Simple Patient History Checklist

This is an unfinished work. RSI sufferers will often ask for help and then apologize for being too long-winded in their request, but the opposite is usually the case... they need to supply MORE information, thus this checklist.

  1. I'm a computer user
  2. I do very repetitive or monotonous or strenuous non-computer work all day
  3. I've been using computers for more than 3 years
  4. I use the computer more than 4 hours per day
  5. I use the computer day and night
  6. I am a compulsive computer user
  7. I'm required to spend long hours at the computer
  8. I am a data entry worker
  9. I am a legal secretary
  10. I am a stenographer/court reporter/10-key operator or similar
  11. I am a long-time musician
  12. I do graphic art on the computer
  13. I do lots of mouse-intensive computer work
  14. I've spent years as an artist with traditional, non-computer tools
  15. My symptoms become noticeable when driving a car
  16. My symptoms become noticeable when on the phone
  17. I can reproduce my symptoms with deliberate actions
  18. My symptoms become noticeable when lifting my arms overhead or holding them up for much time
  19. I wake up at night with pain
  20. I wake up at night with numbness
  21. I find myself slouching forward when working
  22. I am over 30 years old
  23. I am over 40 years old
  24. I notice that wounds heal more slowly than in years past
  25. I am a perfectionist
  26. I'm sedentary away from work
  27. I've had my eyesight checked within a year
  28. I have a highly adjustable keyboard tray
  29. I have a highly adjustable chair
  30. I rest my wrists on the edges of the keyboard or desk when typing
  31. I type on a laptop computer a lot
  32. I'm under a lot of pressure or stress
  33. I eat a well-balanced diet
  34. My symptoms include pain
  35. My symptoms include imperfect nerve sensations in the fingers (sensations of full or partial numbness, or "pins-and-needles")
  36. I have imperfect nerve sensations in the pink and/or ring finger
  37. I have imperfect nerve sensations in the thumb/index/middle finger
  38. I have imperfect nerve sensations in all fingers
  39. I have imperfect nerve sensations or pain where the thumb meets the wrist
  40. My fingers seem colder than normal
  41. My fingertips are bluish
  42. I know I have an extra first rib
  43. I've often worked at the computer with my head looking to the side
  44. I've used chiropractic and it helps
  45. I've used chiropractic and it doesn't help
  46. I've used anti-inflammatory drugs and it helps
  47. I've used anti-inflammatory drugs and it doesn't help
  48. I've used surgery and it helps
  49. I've used surgery and it doesn't help
  50. I've used splints and it helps
  51. I've used splints and it doesn't help
  52. I've used Alexander, Feldenkrais, or similar and it helps
  53. I've used Alexander, Feldenkrais, or similar and it doesn't help
  54. I've used acupuncture and it helps
  55. I've used acupuncture and it doesn't help
  56. I've used massage therapy or similar and it helps
  57. I've used massage therapy or similar and it doesn't help
  58. I've used ice and it helps
  59. I've used ice and it doesn't help
  60. I've used heat and it helps
  61. I've used heat and it doesn't help

 

 

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