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Sunday, June 6, 2010

Pain: Giving a Good Medical History

Giving Good Historical Information: Helping to Steer the Course of Treatment

More Inspiration from Portovenere, Italy

I have been watching ships and boats sail through the narrow channel between Portovenere and the Island of Palmaria (as seen in the photo above). They perform this task so effortlessly since they have done it so many times. In the medical arena, an important time to steer the ship/treatment plan in the right direction is by giving good historical information. Come prepared with the information typed (unless you have great handwriting; typing in the best). Point your doctor or therapist along the right path/channel and it help you get better faster. Think over each question carefully when answering. The process will clear your head and keep you focused on the most important aspects. While many of these questions can be the most helpful clues, it may also free the doctor/therapist to ask the key specific questions related to your specific injury (for example, does your painful knee lock where you can not bend it?)

I would like to introduce you to a mnemonic that I used in medical school for asking a great history. The basic questions over the years have remained the same and the hallmark of great history taking. I hope you can take these questions and make them paint an accurate picture of your problem for the doctor/therapist you see next. If they are not impressed by your organizational skills, I will be amazed.

The mnemonic goes like this---

F Family History of similar problem? Frequency of pain (how often)?

A What is your Assessment of the problem (what do you think it is)?
What part of your Anatomy is involved?

I How Intense (use Pain Scale) is the pain? What Irritates (makes it


L With one finger, point to the exact Location of the worse pain?

E What Eases the Pain? Does the pain have an Electric sensation with it

D What has been it’s Duration (how long has it been going on)?

O What were all the events surrounding the Onset of Pain? Are there

any Observable skin changes?

P Pain Scale (0-10) Sleeping? Getting out of Bed? During Activity? End

of the day?

Q What is the Quality of Pain (burning, tingling, dull ache, sharp,

numbness, throbbing, pulsating, etc)?

R Is there Redness? Does the pain Radiate and where to?

S How does Shoe gear or barefoot affect it (or high heels, or various

types of shoes)?

T What have you done to Treat the problem? What Treatment has

helped? What Treatment has made it worse?

U Are there Underlying Health Issues (diabetes, osteoporosis,

arthritis, poor circulation, etc.)?

V Does the pain Vary (better at different times, worse at other times)?

W Can you Work? Were you injured at Work? Does this affect your Work


Good Luck and I hope this is really helpful to you. I hope your boat ride is enjoyable.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.