The nine stages of an ISRA assessment, explained simply
If you come to the Matib Al Mualij clinic, your care begins with an ISRA assessment. It has nine stages, always in the same order. This is what each one feels like, as a patient — what happens, and why.
1. Intake — you are listened to first
You sit down, and you talk. What hurts. When it started. What makes it better, what makes it worse. What you have already tried. The practitioner listens, properly, and takes notes. This is not a formality. You are the expert on your own pain, and the assessment begins with your story. Nothing is examined, scanned or treated before you have been heard.
2. Lifestyle — your daily life is part of the picture
Next come questions about how you live: your work, your sitting, your sleep, your food. It can feel unrelated to back pain. It is not. The hours you sit, the way you lift, the mattress you sleep on — all of it is load on your spine. This stage finds the daily habits that are feeding the problem, because a plan that ignores your life will not hold once you go home.
3. Unani constitutional assessment — Mizaj and Nabz
This is the Unani part — Unani being the traditional Greco-Arab medicine the clinic practices. The practitioner assesses your Mizaj, your temperament: the natural constitution of your body, the balance of hot and cold, wet and dry that shapes how you respond to food, weather and work. And your Nabz, your pulse, read by hand at the wrist. It takes a few quiet minutes. It tells the practitioner about the state of your body in a way no scan can, and it guides which kind of care will suit you.
4. Clinical exam — examined by hand
Now the practitioner examines you by hand: your spine, your posture, how you move. You will be asked to stand, bend, walk and turn. The practitioner feels where the movement is free and where it is restricted, which structures are tender, which muscles are tight. This is the hands-on part, and it is often where a trained hand finds what a scan cannot show.
5. Imaging — your reports, in plain words
If you have MRI or X-ray reports, they are looked at here — and explained to you in plain words. Not medical shorthand, but what the finding actually means for you, and what it does not mean. A scan shows structure. It does not show pain. That is why imaging comes at stage five, not stage one: it is one piece of the picture, not the whole picture.
6. SBRA analysis — your structure and biology, scored
This is where the SBRA engine — the assessment engine inside ISRA — scores what has been found. Your structure and your biology are each scored, pillar by pillar, and the scores are turned into numbers you can follow: a Structural Integrity Score out of 100, a Structural Age, and more. You will be told what the numbers mean. They are not a verdict. They are a starting point.
7. Classification — Types A–D
Your case is classified into one of four types, A to D. This is not a label on you. It is a way of making sure the plan fits the kind of problem that was found, rather than giving everyone the same routine. The classification is the bridge between the assessment and the treatment.
8. Four-phase roadmap — Assess, Correct, Support, Maintain
The findings become a roadmap in four phases. Assess is everything you have just been through. Correct is the correction work — including hands-on structural correction where the assessment shows it is needed. Support is the care that helps the correction hold: food, regimen, herbal medicine and exercises. Maintain is the long-term habits that keep the improvement once you are better. You will know which phase you are in, and what comes next.
9. Follow-up — the plan adjusts as you improve
The last stage is not really a last stage at all. It is what happens at every visit after the first. Your progress is measured, and the plan adjusts as you improve. If something is working, you build on it. If it is not, you change it. The assessment is not a one-time event. It is a running record, and it is what keeps the treatment honest.
What to expect
That is the whole assessment: nine stages, in order, none skipped. It takes time, and it is meant to. When it is finished, you will know what the problem is, what the plan is, and how your progress will be measured. And nothing will have been treated before it was understood.
If you would like to understand the method more deeply, the ISM Academy teaches it — and the academy’s own pages explain ISRA and SBRA in full.