Symptom: Pain, Back

Initial Grading Reminder

Grade 1: Mild pain
Grade 2: Moderate pain; limiting instrumental ADLs
Grade 3: Severe pain; limiting self-care ADLs

Assessment and Grading

Characterize the symptom (onset, pace)

Ask the patient:

When did the symptom start? Has it developed gradually or suddenly?

Grade the symptom

Ask the patient:

How would you rate your back pain: is it mild, moderate, or severe? Do you typically have back pain? If so, how is it worse? Is it limiting your ability to do the things you want to do or take care of yourself? Is it worse in the morning?

Patient Query Regarding Other Symptoms/Red Flags

Ask the patient:

Are you having any trouble moving your bowels or urinating?

Patient Factors to Consider That Affect the Approach to Intervention

Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?