Physical Exam
In the previous section, we mentioned that sometimes mechanical pain is worsened by movement. Part of the physical exam is performing maneuvers to see what relieves or worsens the pain. So, your doctor may ask you to perform a few movements or try a maneuver on you to see what happens. For instance:
- When pain worsens by extending your neck, spinal stenosis should be ruled out
- When forward flexion worsens your pain, a cervical disk problem can be the cause
- There’s something called an abduction relief sign. The doctor locates the pain (left or right) and takes the arm from the same side. They will raise the arm over your head, and the symptoms improve. This maneuver helps distinguish shoulder pain from radiculopathy.
- There are plenty of tests to diagnose vascular thoracic outlet syndrome. This problem is commonly mistaken for cervical radiculopathy. For example, the doctor touches the insertion of the pectoralis minor muscle or the scalene triangle, and the area is tender.
- Cognitive and neurologic tests can be performed to evaluate the nervous system. It is essential in the case of spinal cord injuries, neuropathic pain, and vertebral fractures.