Back pain physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Overview

Patients with back pain have variable presentation depending on the severity of pain and associated signs and symptoms.

Physical Examination

Physical examination of patients with back pain depends on the underlying etiology and severity.

Appearance of the Patient

Vital Signs

Skin

HEENT

  • HEENT examination of patients with [disease name] is usually normal.

OR

  • Abnormalities of the head/hair may include ___
  • Evidence of trauma
  • Icteric sclera
  • Nystagmus
  • Extra-ocular movements may be abnormal
  • Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
  • Ophthalmoscopic exam may be abnormal with findings of ___
  • Hearing acuity may be reduced
  • Weber test may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
  • Rinne test may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
  • Exudate from the ear canal
  • Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
  • Inflamed nares / congested nares
  • Purulent exudate from the nares
  • Facial tenderness
  • Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae

Neck

  • Neck examination of patients with [disease name] is usually normal.

OR

Lungs

Heart

Abdomen

Back

Genitourinary

Neuromuscular

Extremities

References

  1. Casser, Hans-Raimund; Seddigh, Susann; Rauschmann, Michael (2016). "Acute Lumbar Back Pain: Investigation, Differential Diagnosis, and Treatment". Deutsches Aerzteblatt Online. doi:10.3238/arztebl.2016.0223. ISSN 1866-0452.
  2. Middleton, Kimberley; Fish, David E. (2009). "Lumbar spondylosis: clinical presentation and treatment approaches". Current Reviews in Musculoskeletal Medicine. 2 (2): 94–104. doi:10.1007/s12178-009-9051-x. ISSN 1935-973X.
  3. Deyo RA, Rainville J, Kent DL (1992). "What can the history and physical examination tell us about low back pain?". JAMA. 268 (6): 760–5. PMID 1386391.
  4. Patel DR, Kinsella E (2017). "Evaluation and management of lower back pain in young athletes". Transl Pediatr. 6 (3): 225–235. doi:10.21037/tp.2017.06.01. PMC 5532202. PMID 28795014.

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