In this section we ask some general questions about your illness. These answers will help our experts to understand your inquiry better. After submitting this form you will be redirectd to an upload form for files and medical images. You may leave this section empty and proceed to the "Submit" button below.
Please describe the beginning of you condition. How many weeks, months or years do you suffer already?
Please give us the clinical term(s) of your medical conditions
Is your condition work related, sports related, accident related, or age related?
Please describe your pain. Did the pain become worse quickly? Is it worse when you are walking? Do you feel pain while resting? Do you need pain medication? What gives you relieve (e.g. bending forward, sitting, lying down)
Particularly back pain do you feel numbness, loss of sensitivity, paralysis, Loss of motoric coordination, loss of strength or tingling in neck, back, arms, hands, legs, ankle or feet?
Here you can tell us about your health. Do you have underlying conditions such as osteoporosis, diabetes, obesity, high blood pressure, neurological conditions? Do you practise a particular sport? Do you have specific work related strains? Did you suffer a trauma in the past, such as an accident?