BACK PAIN

If your child has Back Pain please print and answer these questions before seeing your clinician:

1. How long has been the back pain?

2. Where does it ache or pain?

3. Is the pain severe enough to hamper child’s regular activities?

4. Where does it radiate? Does it radiate to shoulders?

5. Was there a history of fall or injury?

6. Does it hurt with forward bending or backward bending?

7. Is there a deformity at the back?

8. Is there accompanying fever, numbness, or weakness?

9. Is there pain in other body parts?

10. Has the child been coughing excessively?

You child's clinician might ask more questions depending on your answers.