Can you tell me what brought you into the
Emergency Department today?
Yes.
I have got really bad back pain.
It seems to be either side of my spine.
Can you tell me how you’d rate your back
pain right now?
You mean…how painful it is now?
That’s right.
Could you rate the intensity of your pain
on a scale from 0 to 10?
Firstly, how strong is the pain when you are at rest?
It’s not bad if I lie still.
I’d say it’s a 2.
OK.
2 out of 10 if you don’t move about.
That’s right.
What about if you’re moving around?
That’s a different story!
If I bend my back, if I bend over for example, it’s a 6.
It hurts as much when I cough or sneeze.
OK.
6 out of 10 on movement.
What does the pain feel like?
It feels like a sharp pain if I move.
Like a knife in my back.
I see.
It’s quite an acute pain not a continuous
aching pain, right?
Yes.
The pain comes on suddenly if I move too much.
Like I said, if I keep still the pain is hardly
noticeable.
When did you first notice the pain?
It started yesterday.
I hadn’t noticed it before then.
OK.
Is the pain linked to an injury?
You mean, did I have an accident like a fall?
Yes.
I wondered if you had injured your back recently at all?
No.
I haven’t had an accident.
I was just unloading shopping bags from my car.
I’d put them in the back seat, so I had
to bend down to pick them up.
I had to twist my back to reach into the car.
OK.
It started as a twinge in my back.
When I tried to straighten up, it was excruciating.
Does the pain radiate from your spine?
Radiate?
Does the pain move anywhere else in your body?
No.
It stays in the same spot.
OK.
The pain is localised.
Have you ever experienced this type of pain before?
No.
I’ve never had any problems with my back
before.
You said that the pain is worse if you bend over.
Is there anything that relieves the pain?
I tried taking some paracetamol, but it didn’t help much.
The best thing seems to be to lie down quietly and not to move.
Obviously, I can’t stay in bed all day!
Can I just return to the type of pain again?
Is it there all the time?
No.
It seems to come and go.
I’m a bit worried I might have a slipped
disc.
I read about it on the internet.
It said the pain gets better if you rest.
Right.
There are some important differences between a herniated disc and back strain.
Herniated discs are often associated with
shooting pains and numbness which travel down
one of the legs.
Back strain tends to cause central back pain which doesn’t radiate at all.
Oh OK.
So, you think I have strained a back muscle then?
I’d say it’s likely, but I’ll do a physical
examination first then arrange for you to
have an MRI to rule out a herniated disc.
Then we can discuss the results.
All right.
Now, the first thing I’m going to do is
help you to lie down…
