Spine Assessment

To begin the process of eliminating your back pain or sciatica, it’s important for you to begin thinking about the toll back pain has had on your life. In other words, what has back pain taken from you?

Take a look at the list of statements below. If the statement resonates with you, click on the slider bar beneath the statement and score yourself from “0 = Does not describe me at all” to “10 = Completely describes me”

The purpose of this exercise is to get you thinking about what you're missing out on and to help you formulate some personal goals.

With any good sciatica or back pain treatment plan, understanding what you want to ultimately accomplish helps with your recovery.

Once you take the assessment, check your email inbox for your "Report of Findings" so you can review our recommendations on which steps to take next.

Our intention is to have you walk away from this Back Pain Relief Scorecard exercise with greater clarity and a better understanding of how back pain is affecting you and to motivate and inspire you to start making some positive changes in your life.

Simply click anywhere on the bar to indicate your score or enter a number from 0 to 10 in the box to the right of the bar.

0 = Does not describe me at all          7 = Often describes me

4 = Occasionally describes me          10 = Completely describes me

I. Quality of Life

1. I have difficulty sleeping at night and when I do manage to fall asleep, it's only for a few minutes leaving me exhausted and irritable in the morning.

2. I feel a decreased sense of enjoyment in life - going to a movie, traveling, playing a round of golf, gardening - everything is such a chore that I'd just as soon do nothing than "pay the price" later.

3. I eat painkillers, muscle relaxants, and anti-inflammatory medications like candy - anything to try and stay ahead of the pain - but nothing seems to work anymore.

4. I have low energy and stamina, poor self-esteem, and I've even noticed a decrease in your libido.

5. I have difficulty performing the most simple tasks like getting dressed, cooking, cleaning house, going for a walk, shopping, or simply relaxing around the house. I can't even find a comfortable position to sit or stand for any length of time.

6. I'm constantly battling feelings of frustration and depression because I can't enjoy my normal life.

7. I feel grumpy and irritable all the time - I'm convinced people are tired of hearing me complain and, truthfully, I just don't feel very sociable.

8. I find it difficult to concentrate and can't seem to accomplish anything at work.

9. I've spent a small fortune on doctor visits, medications, and even the "miracle cures" I've seen on late night TV, but its all been a waste of time and money.

10. I feel just plain defeated all the time and I'm constantly wondering, "Will this pain ever go away?

II. My Commitment to a Pain Free Life (0 = not committed, 10 = totally committed)

1. I’m motivated to invest in myself in order to reduce or eliminate my back pain, within the next 30 days.

2. I’m open to discussing my personal goals, challenges, and opportunities that will help shape the life I want for myself.

3. If eligible, I’m ready to schedule a consultation to explore my back pain relief options.

Please provide your name and best email
to receive your Report of Findings.

The information submitted with this assessment will be processed and used by PRIMed for the purpose of sending you your assessment results.