the back

Examination:
Symptoms:
1- pain: is it sudden or gradual ? constant or intermittent ?
Sciatica: is pain radiating from the buttock into the thigh &calf
along the course of sciatic nerve, any pathology in a spinal
segment can cause the sciatica pain.
2-stiffness;3-deformity;4-paraesthesia &weakness
in the lower limb & urinary incontinence.
Signs: standing position:
Look: skin ?scar or crease; shape &posture ? list (lateral deviation
of the spine because of pain); Scoliosis (lateral curvature of spine);
Kyphosis(posterior curvature) or kyphos(sharp angulation).
Feel: the spinous processes & interspinous ligaments.
Move: spine Flexion, Extension, Lateral flexion to the right &left, Rotation then ask to Stand on toes(plantarflexion power) &heels(dorsiflexion power).
Prone position
Supine position: do SLR test(Lasegue s test): elevate the straight
leg ? if feel pain(means root tension) and if do ankle dorsiflexion
? more pain because of more stretching on the nerve root.
Examination of the lower limbs: for neurological deficit & vascular problems.

Investigation:
1- plain x-ray: anteroposterior, lateral & oblique
views looking at the spine, pelvis &sacroiliac joints.
2- CT: for bone pathology.
3- MRI: for soft tissues pathology.
4- Radio-isotope scan: for secondaries & infection.
5- Discography & facet joint arthrography: inject dye
into disc or facet joint ? x-ray.