Neuroplastic Symptom Questionnaire
Considering any current or past symptoms, work your way through the following list of questions. Each one is designed to build evidence for ruling-in a neuroplastic or brain-amplified diagnosis and ruling-out structural pathology. Add up your "yesses" as you go along, then click [Submit] at the end to learn more.
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Do you have multiple symptoms that are different in type (back pain AND fatigue; or headaches AND digestive problems AND insomnia; or neck pain, anxiety, bladder urgency, AND tinnitus)?
1 point
Clear selection
Have your doctors or other practitioners completed diagnostic testing without finding a definite cause for your symptoms (beyond age-related changes like arthritis/disc bulges, being overweight, “wear and tear”; or vague explanations like gluten intolerance, mold sensitivity, a weak core, too much inflammation, or “just bad genes”)?
1 point
Clear selection
Do you have a history of prior symptoms in your childhood/college/your 30’s/etc (any chronic pain, anxiety or depression, digestive or bladder problems, ADHD, an eating disorder, headaches, any addiction, significant insomnia, OCD, fatigue)?
1 point
Clear selection
Do your symptoms vary in severity without obvious physical changes (some days 3 out of 10 and other days 7 out of 10; or you can walk 2 miles some days and other days only 2 blocks before symptom onset; or at times you can have some gluten and others you can’t have any before it upsets your GI tract; or they’re worse during the week, but reliably better on weekends)?
1 point
Clear selection
Would you be upset if you discovered that a child you care about is experiencing everything you did as a child?
1 point
Clear selection
Do you tend to frequently check on, worry about, research, think of ways to escape, feel very frustrated by, or dread your symptoms and their triggers throughout the day?
1 point
Clear selection
Are your symptoms triggered by things that don’t have to do with the body or area in question, like changes in the weather, foods, strong smells, specific sounds, certain lights, time of day, screens, or menses?
1 point
Clear selection
Did your symptoms begin around a time of intense stress, trauma, great frustration, or loss – or after an event that triggered intense memories of the above?
1 point
Clear selection
Do you tend to be very self-critical, a perfectionist, overly conscientious, a worrier, a people-pleaser, often insecure/doubtful of yourself, or get easily overwhelmed/angered?
1 point
Clear selection
Have your symptoms changed over time, migrating to different locations in the body (usually in right leg, but it has moved to the left; low back pain in the morning, but it moves to upper-back or neck pain in the afternoon; formerly painful intercourse, but now crampy, irritable bowels), or are your symptoms symmetrical (both wrists; entire right side of body)?
1 point
Clear selection
Did your symptoms begin without an injury or long after one (you “woke up with it" or "must have slept wrong”; it gradually developed “out of nowhere”; the suspected acute injury was more than 3 days prior to symptom onset; or you attribute it to an “old” injury like in high school or a car accident from years ago)?
1 point
Clear selection
Are your symptoms triggered/worsened by stressful situations (prior to school or work; “the holidays”; a social gathering), or are they less severe/frequent when you are engaged in something enjoyable or distracting (events w/ friends; weekends/vacation; some situation that feels safe or fun for you)?
1 point
Clear selection
Have you tried numerous treatments including traditional (medications, PT, injections, surgical procedures), alternative (massage, chiropractic, acupuncture, Reiki, herbal or vitamin supplement), or a NOVEL treatment (a famous practitioner, renowned modality, high-tech intervention), and only achieved temporary or minimal benefit?
1 point
Clear selection
First and Last Name
Email Address (to join our mailing list)
How did you find us? (e.g. web search, referred by friend or clinician, business card, etc.)
In what state do you live (or country if not the US)?
Submit
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