Spine Examination

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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"

  • 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.