Back pain can be complex and difficult to describe in the short time you may have with your health
care provider. This tool can help you create a detailed picture of your pain---where it is, how it feels,
how much it hurts, and what triggers it. Fill it out before your visit, print it, and share it with your
provider. It will provide a lot of important information fast, so you and your provider can begin to
address your issues more quickly.
In addition, this tool can help you track your progress over time. Keep printouts of your results;
they will help you see which treatments and activities reduce your pain and which don’t. That can
be a big step in gaining better control over your pain and improving your quality of life.
1. Click at least one area of the body marked by a red arrow.
2. Select all symptoms that apply in the menu that appears.
3. Click 'Print' when ready.
Your Back Pain Map can be printed after selecting symptoms from at least one area of the body.