What is the role of physical exam in the diagnosis of low back pain (LBP)?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Physical examination is important to confirm a mechanical or benign cause for the patient's LBP. Observations of verbal and nonverbal behaviors suggesting symptom magnification should be noted. Inspection of the spine requires the patient to disrobe. Open-back gowns give the physician only 1 view of the spine; therefore, swimming attire is often appropriate for complete, 360° inspection. Leg-length discrepancy and pelvic obliquity, scoliosis, postural dysfunction with forward-leaning head and shoulders, or accentuated kyphosis should be noted. Physicians' preferences vary with regard to the importance of testing range of motion; however, just asking the patient to bend forward often enables the most worthwhile observations.

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