History (spine)
When taking a history from a patient with spinal problems, the following areas should be broached:
- pain:
- onset, site, radiation
- does the pain radiate to the leg as in sciatica
- aggravating and relieving factors e.g. posture, or if neurogenic claudication appears to be the problem, is cycling easier?
- persistent pain which occurs throughout the night should alert one to the possibility of a tumour
- stiffness:
- sudden and complete in disc prolapse, or continuous and worse in the morning with arthritis or ankylosing spondylitis
- sudden and complete in disc prolapse, or continuous and worse in the morning with arthritis or ankylosing spondylitis
- deformity:
- onset, changes, general history, neurological features, pain
- onset, changes, general history, neurological features, pain
- neurological symptoms:
- numbness, paraesthesia; onset, progress, degree
- spinal claudication ?
It is also important to ask specifically about weight loss, bowel, pulmonary and bladder dysfunction.
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