title: A narrative review of evidence-based recommendations for the physical examination of the lumbar spine, sacroiliac and hip joint complex.
abstract: Non-specific low back pain is a frequent complaint in primary care, but the differential diagnosis for low back pain can be complex. Despite advances in diagnostic imaging, a specific pathoanatomical source of low back pain can remain elusive in up to 85% of individuals. Best practice guidelines recommend that clinicians conduct a focused physical examination to help to identify patients with non-specific low back pain and an evidence-based course of clinical management. The use of sensitive and specific clinical methods to assess the lumbar spine, sacroiliac and hip joints is critical for effective physical examination. Psychosocial factors also play an important role in the evaluation of individuals with low back pain, but are not included in this narrative review of physical examination methods. Physical examination of the lumbar spine, sacroiliac and hip joints is presented, organized around patient position for efficient and effective clinical assessment.
authors.affiliation: Columbia University, New York, NY 10032, USA. ckw7@columbia.edu
authors.forename: C K
authors.initials: CK
authors.lastname: Wong
authors.forename: E K
authors.initials: EK
authors.lastname: Johnson
mesh_terms: D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D006621:Hip Joint; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis*; D008159:Lumbar Vertebrae; D008487:Medical History Taking; D010808:Physical Examination / Q000379:methods*; D055958:Piriformis Muscle Syndrome / Q000175:diagnosis*; D016059:Range of Motion, Articular; D012446:Sacroiliac Joint; D012585:Sciatica / Q000175:diagnosis*