Table 1 Vertebral Screening Questionnaire

Your pain

Have you ever had, or do you have now, severe back pain?

Does your back pain shoots down to one or both of your legs?

Has your back affected your sleep?

Are you able to lie down on your back?

Does sitting aggravates your back pain?

Do you feel tingling/numbness/pins and needles in your feet or toes?

Does your back pain increase with rolling over or sitting up after lying down?

Your look

Have you noticed that you developed a hump in your back or your back started to bend forward?

Have you noticed that you got shorter than before or lost few centimeters of your height?

Do you find it difficult to look in front of you?

Medical status

Have you ever been diagnosed with osteoporosis?

Have you ever been diagnosed as having vertebral fracture?

Have you ever had infection in your spine?

Have you ever been diagnosed to have cancer?

Have you ever jumped or fell from a height?

Did you undergo spine surgery before?

Do you have a history of falling from standard height before the development of back pain?

Do you have history of high energy trauma or accident before the development of back pain?

Have you ever been diagnosed to have kidney failure?

Have you ever been diagnosed to have heart problem(s)?

Investigations

Have you had an X-ray or MRI scan for your back recently?

Have you ever had a scan for osteoporosis?

Have you had recent blood checks?