Treatment Decision Guide
Step 1: Assess Your Current Symptoms
By answering the questions below, you can begin to see which treatment direction may be right for you.
This is not a diagnosis -- think of it as preparation for your conversation with your doctor.
Walking Ability
How far can you walk continuously?
| Answer | Severity |
|---|---|
| More than 500 meters | Mild |
| 100-500 meters | Moderate |
| 50-100 meters | Moderately severe |
| Less than 50 meters | Severe |
| Can barely walk at all | Severe |
Your answer: _______________
Pain Level
On a scale of 0 to 10, how would you rate your current pain? (0 = no pain, 10 = worst possible pain)
| Score | Level |
|---|---|
| 0-3 | Mild |
| 4-6 | Moderate |
| 7-10 | Severe |
Your score: _____ /10
Neurological Symptoms
Check any that apply to you:
- Numbness in the legs
- Reduced sensation in the legs
- Weakness in the legs
- Tendency to stumble or trip
- Difficulty urinating or urinary leakage
- Difficulty controlling bowel movements
If you have urinary or bowel symptoms, contact your doctor immediately.
Impact on Daily Life
Check any that apply to you:
- Unable to do housework
- Unable to go shopping
- Interferes with work
- Unable to enjoy hobbies
- Avoiding going out
- Unable to sleep at night
Number of items checked: _____ items