history (spine)

Last reviewed 10/2020

When taking a history from a patient with spinal problems, the following areas should be broached:

• pain:
• onset, site, radiation
• does the pain radiate to the leg as in sciatica
• aggravating and relieving factors e.g. posture, or if neurogenic claudication appears to be the problem, is cycling easier?
• persistent pain which occurs throughout the night should alert one to the possibility of a tumour

• stiffness:
• sudden and complete in disc prolapse, or continuous and worse in the morning with arthritis or ankylosing spondylitis

• deformity:
• onset, changes, general history, neurological features, pain

• neurological symptoms:
• numbness, paraesthesia; onset, progress, degree
• spinal claudication ?

It is also important to ask specifically about weight loss, bowel, pulmonary and bladder dysfunction.