symptoms responded to analgesic medications? |
No improvement/ improved with paracetamol/ improved with NSAIDS/ improved with opioids/ improved with atypicals/neuropathic medications |
Leg pain |
Does the patient have pain radiating down their leg? |
Yes/no |
Leg pain worse than back pain |
Which is worse - leg pain or back pain? |
Leg pain worse than back pain/ back pain worse than leg pain |
Functional capability |
Is the patient able to perform all their usual activities? |
Yes/no |
Physical activity |
What is the patients current physical activity level? |
Inactive, moderately inactive, moderately active, very active |
Weakness -specific |
What is the patient's myotome assessment? |
5/5 bilaterally/ myotome weakness/ unable to complete assessment |
Weakness - global |
Does the patient have signs of deconditioning? |
Yes/no |
Upper motor neuron / lower motorneuron signs |
Does the patient have any UMN/LMN signs? |
Positive babinski/ positive clonus/ altered reflexes/ no UMN/LMN signs |
Paraesthesia type |
What type of paraesthesia does the patient have? |
P&N, numbness, none |
Paraesthesia severity |
Is the paraesthesia constant or intermittent? |
Constant / intermittent |
Paraesthesia location |
What is the location of the paraesthesia? |
Bilateral / unilateral |
Abnormal neural dynamics |
Does the patient have abnormal neural dynamics (i.e. positive Straight Leg Raise or Slump test)? |
Yes/no |
Deformity |
Does the patient have any spinal deformities? |
Kyphosis/ scoliosis/ trunk shift/ none |
Sleep disturbance |
Does the patient have any sleep problems (due to the pain)? |
No sleep problem/ minimal sleep problem/ moderate sleep problem/ severe sleep problem |
Onset of symptoms |
How did the patient’s pain start? |
Sudden/ insidious/ acute on chronic/ traumatic/ atraumatic |
Condition progression |
Is the patient getting better, worse or staying about the same? |
Worse over last week/ same over the last week/ better over last week |
Response to movement |
How do symptoms respond to movement? |
Aggravates/ no change/ eases |
Stiffness form |
What form does the stiffness take? |
Multidirectional / unidirectional |
Movement pattern |
Does the patient move in a way that suggests an underlying problem - could relate to numerous causes - that probably needs to be addressed to improve pain and function? |
Yes/no |
Muscle tightness |
Does the patient have any evidence of restriction to any spinal or limb movement due to muscle tightness? |
Yes/no |
Range of movement |
Does the patient have limited range of movement? |
Less than 50% FROM/ within 50% FROM/ within 25% FROM/ full range of movement |
Palpation |
How is the patient’s pain on palpation? |
Diffuse/ local/ hypersensitive/ allodynic/ none |
Results of investigations |
Is any pathology present on the scan, MRI, blood test, Xray? |
|
Depression |
Does the patient report depression? |
PHQ-9 |
Anxiety |
Does the patient have anxiety? |
GAD-7 |
Kinesiophobia |
What is patient's level of kinesiophobia? |
TSK |
Fear avoidance |
Is the patient avoidant of activity for fear of further injury/pain? |
FABQ |
Catastrophising |
Is the patient catastrophising? |
PCS |