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Look from behind for:
- Muscle wasting
- Loss of symmetry
- Scoliosis of the spine.
Then look from the side for normal:
Feel down the spinal processes, and the sacral iliac joints Palpate paraspinal muscles for any obvious tenderness.
"Try and touch your toes, please?"
- two fingers on lumbar spine measures flexion.
- Then get them to go as far back as possible - extension
"Can you run a hand down your side towards your knee?"
- Lateral flexion
"Touch your ear on your shoulder..."
- Cervical lateral flexion
"Look over your shoulder"
"Put your chin on your chest, then tilt back as far back as it will go"
- flexion, and extension
Sit them on couch (to fix their pelvis), arms crossed, rotate upper body manually
- Tests thoracic rotation
Lie patient back, straight leg raised, and perform dorsi-flexion of the foot.
- If there is trapped nerve involvement, or a prolapsed intervertebral disc, this can make the pain worse.
If the history has indicated any problems, ideally I would also like to do a full neurological examination.