It is essential to take a thorough history when you have a client in pain. Too often, therapists will begin with orthopedic tests or treatment without getting a good history of the problem.
In this video, I offer a mnemonic to help you remember questions to ask when a client presents with pain. The seven-word mnemonic is based on the letters of the alphabet OPPQRST, standing for:
Onset
Provoke, Palliate
Quality
Radiation
Severity
Time
O – Onset
What were you doing when the pain first occurred? Often, this question in itself will tell you the cause of the pain.
P – Provoke, Palliate
What makes the pain better? What makes it worse?
This can provide clues to the cause of the pain and also guide you in your treatment.
Q – Quality
What is the quality of the pain? Is it dull, sharp, burning, aching, throbbing, etc.? Different qualities have different meanings. Dull pain tends to be chronic; sharp pain is more acute. Throbbing pain may be vascular, as in a migraine headache. Burning pain may be from muscle tears or nerve irritation.
R – Radiation
Does the pain travel anywhere from where you feel it most? This can indicate pressure on a nerve root or referred pain from a trigger point.
S – Severity
Does the pain prevent you from participating in any activities?
T – Time
How long does the pain last when you have it? Are there times of day when it is worse?