CONSULTATION

CONSULTATION

CONSULTATION

1. Case History

On arrival at the clinic, we will ask you to complete a case history, detailing any past and present problems that you have and are suffering with. Your case history should contain detail about any treatments that you are currently having  or those that you have had in the past, either through the NHS or privately.
Your Specialist will then go through your case history with you, to identify where things have become dysfunctional and what may be contributing to your pain. Your Specialist will assess your movements passively, actively and functionally to identify all areas of dysfunction, and pain.

A comprehensive case history and thorough consultation will help us to identify any risk factors such as those listed below for the occurrence and chronicity of back pain.

Firstly, we have to make sure that the cause of your back pain is not a medical emergency and that you do NOT have:

  1.  A RED FLAG CONDITION eg. Fracture, Tumour or Cauda Equina Syndrome
  2. NERVE ROOT COMPRESSION

Red Flag Conditions often require immediate acute medical attention and if you are diagnosed with one, you will be referred immediately into the appropriate setting for you.
Nerve Root Compression will require urgent diagnostics, usually an MRI scan, to confirm diagnosis and then will likely need a referral to a Neuro-Spinal Consultant that we can recommend locally.

Once we are certain that your presentation is …….SIMPLE BACK PAIN that we can effectively and safely manage and treat then we move onto stage 2.

2. Risk Factors

The next part of the Consultation will be focused on the risk factors that affect back pain and discussing them further if required. These include;

Individual Risk Factors

  • ​Age
  • Physical Fitness
  • Weakness of back and abdominal muscles
  • Smoking
  • Obesity
  • Low educational ability
  • High levels of pain and disability

Psycho-Social Risk Factors

  • ​Stress and Anxiety
  • Negative Mood or Emotions
  • Poor Cognitive Functioning
  • Pain Behaviour
  • Distress
  • Depressive Mood
  • Somatisation

Occupational Risk Factors

  • ​Manual material handling; bending and twisting
  • Whole body vibration
  • Job dissatisfaction; monotonous tasks
  • Poor work relationships and social support
  • Job dissatisfaction; unavailability of light duty on return to work
  • Job requirement of lifting for three quarters of the day
Referenced from ​B W Koes, M W van Tulder, S Thomas. Diagnosis and Treatment of Low Back Pain. BMJ 2006 Jun 17;332:1430-4

3. Examination

After the consultation, you will be examined. At this stage you may be asked to dress down to you under wear to examine you. This will include standard Orthopaedic and neurological testing to confirm diagnosis. Futher tests may be required. Please click below to see what further tests we can offer.