What have you tried so far to help with this pain?

"Well, I take a Tylenol sometimes, but that doesn't really help. Can't you give me something stronger than that, doc? I am really tired of this constant pain" 

It is not clear to you what John wants out of this visit. You decide to FIFE the patient.

Go to FIFE patient.

*FIFE stands for: Feelings: How does the patient feel about this back pain (sad, depressed, angry, etc.). Idea's: Does the patient have any idea's what is the cause, what they can do about it, what is the natural history. Function: How does this affects his daily life functioning. Expectations: What does the patient expect from this visit today.