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What to actually ask at your back-pain appointment

Print this page, take it to the appointment, ask the questions in order, and write the answers in the margin.

• Am I cleared for progressive loading of the lumbar extensors? 1

  This is the decision the rest of the visit should serve. A useful answer is yes, no plus a reason, or yes with named limits. “Stay active” does not settle it.

• Does anything on my exam or imaging restrict how I load? 2

  Scan language often reads like a ban. You want a specific restriction, or an explicit “nothing here changes loading.”

• Which symptoms mean I stop and come back? 3

  A blanket “stop if it hurts” ends training. A useful answer names stop signs in their words: new weakness, saddle numbness, bladder or bowel change, fever, trauma. Ordinary working ache is allowed.

• If I am cleared, can the demand rise while next-morning pain stays near my usual baseline? 4

  Capacity grows only while demand rises. A useful answer allows small steps paced by the next morning, not the same ten reps for months.

• Is the printed exercise sheet a start or the destination? 5

  Bird dogs and dead bugs have no load lever. A useful answer treats them as an on-ramp and then names a loaded extensor movement.

• Do I need another scan, injection, or adjustment series before I can start loading? 6

  The usual tour offers the next passive station. A useful answer gives a reason that station is required now, or says you can load.

Write the answers in the margin. After a clinician clears you to load, the program is the loaded 45-degree back-extension progression, paced by the next morning. Floor work is an on-ramp only if there is no 45-degree bench yet. The PT-sheet stall and the care circuit are the visits that usually skip question one.

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