Patient History

The history taking should be aimed at addressing the patient’s problems and asking the questions necessary to be able to formulate appropriate assessment objectives. The questions are directed at getting an idea of what the patient is experiencing and ruling out any specific morbidities they may have to be able to diagnose the pain as aspecific.

Questions may include:

  • Onset
  • Occupation: Low social class and low work satisfaction may have an influence on the pain (Waddell et Waddell, 2000)
  • Changes in quality of life, activities and participation, job status
  • The course of the pain, sites and boundaries
  • Present status: Listen for red flags and contraindications
  • Coping mechanisms: They depend on the specific patient’s characteristics and the significance they place on their pain (KNGF, 2003)
  • Co-morbidities
  • Present and previous treatment
  • Delayed recovery risk factors including:

    • Fear-avoidance beliefs
    • Catastrophizing
    • Somatization
    • Depressed mood
    • Distress and anxiety
    • Early disability or decreased function
    • High initial pain levels
    • Increased age
    • Radiation of pain
    • Poor general health status
    • Non-organic signs

(ICSI 2012, Magee 2006)

Assessment

Treatment