Back Pain Assessment

Back pain affects more than just your body—it can impact your daily routine, mobility, and quality of life. This back pain assessment includes real-life statements from people just like you who have struggled with back pain.

As you read through each sentence, think about how you feel today. If a statement reflects your current experience, check the box next to it. If it doesn’t apply, simply move on to the next. This tool is not a diagnosis, but it can help you—and us—understand how your pain is affecting your life and whether you may benefit from non-surgical back pain relief at Waterside Chiropractic + Medical.

Take a few moments to complete the assessment honestly. Your responses may be the first step toward feeling better and getting your life back.

  • Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.
  • This field is for validation purposes and should be left unchanged.