[Verse 1]
Pull up to the bedside, clipboard in my grip
PQRST tattooed on my fingertip
Provocation, Quality, Region, Severity
Timing tells the story with total clarity
Oldcarts rolling — Onset, Location, Duration
Character of pain, Aggravating causation
Relieving factors, Timing, and the S is Signs
Associated symptoms threading through the lines
Patient keeps a diary, maps it day by day
Functional goals matter — what they need to say
Not just "kill the pain" but "coach my daughter's team"
Understand the context, understand the dream
[Chorus]
PQRST and OLDCARTS, map the pain terrain
Sensory, psychosocial, red flags in your brain
Allodynia, mood, the sleep, the job, the dread
Examine every axis — body, soul, and thread
PQRST and OLDCARTS, never skip a part
History and examination — that's the whole art
[Verse 2]
Now we're in the neuro lane, neuropathic case
Sensory mapping on the dermatomal space
Cotton wool for light touch, pin for sharp sensation
Thermal threshold testing — hot and cold gradation
Allodynia presents when a breeze becomes a blade
Gentle brush on skin that screams — the nervous system frayed
Quantitative sensory testing, QST protocol
Measures thermal and mechanical across the pain threshold wall
Hyperalgesia, wind-up, central sensitization
Map the aberrant wiring, document the deviation
[Chorus]
PQRST and OLDCARTS, map the pain terrain
Sensory, psychosocial, red flags in your brain
Allodynia, mood, the sleep, the job, the dread
Examine every axis — body, soul, and thread
PQRST and OLDCARTS, never skip a part
History and examination — that's the whole art
[Verse 3]
Musculoskeletal exam — palpate, load, and range
Visceral referred pain got a pattern, ain't it strange
Right shoulder ache could be the diaphragm's complaint
Rebound, guarding, rigidity — that visceral taint
Now the red flags waving — malignancy in bone
Night sweats, weight loss, age over fifty, pain that's grown
Cauda equina screaming — saddle numb and bladder fails
Fever, IV drug use — infection on the rails
Aortic pathology — tearing pain that radiates
Fracture after minor trauma — osteoporosis waits
Palliate nothing till you've cleared the sinister cause
The red flag doctrine written straight into your laws
[Bridge]
Here's a word the lexicon keeps fugacious — fleeting, hard to catch
Psychosocial factors fading fast unless you snatch
Mood disorders lurking, PHQ nine on the table
Sleep disrupted nightly, barely functional, barely stable
Trauma history coiled like a spring beneath the floor
Substance use — opioid misuse? Screen before you pour
Social scaffold — isolation amplifies the ache
Work status, compensation — all of that's at stake
The soma and the psyche locked in crosstalk, not discrete
Miss the biopsychosocial and your workup's incomplete