Survey

Take this brief self-survey to help you determine if chronic back pain is spinning a painweb within your life.

YOUR SYMPTOMS Yes No
Does your back pain shoot down your legs?
Do you have numbness or weaknessin your legs?
Do you have trouble controlling your bladder or bowels?
Are you taking pain medication all the time?
Do you have trouble with daily actions like getting out of bed?
YOUR FEELINGS
Is your pain worse when you’re upset, angry, or stressed?
Are you unhappy about the changesin your life caused by chronic pain?
Have you given up a lot in your work and social life due to chronic pain?
Does your family think your just complaining? Or, do you feel they are “babying” you?
Do you feel excluded, as though life is passing you by?
YOUR WORK
Is your job becoming harder to perform?
Are you losing income?
Is your employer unsympathetic about your chronic back pain?
Are your coworkers treating you differently?

THE MORE “YES” ANSWERS, THE MORE COMPLICATED YOUR PAINWEB.
mypainweb WILL SHOW YOU HOW TO TAKE CHARGE OF YOUR PAINWEB TO HELP REDUCE YOUR CHRONIC PAIN WHILE IMPROVING YOUR QUALITY OF LIFE.

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