It won’t be a lot different from what you’re used to with other medical providers. I first gather a lot of information about you by asking questions: how your pain began, what is the effect on your pain when you do this or that, what your level of pain is, and any other symptoms you may have. If your information is in Duke MyChart, I’m going to read it beforehand. This includes if you have images -- MRIs, X-rays -- or blood work.
Then I’m going to perform an exam that assesses both the medical and mechanical aspects of your pain. For example, I’ll look at alignment, muscle tone, nerve function, how your body is moving, how well you can bend, turn, twist, and what kind of movements reproduce the symptoms you’re having. If you haven’t had X-rays or other imaging and we need to order it, we can do that. However, most patients do not need imaging at their first visit.
After the exam, we have a discussion: “This is what I think is happening with your spine, these are the treatments I would recommend, and this is how I think it will help you.” Since I’m part of a team, if I think a patient will get additional benefit or more benefit from seeing a physical therapist, physiatrist, spine surgeon, or other provider, I will also suggest that referral.