Spine Examination

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Look

Look from behind for:

• Muscle wasting
• Loss of symmetry
• Scoliosis of the spine.

Then look from the side for normal:

• Cervical lordosis
• Thoracic kyphosis
• Lumbar lordosis

Feel

Feel down the spinal processes, and the sacral iliac joints Palpate paraspinal muscles for any obvious tenderness.

Move

"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"

• Rotation

"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.