- Does laying provoke or ease symptoms?
- Which positions provoke or ease the symptoms?
- How many pillows does the patient use?
- Has there been a change in bed or mattress?
Is the patient woken by their symptoms?
- Is this provoked by movement
- How many times is the patient woken in one night?
- How many nights in the past week?
What does the patient do when they are woken?
- How do they get back to sleep?
- How long does it take them to get back to sleep?
Morning Symptoms
Prolonged morning pain and stiffness that improves minimally = inflammatory process (Magee, 2006). Minimal or absent pain in the morning with stiffness = degenerative condition such as osteoarthritis.
Evening Symptoms
- Beginning of day vs end - progression
- Pain that is aggravated by movement and eased at rest = mechanical problem
- Pain that increases with activity = repeated mechanical, inflammatory or degeneration
- Ischaemic pain is eased with activity
- If pain is worse in the evening, what are they doing throughout the day? What is their workplace like?
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