January 2006
Tell Me Where it Hurts
One of the most frustrating issues both the patient and their healthcare provider must deal with is poor communication. On some occasions when I see a patient about an injury, they go on at length providing details that do not relate to the problem. Here, in brief, are the details that you should provide your healthcare provider with to help them solve your injury problems.
We use the letters OPQRST to shape the history taking part of an examination.
O = Onset. This is the what, when, where and how question. Did you have trauma or not? Did this start slowly or suddenly? Is this recent or an ongoing injury. This question relates to the possible mechanism of the injury. Try to be accurate in describing things such as is the injury one week or one year old.
P = Palliative and Provocative. What makes the injury feel better or worse? Be specific with these details.
Q = Quality. What does the injury feel like? (Dull, achy, sharp, tingling, burning or loss of strength) If you have problems relating to these descriptions, try relating it to things you are familiar with.
R = Radiation. Does the pain stay in one place or does it travel around. If the pain travels around, what does this pain feel like?
S = Severity. How much does it hurt? I use a scale of 0 to 10, where 0 is no pain and 10 is the most pain you could possibly feel. Does the pain vary in intensity?
T = Temporal. What is the timing of the pain? Is there a certain time of day or night that the problem seems better or worse? Is there a pattern?
Hopefully, if you can go to your care provider with all these details in hand, a more focused and effective visit will be the result. I have found that it is not the amount of time spent during the visit that matters, it is the quality of information obtained that most determines a successful outcome.