How to express the chief complaint and current medical history online The description of your condition (onset time, main symptoms, hospital visited) in the patient consultation area is the most central and important part, equivalent to the first question of the doctor when you go to the hospital: “Where are you not feeling well (how do you which?)” That is to ask you the main symptoms of the onset of the disease, plus the time of the onset of the disease, which constitutes your chief complaint, that is, the first sentence of the doctor to write the clinic or medical record, so it is very critical. The next step is to start a dialogue for your complaint, so as to further understand the relative details of your entire disease development process, and then the doctor can summarize and infer your preliminary diagnosis, and then give the corresponding necessary auxiliary examinations according to the clues provided, which often involve imaging examinations, i.e. X-ray, CT, MRI, etc. For patients with cervical and lumbar pain, some of them need blood sampling. For patients with cervical and lumbar pain, imaging tests, i.e. X-ray, CT, MRI, etc., and blood tests to understand whether there is rheumatoid, inflammation, gout, etc., and a small number of patients need electromyography, vascular ultrasound or TCD (transcranial Doppler examination), etc., so as to provide a more scientific, rigorous and effective treatment plan, which is the common process when going to outpatient clinics. Online consultation does not have such conditions, and because of this, it is important to accurately express the chief complaint and current medical history. What are symptoms? A symptom is the experience and sensation of an abnormal physiological function of the body after an illness or discomfort. For patients with neck, back and leg pain, the most common symptom is pain. A good expression of the nature, location, extent, time of onset, and factors affecting the pain is important for the diagnosis of degenerative spine disease. The nature of pain includes dull, aching, distending, and boring pain; sharp, stabbing, cutting, burning, and cramping pains. The form of pain is divided into drill-top-like pain; violent cracking pain; throbbing pain; tearing pain; pulling pain; and pressure-like pain. The degree of pain is divided into micro-pain like pain and non-pain, often compounded with other sensations. Such as itching, soreness, heaviness, discomfort, etc.; light pain with pain limitation and pain response; very pain with more pain and strong pain response; severe pain with unbearable pain and strong pain response. The pain should indicate whether it is related to labor, position change, walking, weight bearing, coughing, sneezing, weather changes, etc., whether it is pain when resting in bed, or pain after turning over and moving, whether it is daytime or nighttime pain, and how the pain changes throughout the evolution of the disease, how the treatment is, and how effective it is. Is there any accompanying pain in other parts of the body, etc.? As for the expression of the pain site, it is necessary to understand the basic anatomical structure of the human body first, please refer to the figure below to express it basically. The second common symptom is numbness. The original meaning refers to the loss of sensation, which is similar to “paralysis” in colloquial language. The term “numbness” refers to the feeling of insects walking in the muscles and pressing on them; “wood” refers to the lack of pain and itchiness in the skin and the lack of knowledge when pressing on it. For patients with cervical, lumbar and leg pain, it is common to have numbness in the upper or lower extremities, or numbness in the back of the neck and lower back. This is mostly an abnormal reflection of the sensory nerves, sometimes accompanied by a decrease in the temperature of the affected limb and a feeling of coldness. The third common symptom is mobility disorder. It refers to the loss of random muscle movement. Some people express it as inability to move, inability to move, weakness, tenderness, walking like stepping on cotton, unstable walking, paralysis, etc., or it is called inability to hold things, unstable holding things. There are 10 main types of movement disorders, but cervical and lumbar pain mainly involves (1) movement disorders caused by lesions of motor conduction pathways. This includes movement disorders caused by upper motor neuron lesions and movement disorders caused by lower motor neurons; (2) movement disorders caused by lesions of the extravertebral system. Patients have increased muscle tone and generalized muscle stiffness, so they have clumsy movements, difficulty in fine movements, slow walking, panic gait, and dull expression. Commonly seen in Parkinson’s disease or Parkinson’s syndrome. (3) Movement disorders caused by muscle lesions, myasthenia gravis, progressive muscular atrophy, etc.; (4) Movement disorders caused by skeletal lesions. The fourth common symptom is dizziness, which is a functional brain disorder. When dizziness is accompanied by balance perception disorder or spatial perception orientation disorder, patients feel that their peripheral environment or themselves are rotating, moving or shaking, which is also one of the common clinical symptoms. It is also a common clinical symptom. It is a feeling of dizziness, dizziness, light-headedness, shaking in the brain, and blurred vision. Dizziness can be caused by a variety of reasons. In addition to cervical spondylosis causing cervical spinning dizziness, it is also commonly associated with febrile diseases, hypertension, cerebral arteriosclerosis, craniocerebral trauma syndrome, neuropathy, etc. In addition, anemia, arrhythmia, heart failure, hypotension, drug intoxication, uremia, and asthma can also cause dizziness. Dizziness is also often present in the early stages of depression. So dizziness is very complex and needs to be carefully identified. The fifth symptom is dysbiosis. This refers to the inability to control urination and defecation voluntarily, or incomplete control. This is a sign of severe spinal cord or cauda equina damage and requires immediate examination and treatment in a hospital. The present medical history is the whole course of the patient’s illness, i.e., the occurrence, development, evolution and treatment. It includes seven aspects: (1) the onset of the disease and the duration of the disease. (2) The characteristics of the main symptoms: the location, nature, duration and degree of the main symptoms, and the factors of remission or exacerbation; (3) Causes and triggers: causes – such as trauma, etc., and triggers – such as climate change, environmental changes, emotions, etc.; (4) The development and evolution of the disease: including (5) Concomitant symptoms: a series of other symptoms appear at the same time on top of the main symptoms; (6) Diagnosis and treatment; such as which hospital to visit, what drugs have been taken, Chinese and Western medicines, massage, etc.; (7) General conditions during the course of the disease: such as mental and physical state, appetite, sleep, urination and defecation after the disease. Among them, it is worth noting the issue of the time of onset, especially if you have a history of chronic back and leg pain, it is best to remember from the initial discovery of pain (maybe years, decades, maybe months are good), in the middle maybe there has been an improvement or no pain, the recent pain and when such changes are meaningful, it is best to provide out. In this way, the content provided by your consultation is enriched and the doctor will be better able to capture useful information to help you solve the problem.