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Pain
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1) Do you use any of these pain medications?
*
Non steroidal anti-inflammatory drugs including aspirin (NSAIDS)
Acetamenophen (Tylenol)
Narcotics
Neurontin or Lyrica
Dimethylsulfoxide (DMSO)
Others
No, I don't take pain medications
2) Do you use any of these modalities to manage your pain?
*
Acupuncture/Acupressure
Chiropractic/Osteopathy
Homeopathy
Physical therapy
Somatic therapies
Infrared light therapy (photonic stimulation)
Electrical stimulation (Transcutaneous electrical nerve stimulation, or TENS unit)
Other
No, I don't use health care modalities to treat my pain
Hypnotherapy/Guided imagery
Qigong/Tai Chi/Yoga
Energy medicine
Biofeedback
3) What kind of pain do you have?
*
Arthritis (osteoarthritis, rheumatoid arthritis, gout)
Fibromyalgia
Dental
Lumbar/cervical disc disease
Compression fracture
Reflex sympathetic dystrophy (RSD or CRPS)
Plantar fasciitis
Bone pain from cancer metastases
Sports or other injury
Carpal tunnel/repetitive stress injuries
Headache
Fractured bone(s)
Shingles
Trigeminal neuralgia
Post surgical pain
Other
4) Does pain interfere with your sleep?
*
Yes
No
5) Does pain restrict your activities?
*
Yes
No
6) Are you on an anti-inflammatory diet?
*
Yes
No
7) Are you anxious or depressed?
*
Yes
No
8) Are you interested in lifestyle, dietary, and supplement recommendations to help your symptoms?
*
Yes
No
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