Psychosocial Questioning, Questionnaires and Judging Relevance

Mark leaves explicit psychosocial questions to the end of the subjective examination, once rapport is built, opening with questions about understanding and asking how the patient is coping. Screening applies to every patient and every pain type, including the athlete ignoring hamstring soreness before a game. Questionnaires show what a person thinks but not why. He contrasts multidimensional tools such as the Örebro Musculoskeletal Pain Screening Questionnaire with unidimensional ones, including the Fear Avoidance Beliefs Questionnaire, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Pain Self-Efficacy and Brief Illness Perception Questionnaire, and matches them to cues from the history, such as the Central Sensitization Inventory for widespread pain. Results should be checked against cutoff scores and reviewed with the patient to discuss the reasons behind their answers. Relevance is judged through behavioral and historical relationships: psychosocial factors may dominate, be present but well managed, contribute alongside physical impairment, or act as a risk factor for persistent symptoms.