UNDERSTANDING BACK TROUBLE: QUESTIONS AND ANSWERS
The first thing the specialist will ask is where the pain and other symptoms are, and how far they extend. Try to point them out as clearly as possible. Be prepared to go into considerable detail, if asked. The specialist will want to know how long ago the trouble began; what you were doing when it started (or just before); what the symptoms were like to start with, and how they have changed since. In other words, whether you are between attacks, in continuous pain, getting better or worse.
If by the time you see the specialist your back is better, say so. Specialists are used to this, and they will not think that their time has been wasted. Their job is to get you completely well, and to prevent further trouble.
You should tell the specialist what makes the pain better, and what makes it worse – things like bending, sitting, walking and so forth – and the effect the pain has on your usual activities. Tell the specialist about your state of mind, too – if you are under any strain in your work, home, relationships or other personal factors, say so, in case it has any bearing on your back pain. The severity and unpredictable nature of the pain, and the disruption it is bound to have caused to your daily life, may be affecting you emotionally.
It may be difficult to describe symptoms other than pain, such as heaviness, dullness, tightness, numbness and weakness. Numbness, for example, means different things to different people. Some use it in a general way to describe a sensation that a leg, for instance, has ‘gone to sleep’. But it may also mean, more precisely, that the skin itself has lost all sensation and that you could scald it without feeling pain. Weakness, for instance, could describe feeling limp because of pain, or else being forced to drag your toes along because you cannot bend up your ankle. Analyse the feeling or pain carefully, explain it as descriptively as you can and try to make sure that the doctor understands what you are trying to describe. It is important for you to tell the doctor what you feel, not what you think you ought to feel. Spontaneity is the patient’s great asset. Analysis is the doctor’s job.
It is useful to be able to give information about any previous back trouble before the current attack. But when it is a long and complex story, it may be difficult to know how much to tell your doctor. On the whole, unless asked directly, it is better to avoid recounting in detail what has been said to you by various doctors, surgeons, chiropractors and physiotherapists you may have seen in the past. Doctors like to make their own diagnosis and it does not really help to give them other people’s. The important thing is where the pain was and whether you had to go to bed or could continue at work; how many times you have had the pain since and whether the pain then, and subsequently, was like it is now; what investigations were made (if you know); whether you have had any treatment and, if so, what helped and what made it worse.
Going to a specialist can bean intimidating occasion. You may feel more confident if you jot down some notes beforehand, with dates, of your case history so that you do not return home wishing you had mentioned all sorts of things you forgot at the time.
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