Clinical Examination of the Adult Lumbar Spine

A meticulous clinical examination coupled with detailed history-taking is the first step toward making a provisional clinical diagnosis in patients with lumbar spine disorders—this helps in performing targeted investigations and drawing clinical correlations with pathology detected on imaging. Apart from conventional inspection and palpation of the local area, clinical examination of the adult lumbar spine involves provocative tests and maneuvers for identifying potential pain generators and a detailed neurological examination of the lower limbs. Clinicians must master the art of performing these tests which can provide a vital clue regarding potential underlying disorders. The clinical examination of the adult lumbar spine is also incomplete without examining regions with overlapping referred pain patterns—these include the hip joints, certain visceral structures, and the sacroiliac joint. This chapter outlines the key aspects of clinical examination of the adult lumbar spine and summarizes the usual examination findings seen in various lumbar spine disorders.