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Chiropractic Research Review

Pain Drawings and Questionnaires: Valuable Tools

An accurate clinical diagnosis can frequently be reached with a careful physical evaluation and interpretation of patient symptoms. In the search for the cause of pain, patient-generated pain drawings have long been used to assess the site, distribution and quality of symptoms.



This study compared the magnetic resonance imaging reports and pain drawings of 100 patients with complaints of low-back or neck pain. Results showed that pain drawings (along with pain questionnaires) were a useful tool in the evaluation of patients, especially when the diagnosis of herniated nucleus pulposus or spinal stenosis was in question. The most conclusive findings were related to the negative predictive power of the pain drawings (the ability to rule out diseases based on sources of pain not indicated on the drawings by patients).

image - Copyright – Stock Photo / Register Mark


Pain drawings and questionnaires are helpful adjuncts in the clinical diagnosis of neck pain and upper extremity symptoms, and to a lesser degree in the diagnosis of lower back and lower extremity symptoms. These drawings are particularly useful in ruling out herniated nucleus pulposus or spinal stenosis in patients reporting localized neck or lower back symptoms without radiation, numbness or tingling. If you are not currently using these tools in your practice, consider them for your neck and back-pain patients.

Gioia F, Gorga D, Nagler W. The value of pain drawings in the care of neck and back pain. Journal of Back and Musculoskeletal Rehabilitation, 1997;8, pp209-14.

Chiropractic Research Review

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