Herniated Disc Survey

Welcome to the herniated disc survey, presented in partnership with The Cure Back Pain Network and SAR Research and Statistics Ltd. 

This survey allows patients to share their own personal experiences with herniated discs and degenerative disc disease, in order to facilitate more accurate diagnosis, and better treatments, through dedicated research efforts.

In essence, by taking one minute to fill out this completely anonymous survey, you can help us to help you, as well as to assist other suffering people all around the world. 

You will not be placed on any mailing lists from participation in this survey and your information will not be shared with anyone else.  The only correspondence that you will ever receive is a one time confirmation of participation from this website.

Please be honest and thorough when filling out this survey.  Remember, the results are critical for improving herniated disc care around the world.

Our back and neck pain surveys have been used since 2006 to implement positive changes in the global healthcare system.

Thank you for your contribution. We offer our best wishes for a complete recovery from your disc-related pain.


Herniated Disc Survey

Please note that all fields followed by an asterisk must be filled in.
Male
Female
Under 18
18 to 25
26 to 35
36 to 45
46 to 55
56 to 65
66 to 75
76 to 85
over 85
Degenerative Disc Disease
Bulging Disc
Herniated Disc
Ruptured Disc
Cervical Spine
Thoracic Spine
Lumbar Spine
Neck
Upper Back
Middle Back
Lower Back
Buttocks
Legs
Feet
Shoulders
Arms
Hands
Hips/Pelvis
Less than 1 month
Less than 3 months
Less than 6 months
Less than 1 year
1 to 3 years
4 to 7 years
8 to 12 years
13 to 20 years
20 years or longer
One time
Several times
Occasional
Somewhat frequent
Frequent
Always present
Pain
Tingling
Numbness
Weakness
Foot Drop
Other
Mild
Moderate
Severe
Extreme
Yes
No
Not Sure
Acupuncture / Acupressure
Alternative Medicine
Chiropractic
Pharmaceutical Drugs
TENS
Inversion
Massage
Epidural Injections
Knowledge Therapy
Physical Therapy / Exercises
Non-Surgical Spinal Decompression
Surgery
I am completely recovered
I still have a little pain
I have occasional moderate pain
I have chronic moderate pain
I have occasional severe pain
I have chronic severe pain
I have occasional extreme pain
I have chronic extreme pain
No
Somewhat Helpful
Helpful
Super Helpful


Thank you for taking our herniated disc research survey.

You might also be interested in sharing your story on our reader forum.



Herniated Disc > Herniated Disc Survey