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Areas of pain
|
Rated the pain ___/10
|
|
2. Constant _____
|
Rated the pain ___/10
|
|
The symptoms seem to be increased by_____
• • •
|
|
|
Heart Evaluation:
|
|
|
Heart was examined and found to be normal
|
Comments
|
|
Lung Evaluation
|
|
|
Lungs were examined and found to be normal
|
Comments
|
|
Deep Tendon Reflex Testing:
|
|
|
All DTRs normal.
|
Comments
|
|
Sensory Perception:
|
|
|
Areas of hyperesthesia corresponding to the___
• • •
|
on the left/right
|
|
Comments
|
|
|
Orthopedic Evaluation
• • •
|
Comments
|
|
Palpation:
|
Subluxations were found at____
• • •
|
|
Lumbosacral R.O.M. Testing:
|
|
|
Flexion: (Normal = 60)
|
_____due to sharp pain and spasm
|
|
Extension: (Normal = 25)
|
_____due to sharp pain and spasm
|
|
Left Rotation: (Normal = 30)
|
_____due to sharp pain and spasm
|
|
Right Rotation: (Normal = 30)
|
_____due to sharp pain and spasm
|
|
Plan of Treatment
|
|
