- Past medical history
- Past surgical history
- Onset of pain / injury
- Previous back injury
- Traumatic mechanism
- Location of pain
- Improvement or worsening with activity
Signs and Symptoms:
- Pain (paraspinous, spinous process)
- Pain with range of motion
- Extremity weakness
- Extremity numbness
- Shooting pain into an extremity
- Bowel / bladder dysfunction
- Muscle spasm / strain
- Herniated disc with nerve
- Spine Fracture
- Kidney stone
- Spinal Epidural Abscess
- Metastatic Cancer
Injury or traumatic mechanism ?
Signs of Shock ?
Positive Orthostatic ?
Negative Orthostatic / Unable to Perform ?
- Recommended Exam: Mental Status, HEENT, Neck, Chest, Lungs, Abdomen, Back, Extremities, Neuro
- Abdominal aneurysms are a concern in patients over the age of 50.
- Kidney stones typically present with an acute onset of flank pain which radiates around to the groin area.
- Patients with mid-line pain over the spinous processes should be spinally immobilized.
- Any bowel or bladder incontinence is a significant finding which requires immediate medical evaluation.
- In-patient with history of IV drug abuse a spinal epidural abscess should be considered.