The Eloquent Physician - a Medical Record Software Program. Sample Doctor’s Chart Note

HISTORY: (firstName) presents to the office today for a follow up visit concerning (his_her) cervical symptomatology. {The patient denies any injuries subsequent to their previous visit. | The patient denies any injuries since their last visit. | The patient denies any injuries subsequent to their initial injury. | The patient notes that there was a new injury since their last visit to this office. {NEW INJURY LOCATION} {NEW INJURY SPECIFIC} | | The patient notes that there was an additional injury subsequent to their initial injury, but prior to today.} {The patient notes that there has been some modest improvement in their condition since the previous visit. | | The patient notes that there has been no improvement in their condition since the previous visit. | The patient notes that there has been no change in their condition since the previous visit. | The patient notes that there has been worsening in their condition since the previous visit. | There has been a complete resolution in the symptoms since the last visit.} {Chiropractic therapy has been continued since the last visit and has been found to be helpful. | Chiropractic therapy has been continued since the last visit but, unfortunately, has not been helpful. | Chiropractic therapy has been discontinued since the last visit. | Physical therapy continues to be undertaken, and has been helpful. | Physical therapy continues to be undertaken, but unfortunately has not been helpful. | Physical therapy has been discontinued since the last visit. | There is no therapy currently being performed. | The patient has been compliant with their therapy program. | The patient has been not been compliant with their therapy program. | The patient has continued therapy with some relief.} {Celebrex is being used, without difficulty, and with good results. | The patient will be changed to Mobic 7.5 mg 1 TAB PO QD. | Celebrex is being used, without difficulty, with fair results. | Vioxx is being used, without difficulty, with fair results. | Vioxx is being used, without difficulty, with good results. | Ibuprofen has been utilized with good results. | | Anti-inflammatory medications have been discontinued because of gastro-intestinal complications. | Anti-inflammatory medications have not been utilized because of a past history of gastro-intestinal difficulties. | | Advil | Aspirin | Accupril | Accutane | Adalat CC | Allegra | Augmentin | Axid | Azmacort | BuSpar | Calan SR | Cardizem CD | Cardura | Claritin D | Clozaril | Cordarone | Coumadin | Daypro | Depakote | Dilacor XR | Dilantin | Flonase | Fosamax | Glucophage | Humulin 70-30 | Humulin NPH | Hytrin | Imdur ER | Imitrex | K-Dur | Lamisil Oral | Lanoxin | Lescol | Lipitor | Lodine | Lotensin | Mevacor | Norvasc | Ortho-Novum | Oruvail | Paxil | Pepcid | Pravachol | Premarin | Prempro | Prevacid | Prilosec | Prinivil | Procardia XL | Propulsid | Prozac | Relafen | Rezulin | Risperdal | Serevent | Serzone | Sporanox | Synthroid | Ticlid | Toprol XL | Trental | Trtiphasil | Ultram | Vasotec | Zantac | Zestril | Ziac | Zocor | Zoloft | Zovirax | Zyprexa | Zyrtec} {The patient has been working. | The patient has been working at full duty. | The patient has been working at full duty, but is having problems with the current work load and needs new restrictions imposed. | The patient is not currently employed, but anticipates starting a new job in the near future. | The patient has been working at light duty, but feel ready to begin unrestricted duty after today's evaluation. | The patient has been working, but at a restricted duty. | The patient has not been working at all.} {No additional studies are available for today's visit. | The patient has had an MRI for the right shoulder, but the results are not yet available. | The patient has had an MRI for the left shoulder, but the results are not yet available. | The patient presents to the office today with an MRI of the cervical spine. The results show no evidence of frank disc herniation. | The patient presents to the office today with an MRI of the cervical spine. The results show evidence of frank disc herniation at the level of {C-SPINE HNP}. | The patient presents to the office today with an MRI of the lumbar spine. The results show evidence of frank disc herniation at the level of {HNP L-SPINE}. | The patient presents to the office today with the results of an EMG-NCS of the RUE. The results show evidence of carpal tunnel syndrome. | The patient presents to the office today with the results of an EMG-NCS of the LUE. The results show evidence of carpal tunnel syndrome. | The patient presents to the office today with the results of EMG-NCS of BUE. The results show evidence of carpal tunnel syndrome in both wrist. | The patient presents to the office today with the results of EMG-NCS of the RLE. The results show evidence of radiculopathy at the level of {HNP L-SPINE}. | The patient presents to the office today with the results of EMG-NCS of the LLE. The results show evidence of radiculopathy at the level of {HNP L-SPINE}. | An MRI is available for review during today's visit. | An MRI report is available for review during today's visit. | An EMG report is available for review during today's visit.} PHYSICAL EXAMINATION: {Cervical flexion: {C-SPINE FLEXION} degrees Cervical extension: {C-SPINE EXTENSION} degrees Left lateral bending: {C-SPINE L-LATERAL BEND} degrees Right lateral bending: {C-SPINE R-LATERAL BEND} degrees Turning to the left: {C-SPINE L-ROTATION} degree | The range of motion in the cervical region is moderately diminished. | The range of motion in the cervical region is mildly diminished. | The range of motion in the cervical region is severely diminished. | The range of motion in the cervical region is normal.} {There is no loss of motor strength in either upper extremity. | There is mild loss of motor strength in the right upper extremity. | There is mild loss of motor strength in the left upper extremity. | There is severe loss of motor strength in the right upper extremity. | There is severe loss of motor strength in the left upper extremity. | There is severe loss of motor strength in the right upper extremity with visible atrophy noted in the dorsal interosseous muscles and the thenar eminence. | There is severe loss of motor strength in the left upper extremity with visible atrophy noted in the dorsal interosseous muscles and the thenar eminence.} { | The reflexes in both upper extremities are equal. | There is a diminished brachioradialis reflex in the left upper extremity. | There is a diminished brachioradialis reflex in the right upper extremity. | There is a diminished finger jerk reflex in the right upper extremity. | There is a diminished finger jerk reflex in the left upper extremity. | There is evidence of a hyper-reflexive response in the right upper extremity. | There is evidence of a hyper-reflexive response in the left upper extremity. | There is evidence of a hyper-reflexive response in both upper extremities. | There is a diminished biceps reflex in the right upper extremity. | There is a diminished triceps reflex in the right upper extremity. | There is a diminished triceps reflex in the left upper extremity. | There is a diminished biceps reflex in the left upper extremity. | The patient's reflexes are observed to be non-responsive in both upper extremities.} {There is diffuse tenderness noted throughout the cervical region. | There is severe tenderness in the right trapezial region. | There is severe tenderness in the left trapezial region. | There is severe tenderness in the left scapulothoracic region. | There is severe tenderness in the right scapulothoracic region. | There is severe tenderness in the right and left scapulothoracic region. | There is severe tenderness noted throughout the cervical region. | There is tenderness noted in the trapezial region. | There is tenderness noted in the paracervical region. | There is tenderness noted in the rhomboids. | There is tenderness at the base of the occiput.} {There is mild spasm in the trapezius musculature bilaterally. | There is mild spasm in the trapezius musculature on the right. | There is mild spasm in the trapezius musculature on the left. | There is moderate spasm in the trapezius musculature bilaterally. | There is moderate spasm in the trapezius musculature on the right. | There is moderate spasm in the trapezius musculature on the left. | There is severe spasm in the trapezius musculature bilaterally. | There is severe spasm in the trapezius musculature on the right. | There is severe spasm in the trapezius musculature on the left. | Spasm is noted in the paracervical musculature bilaterally. | Spasm is noted in the paracervical musculature on the right. | Spasm is noted in the paracervical musculature on the left.} {There is normal sensation in both upper extremities. | There is evidence of decreased sensation to light touch and pin prick along the median nerve distribution in the right upper extremity. | There is evidence of decreased sensation to light touch and pin prick along the median nerve distribution in the left upper extremity. | There is evidence of decreased sensation to light touch and pin prick along the median nerve distribution in the both upper extremities. | There is evidence of decreased sensation to light touch and pin prick along the ulnar nerve distribution in the both upper extremities. | There is evidence of decreased sensation to light touch and pin prick along the ulnar nerve distribution in the left upper extremity. | There is evidence of decreased sensation to light touch and pin prick along the ulnar nerve distribution in the right upper extremity. | There is diminished sensation in both upper extremities. | There is diminished sensation in the right upper extremity. | There is diminished sensation in the left upper extremity.} { | The vascular status of each upper extremity is within normal limits. | There is diminished vascularity of the right upper extremity. | There is diminished vascularity of the left upper extremity.} DIAGNOSIS: {Cervical sprain - strain. | Cervical HNP at {C-SPINE HNP}. | Muscle spasm. | A radiculopathy. | A radiculopathy in the RUE. | A radiculopathy in the LUE. | A radiculopathy in both upper extremities. | Cervical instability.} PLAN: {It is my recommendation that this patient continue the therapy and medication program currently in progress. | I would recommend that we add a therapy program to the treatment plan at this point in time. | I would recommend that we add anti-inflammatory medications to the treatment program now. | I would recommend that we obtain an MRI of the cervical region. | I would recommend that we obtain an EMG of the right upper extremity. | I would recommend that we obtain an EMG of the left upper extremity.} {I would recommend that there be no limitation in the work activities at this point in time. | I would recommend that this patient be maintained at a light duty work status. | I would recommend that this patient be maintained at a moderate duty work status. | I would recommend that this patient be maintained at a sedentary work status consisting of administrative type task only. | I would recommend that this patient be maintained at a sedentary work status. | Since this patient still has symtomatology, I would recommend that they continue working, but only within their pain tolerance. | The patient is going to attempt a resumption of their current occupation with the understanding the an adjustment in work status may be required if the task prove to be difficult or painful.} {I have asked this patient to return to the office in 1 week. | I have asked this patient to return to the office in 2 weeks. | I have asked this patient to return to the office in 3 weeks. | I have asked this patient to return to the office in 4 weeks. | I have asked this patient to return to the office in 4 weeks, at which time the patient will likely be placed a MMI. | I have asked this patient to return to the office in 6 weeks. | I have asked this patient to return to the office in 8 weeks.}

HISTORY: (firstName) presents to the office today for a follow up visit concerning (his_her) cervical and lumbosacral symptomatology. {The patient denies any injuries subsequent to their previous visit. | The patient denies any injuries since their last visit. | The patient denies any injuries subsequent to their initial injury. | The patient notes that there was a new injury since their last visit to this office. {NEW INJURY LOCATION} {NEW INJURY SPECIFIC} | | The patient notes that there was an additional injury subsequent to their initial injury, but prior to today.} {The patient notes that there has been some modest improvement in their condition since the previous visit. | | The patient notes that there has been no improvement in their condition since the previous visit. | The patient notes that there has been no change in their condition since the previous visit. | The patient notes that there has been worsening in their condition since the previous visit. | There has been a complete resolution in the symptoms since the last visit.} {Chiropractic therapy has been continued since the last visit and has been found to be helpful. | Chiropractic therapy has been continued since the last visit but, unfortunately, has not been helpful. | Chiropractic therapy has been discontinued since the last visit. | Physical therapy continues to be undertaken, and has been helpful. | Physical therapy continues to be undertaken, but unfortunately has not been helpful. | Physical therapy has been discontinued since the last visit. | There is no therapy currently being performed. | The patient has been compliant with their therapy program. | The patient has been not been compliant with their therapy program. | The patient has continued therapy with some relief.} {Celebrex is being used, without difficulty, and with good results. | The patient will be changed to Mobic 7.5 mg 1 TAB PO QD. | Celebrex is being used, without difficulty, with fair results. | Vioxx is being used, without difficulty, with fair results. | Vioxx is being used, without difficulty, with good results. | Ibuprofen has been utilized with good results. | | Anti-inflammatory medications have been discontinued because of gastro-intestinal complications. | Anti-inflammatory medications have not been utilized because of a past history of gastro-intestinal difficulties. | | Advil | Aspirin | Accupril | Accutane | Adalat CC | Allegra | Augmentin | Axid | Azmacort | BuSpar | Calan SR | Cardizem CD | Cardura | Claritin D | Clozaril | Cordarone | Coumadin | Daypro | Depakote | Dilacor XR | Dilantin | Flonase | Fosamax | Glucophage | Humulin 70-30 | Humulin NPH | Hytrin | Imdur ER | Imitrex | K-Dur | Lamisil Oral | Lanoxin | Lescol | Lipitor | Lodine | Lotensin | Mevacor | Norvasc | Ortho-Novum | Oruvail | Paxil | Pepcid | Pravachol | Premarin | Prempro | Prevacid | Prilosec | Prinivil | Procardia XL | Propulsid | Prozac | Relafen | Rezulin | Risperdal | Serevent | Serzone | Sporanox | Synthroid | Ticlid | Toprol XL | Trental | Trtiphasil | Ultram | Vasotec | Zantac | Zestril | Ziac | Zocor | Zoloft | Zovirax | Zyprexa | Zyrtec} {The patient has been working. | The patient has been working at full duty. | The patient has been working at full duty, but is having problems with the current work load and needs new restrictions imposed. | The patient is not currently employed, but anticipates starting a new job in the near future. | The patient has been working at light duty, but feel ready to begin unrestricted duty after today's evaluation. | The patient has been working, but at a restricted duty. | The patient has not been working at all.} {No additional studies are available for today's visit. | The patient has had an MRI for the right shoulder, but the results are not yet available. | The patient has had an MRI for the left shoulder, but the results are not yet available. | The patient presents to the office today with an MRI of the cervical spine. The results show no evidence of frank disc herniation. | The patient presents to the office today with an MRI of the cervical spine. The results show evidence of frank disc herniation at the level of {C-SPINE HNP}. | The patient presents to the office today with an MRI of the lumbar spine. The results show evidence of frank disc herniation at the level of {HNP L-SPINE}. | The patient presents to the office today with the results of an EMG-NCS of the RUE. The results show evidence of carpal tunnel syndrome. | The patient presents to the office today with the results of an EMG-NCS of the LUE. The results show evidence of carpal tunnel syndrome. | The patient presents to the office today with the results of EMG-NCS of BUE. The results show evidence of carpal tunnel syndrome in both wrist. | The patient presents to the office today with the results of EMG-NCS of the RLE. The results show evidence of radiculopathy at the level of {HNP L-SPINE}. | The patient presents to the office today with the results of EMG-NCS of the LLE. The results show evidence of radiculopathy at the level of {HNP L-SPINE}. | An MRI is available for review during today's visit. | An MRI report is available for review during today's visit. | An EMG report is available for review during today's visit.} PHYSICAL EXAMINATION: {Cervical flexion: {C-SPINE FLEXION} degrees Cervical extension: {C-SPINE EXTENSION} degrees Left lateral bending: {C-SPINE L-LATERAL BEND} degrees Right lateral bending: {C-SPINE R-LATERAL BEND} degrees Turning to the left: {C-SPINE L-ROTATION} degree | The range of motion in the cervical region is moderately diminished. | The range of motion in the cervical region is mildly diminished. | The range of motion in the cervical region is severely diminished. | The range of motion in the cervical region is normal.} {There is no loss of motor strength in either upper extremity. | There is mild loss of motor strength in the right upper extremity. | There is mild loss of motor strength in the left upper extremity. | There is severe loss of motor strength in the right upper extremity. | There is severe loss of motor strength in the left upper extremity. | There is severe loss of motor strength in the right upper extremity with visible atrophy noted in the dorsal interosseous muscles and the thenar eminence. | There is severe loss of motor strength in the left upper extremity with visible atrophy noted in the dorsal interosseous muscles and the thenar eminence.} { | The reflexes in both upper extremities are equal. | There is a diminished brachioradialis reflex in the left upper extremity. | There is a diminished brachioradialis reflex in the right upper extremity. | There is a diminished finger jerk reflex in the right upper extremity. | There is a diminished finger jerk reflex in the left upper extremity. | There is evidence of a hyper-reflexive response in the right upper extremity. | There is evidence of a hyper-reflexive response in the left upper extremity. | There is evidence of a hyper-reflexive response in both upper extremities. | There is a diminished biceps reflex in the right upper extremity. | There is a diminished triceps reflex in the right upper extremity. | There is a diminished triceps reflex in the left upper extremity. | There is a diminished biceps reflex in the left upper extremity. | The patient's reflexes are observed to be non-responsive in both upper extremities.} {There is diffuse tenderness noted throughout the cervical region. | There is severe tenderness in the right trapezial region. | There is severe tenderness in the left trapezial region. | There is severe tenderness in the left scapulothoracic region. | There is severe tenderness in the right scapulothoracic region. | There is severe tenderness in the right and left scapulothoracic region. | There is severe tenderness noted throughout the cervical region. | There is tenderness noted in the trapezial region. | There is tenderness noted in the paracervical region. | There is tenderness noted in the rhomboids. | There is tenderness at the base of the occiput.} {There is mild spasm in the trapezius musculature bilaterally. | There is mild spasm in the trapezius musculature on the right. | There is mild spasm in the trapezius musculature on the left. | There is moderate spasm in the trapezius musculature bilaterally. | There is moderate spasm in the trapezius musculature on the right. | There is moderate spasm in the trapezius musculature on the left. | There is severe spasm in the trapezius musculature bilaterally. | There is severe spasm in the trapezius musculature on the right. | There is severe spasm in the trapezius musculature on the left. | Spasm is noted in the paracervical musculature bilaterally. | Spasm is noted in the paracervical musculature on the right. | Spasm is noted in the paracervical musculature on the left.} {There is normal sensation in both upper extremities. | There is evidence of decreased sensation to light touch and pin prick along the median nerve distribution in the right upper extremity. | There is evidence of decreased sensation to light touch and pin prick along the median nerve distribution in the left upper extremity. | There is evidence of decreased sensation to light touch and pin prick along the median nerve distribution in the both upper extremities. | There is evidence of decreased sensation to light touch and pin prick along the ulnar nerve distribution in the both upper extremities. | There is evidence of decreased sensation to light touch and pin prick along the ulnar nerve distribution in the left upper extremity. | There is evidence of decreased sensation to light touch and pin prick along the ulnar nerve distribution in the right upper extremity. | There is diminished sensation in both upper extremities. | There is diminished sensation in the right upper extremity. | There is diminished sensation in the left upper extremity.} { | The vascular status of each upper extremity is within normal limits. | There is diminished vascularity of the right upper extremity. | There is diminished vascularity of the left upper extremity.} {Lumbar range of motion is mildly to moderately diminished in all planes consistent with previous examinations. | The lumbar range of motion is noted to be diminished in all planes and is consistent with previous examinations. | The lumbar range of motion is noted to be normal in all planes of movement. | The lumbosacral range of motion is noted as follows: Flexion: {L-SPINE FLEXION} degrees Extension: {L-SPINE EXTENSION} degrees Left Lateral Bending: {L-SPINE L-LATERAL BEND} degrees Right Lateral Bending: {L-SPINE R-LATERAL BEND} degrees | The lumbar range of motion is noted to be severely diminished in all planes of movement.} {The motor function in both lower extremities is within normal limits. | The motor function in both lower extremities is noted to be diminished. | The motor function in the RLE is noted to be diminished. | The motor function in the LLE is noted to be diminished. | The motor function in the LLE is noted to be severely diminished. | The motor function in the RLE is noted to be severely diminished. | The motor function in the RLE is noted to be severely diminished with obvious muscle atrophy. | The motor function in the LLE is noted to be severely diminished with obvious muscle atrophy.} { | Reflexes in both lower extremities are noted to be equal and symmetrical. | Reflexes in both lower extremities are noted to be diminished. | Reflexes in both lower extremities are noted to be severely diminished. | Reflexes in both lower extremities are noted to be absent. | Reflexes in the LLE are noted to be absent. | Reflexes in the RLE are noted to be absent. | Reflexes in the RLE are noted to be diminished. | Reflexes in the LLE are noted to be diminished. | Reflexes in the LLE are noted to be hyper-reflexive. | Reflexes in the RLE are noted to be hyper-reflexive.} {On palpation of the paralumbar region, tenderness is noted at the level of L5-S1 bilaterally. | On palpation of the paralumbar region, tenderness is noted at the level of L5-S1 on the right side only. | On palpation of the paralumbar region, tenderness is noted at the level of L5-S1 on the left side only. | On palpation of the paralumbar region, tenderness is noted to be present throughout the thoracolumbar junction bilaterally. | On palpation of the paralumbar region, tenderness is noted to be present throughout the thoracolumbar junction on the right side. | On palpation of the paralumbar region, tenderness is noted to be present throughout the thoracolumbar junction on the left side. | On palpation of the paralumbar region, tenderness is noted to be present in the right sacroiliac joint. | On palpation of the paralumbar region, tenderness is noted to be present in the left sacroiliac joint. | On palpation of the paralumbar musculature, spasm is noted to be greater on the left. | On palpation of the paralumbar musculature, spasm is noted to be greater on the right. | On palpation of the paralumbar musculature, spasm is noted to be present bilaterally.} {Spasm is noted in the paralumbar musculature at the level of L5-S1 bilaterally. | Spasm is noted in the paralumbar musculature at the level of L5-S1 on the right side. | Spasm is noted in the paralumbar musculature at the level of L5-S1 on the left side. | Spasm is noted in the right thoracolumbar junction. | Spasm is noted in the left thoracolumbar junction. | Severe spasm is noted in the left thoracolumbar junction. | Severe spasm is noted in the right thoracolumbar junction.} {Sensory examination of the lower extremities is normal. | Sensory examination in the lower extremities is diminished. | Sensory examination in the lower extremities is severely diminished. | Sensory examination in the lower extremities is absent. | Sensory examination in the lower extremities is hyper-responsive to light touch. | Sensation to pin prick and light touch in the right lower extremity is diminished. | Sensation to pin prick and light touch in the left lower extremity is diminished. | Sensation to pin prick and light touch in the left lower extremity is severely diminished. | Sensation to pin prick and light touch in the right lower extremity is severely diminished.} { | The vascular status in both lower extremities is normal. | The vascular status in the RLE is diminished. | The vascular status in the LLE is diminished. | The vascular status in the LLE is severely compromised and the patient will require a vascular consult. | The vascular status in the RLE is severely compromised and the patient will require a vascular consult. | The vascular status in BLE is severely compromised and the patient will require a vascular consult.} DIAGNOSIS: {Cervical sprain - strain. | Cervical HNP at {C-SPINE HNP}. | Muscle spasm. | A radiculopathy. | A radiculopathy in the RUE. | A radiculopathy in the LUE. | A radiculopathy in both upper extremities. | Cervical instability.} {Lumbosacral sprain - strain | Lumbar HNP at {HNP L-SPINE}. | Lumbosacral spondylosis. | Lumbosacral spondylolisthesis at L5-S1. | Lumbosacral spina bifida occulta. | Lumbosacral DJD.} PLAN: {It is my recommendation that this patient continue the therapy and medication program currently in progress. | The patient will continue with the prescribed therapy and will be placed on Mobic 7.5 mg, Skelaxin 400 mg. | I would recommend that we add a therapy program to the treatment plan at this point in time. | I would recommend that we add anti-inflammatory medications to the treatment program now. | I would recommend that we obtain an MRI of the cervical region. | I would recommend that we obtain an EMG of the right upper extremity. | I would recommend that we obtain an EMG of the left upper extremity. | The patient has been instructed on a general conditioning program consisting of McKenzie exercises for the low back. | The patient will be scheduled for epidural steroid injections in the lumbar spine due to chronic pain that has not responded to conservative modalities. | The patient will be scheduled for an MRI of the lumbar spine to rule out disc pathology. In the mean time, the patient will continue with therapy and anti-inflammatory medications as directed. | The patient will be scheduled for a provocative discogram to evaluate for integrity of the annulus.} {I would recommend that there be no limitation in the work activities at this point in time. | I would recommend that this patient be maintained at a light duty work status. | I would recommend that this patient be maintained at a moderate duty work status. | I would recommend that this patient be maintained at a sedentary work status consisting of administrative type task only. | I would recommend that this patient be maintained at a sedentary work status. | Since this patient still has cervical symtomatology, I would recommend that they continue working, but only within their pain tolerance. | The patient is going to attempt a resumption of their current occupation with the understanding the an adjustment in work status may be required if the task prove to be difficult or painful. | Since this patient still has cervical and lumbar symtomatology, I would recommend that they continue working, but only within their pain tolerance.} {I have asked this patient to return to the office in 1 week. | I have asked this patient to return to the office in 2 weeks. | I have asked this patient to return to the office in 3 weeks. | I have asked this patient to return to the office in 4 weeks. | I have asked this patient to return to the office in 4 weeks, at which time the patient will likely be placed a MMI. | I have asked this patient to return to the office in 6 weeks. | I have asked this patient to return to the office in 8 weeks.} { | When the patient returns for their next evaluation, they will present with the MRI films for review. Further recommendations will be made at that time depending on the results. | I have asked the patient to keep a mental diary regarding their response to the previous trigger point injections. If the response has been favoralble, then additional injections will be offered. | I have asked the patient to keep a mental diary regarding their response to the epidural steroid injections. If the response has been favorable, then additional injections will be offered. | When the patient returns for their next evaluation, treatment considerations will consist of trigger point injections, medicinal magnets, natural relief and diagnostic studies. | When the patient returns for their next evaluation, treatment considerations will consist of a surgical consult regarding chronic pain. | When the patient returns for their next evaluation, treatment considerations will consist placing the patient at MMI. | When the patient returns for their next evaluation, treatment considerations will consist of a physical medicine consult regarding chronic pain. | When the patient returns for their next evaluation, treatment considerations will consist of patient education regarding activities to avoid in the future.}