The medical history (history of the patient) represents an important component in the diagnosis of back pain or low back pain. Family history
- Is there a history of frequent back pain in your family?
Social history
- What is your profession?
- Is there any evidence of psychosocial stress or strain due to your family situation?
Current medical history/systemic history (somatic and psychological complaints).
- Where is the pain localized?
- How long have you had back pain?
- How severe is the pain?
- How did the pain start?
- Suddenly starting after an effort?
- Slowly increasing or progressing after previous low back pain?
- After a wrong movement?
- After an accident
- Does the pain radiate?
- Where does the pain change, or increase or decrease?
- Is the pain increased with coughing and sneezing? (discogenic pain)
- Walking?
- Standing?
- Sitting
- Lying down?
- Is your pain load-independent (= pain at rest)?
- Do you have diurnal differences in pain intensity?
- More pain during the day than at night?
- Equal amount of pain during the day and at night?
- Does the pain radiate?
- Do you have a continuous pain?
- On a scale of 1 to 10, where 1 is very mild and 10 is very severe, how severe is the pain?
- Do you have any limitation of movement?
- Do you have sensory disturbances/feeling disorders?
- Have you noticed any signs of paralysis? *
- Extremities* ?
- Bladder and rectal disorders* ?
- Do you have accompanying symptoms such as fever or general feeling of illness?
To understand the pain in more detail, a pain diary is usually created, which must be kept by the patient. This gives the doctor valuable insights into the nature and occurrence of the pain, which can be helpful in making an accurate diagnosis. Vegetative anamnesis incl. nutritional anamnesis
- Are you overweight? Please tell us your body weight (in kg) and height (in cm).
- Do you exercise enough every day?
- Are you currently going through alcohol withdrawal?
Self history including medication history.
- Pre-existing conditions
- Bone/joint diseases
- Extravertebral low back pain (pain in the lumbar spine caused by adjacent organs that do not directly belong to the bony, muscular, or disco-ligamentous structures (the discs/ligaments) of the spine):
- Abdominal and visceral processes (e.g., cholecystitis (gallbladder inflammation), pancreatitis (inflammation of the pancreas).
- Vascular changes (e.g., aortic aneurysm / wall sacculation of the aorta).
- Gynecological diseases (eg, endometriosis).
- Neurological diseases (e.g., polyneuropathies/diseases of the peripheral nervous system affecting multiple nerves).
- Psychosomatic and psychiatric diseases
- Urological diseases (e.g. urolithiasis (urinary stone disease)).
- Operations (eg, surgical procedures on the spine).
- Allergies
- Pregnancies
Medication history
- Α4β7-integrin antagonist (vedolizumab).
- Glucocorticoids – osteoporotic fractures (fractures caused by bone loss).
- Opiates – in the withdrawal of opiates.
- Analgesics (painkillers) – in the withdrawal of analgesics.
Caution. Three months or longer systemic glucocorticoid therapy increases the risk of osteoporosis by 30-50 percent. In the case of therapy with metered dose inhalers, such as bronchial asthma, this side effect does not occur. * If this question has been answered with “Yes”, an immediate visit to the doctor is required!(data without guarantee)
