Q. What should I expect on the first visit to my doctor?
A. Your doctor will begin by getting your complete health history, followed by a physical examination. The history and physical examination are needed before your condition can be accurately diagnosed or treated. By getting this information, your doctor can begin to determine the source of your problem.
To help get your physical history, your doctor may ask you some questions about your pain and symptoms. The information you give can help your doctor determine your diagnosis. Examples of the questions that you may be asked include:
- When did your pain first begin?
- Was there an injury that may have caused your pain?
- Are you aware of work postures or other factors that may be causing your pain?
- Do you have a family history of similar problems?
- Where do you feel the pain? What is the intensity?
- Does the pain radiate to other parts of your body?
- What makes the pain feel better or worse?
- Have you had problems with your bladder or bowels?
During your first visit to the doctor, he or she may also order some tests to help with your diagnosis. These tests may include an x-ray, CT scan, MRI, EMG, or blood test.
Most patients with spinal symptoms will settle with conservative therapy over a 4-5 week period. If the patient fails to improve during this time then a neurosurgical spinal referral should be considered. Other indications for a surgical opinion include:
– severe unremitting pain of any duration that is uncontrollable with opiate analgesia
– a progressive neurological deficit (evolving foot drop or sensory loss)
– cauda equina syndrome (indication for an emergency operation)
– any red flag condition
Below is a copy of a referral pathway for spinal pathology.
After spinal surgery the patient will be seen by the inpatient physiotherapy team before discharge. They will go through a number of exercises and educate the patient about posture, lifting and sitting. Booklets will be provided.