PAIN-BACK PAIN, ASSESSMENT

SUMMARY

1. History is everything!

2. Clarify the exact nature and quality of pain experiences, the exact location and referred pain. These should be documented and will shape the physical examination.

3. Physical examination: look, feel, move, special tests. However the pain exam has different emphasis, to observe as much as possible, ask the patient to move and to define the experience as you go.

4. Special tests:
- SLR: looking for root tension signs
- Kemp test (AKA quadrant test): for evidence of facet arthropathy
- Posterior shear test (POSH test): looking for SI joint pain
- FABER/FADER: looking for SI joint pain

5. Do a neurological examination: looking in particular for altered sensation.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.