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Welcome To { Our Center for Best treatment by Top Spine Surgeon in Bangalore | Best spine surgeon in bangalore}

Online Query

Putting patient’s interests before everything else! Caring & curing with compassion!

Dr. Pithwa is a Consulting Spine Surgeon, practicing in Bangalore, India. You can reach him regarding any queries related to spine surgery by filling up the following questionnaire.

Personal Information






    FemaleMale

    Complaints

    #

    Issue

    Status

    If yes, Duration in months

    Other Comments

    1

    Backpain

    YesNo

    2

    Does the backpain wake you up in the night?

    YesNo

    3

    Do you have pain going down from the back to the legs?

    YesNo

    4

    Do you have tingling sensations/ numbness in the hands/ legs?

    YesNo

    5

    Do you have any weakness in the hands/ legs?

    YesNo

    6

    Do you have any unsteadiness while walking?

    YesNo

    7

    Do you smoke?

    YesNo

    8

    Do you have diabetes?

    YesNo

    9

    Do you ride 2-wheelers?

    YesNo

    10

    Have you taken any particular treatment for this problem?

    YesNo

    11

    On a scale of 0 to 10, if 0 is no pain and 10 is maximum tolerable pain, how much pain do you have, looking back at the past one week?

    How severe is your pain in terms of activity restriction?

    12

    Restricts recreational activities

    YesNo

    13

    Restricts occupational activities

    YesNo

    13

    Restricts basic activities such as taking bath, wearing clothes, brushing teeth, etc.

    YesNo


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