PAIN ASSESSMENT TOOL

Back Pain Woman

You’re just a few short steps away from obtaining a better understanding of your pain. We’ll use the information you enter to assist you in finding effective treatment options.

Pain is a language your body uses to tell you something may be wrong. Whenever you feel pain, your body is trying to help you focus on that pain and take action to remedy the source.

Most of us have experienced back, neck and spine pain at some point in our lives. But we often tend to ignore these signs unless the pain aggravates us or interferes with our daily activities.

If this describes you, we strongly urge you to never take pain casually again. A regular pain in your neck, back or spine can increase your risk of early death by up to 14% compared to people who have never suffered any back or neck pain.

There are many causes for pain in the back, neck or spine. These areas are made up of complex, interconnected networks of muscles, ligaments, bones, discs and tendons. Any compression, strain or pressure on these parts can cause pain. This pain can range from dull aches to severe pain. It can also be persistent or something that comes and goes.

Most of these pains are because of strain due to activity, injuries from sports, wrong body postures, accidents or overuse.

Whatever the cause of your back, neck or spinal pain — and whether it’s dull or severe, persistent or intermittent — having this pain diagnosed quickly and efficiently is important. Use our online pain assessment tool to self-diagnose your pain and start finding treatment options today.


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STEP 1:
TELL US ABOUT YOUR PAIN

Choose all that apply:

Lower Back

Middle Back

Neck

Shoulders

Arms

Buttocks

Legs

Other

If other, please explain:
Where is the pain strongest?
How long have you been experiencing pain?
Have you been diagnosed with a specific condition?

STEP 2:
DESCRIBE YOUR PAIN FOR US

How would your describe your pain?
Are you always in pain?
Do you have any of the following symptoms?

Pins and Needles Feeling

Numbness

Tingling Sensations

Progressing Weakness

Loss of Coordination

None

STEP 3:
TELL US MORE ABOUT YOUR SYMPTOMS

When is your pain at its worst? Choose all that apply.
When does your pain feel better?
What caused your pain originally?
If other, please explain:

STEP 4:
TELL US ABOUT YOUR PAST TREATMENT

Have you undergone any of the following?

CT Scan

MRI

X-ray

Nerve Conduction Study

Other

None

If other, please explain:

STEP 5:
GET YOUR RESULTS NOW

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STEP 2:
TELL US ABOUT YOUR CONDITION

What condition do you have?

Bulging Disc

Coccydynia

Disc Degeneration

Disc Tear

Facet Joint Disease

Failed Surgery

Foraminal Stenosis

Herniated Disc

Lower Back Pain

Pinched Nerve

Radiculopathy

Sacroilitis

Sciatic Nerve

Bone Spurs

Spinal Stenosis

Spondylolisthesis

STEP 3:
TELL US ABOUT ANY RECENT TREATMENTS

Have you undergone any of the following?

CT Scan

MRI

X-ray

Nerve Conduction Study

Other

None

If other, please explain:
How long ago was your last Ct Scan, MRI, X Ray, or Nerve Condition Study?
Are you currently undergoing any treatment?
If yes, which treatments?

Medication

Chiropractor

Acupuncture

Physical Therapy

Nerve Block Injections

Cortisone Injections

Other

None

If other, please explain:

STEP 4:
TELL US HOW EFFECTIVE YOUR TREATMENTS ARE

How effective is your current treatment?
What other treatments have you undergone?

Medication

Chiropractor

Acupuncture

Physical Therapy

Nerve Block Injections

Cortisone Injections

Other

None

If other, please explain:

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