Why do chiropractors take a thorough medical history?

Before getting started with any physical tests, the main thing to ask is, “how we can help you?”. When many patients visit a chiropractor for the first time, they will have no idea what to expect on the first visit. Getting a clear understanding of what symptoms you are experiencing, how they affect you, and the impact will help the chiropractor draw a clinical picture. It is crucial to get a solid understanding of the severity, irritability and nature of the condition to reduce the risk of any serious pathology.

Taking a history of the patient is a required component in the evaluation and management of care. Understanding the relevant information is essential to know why things have not been going the way we expect.

By gathering clinical information to determine a working diagnosis:

• An aspect of symptoms - location and distribution, type of pain, aggravating factors, relieving factors

• Current history - onset and mechanism

• Past history - previous injuries or occurrences

• Goals to provide an insight into patients expectations and help us understand the patient’s perspective on their injury.

To a patient, none of these questions may have anything to do with chiropractic. Understanding medical histories are vital for the treatment’s progress, as every person has a different history. For example, treatment for a senior with osteoporosis will be different to a young athlete.

For instance, low back pain is a broad concern, so getting as much information as possible provides more certainty for the chiropractor's diagnosis and ensures the correct treatment plan to get the patient better. Patients may not realise that having chronic knee injuries years ago may affect the hips and lower back. Or, changes in occupation may manifest symptoms to the back, and the list can go on. The more we know, the more we can help.

Getting every relevant information in the history will help put together the puzzle of the patient’s injury or pain.

References:

1. O'Sullivan PIt's time for change with the management of non-specific chronic low back painBritish Journal of Sports Medicine 2012;46:224-227.

2. Refshauge, K. M., & Gass, E. M. (Eds.). (2004). Musculoskeletal physiotherapy: clinical science and evidence-based practice. Butterworth-Heinemann Medical.

3. Boyd, E., & Heritage, J. (2006). Taking the history: Questioning during comprehensive history-taking. Studies in interactional sociolinguistics, 20, 151.