- Anatomy of The Spine
- Back Pain in Children
- Caring for your Spine
- Emerging Spinecare Trends
- Evaluation of Spinal Disorders
- Exercise and The Spine
- Intervention - Spinal Disorders
- Intervertebral Disc
- Non Surgical Options
- Nutrition and Spinecare
- Options for Spine Treatments
- Pregnancy and Back Pain
- Prevalence of Spine Disorders
- Sleep and the Spine
- Spinecare Introduction
- Spinehealth and Disease
- Surgical Interventions
- Treatment with Medications
- Understanding Back Pain
Spinecare Topics
Caring for your Spine
Self Assessment
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Self Assessment
Strength: Each spinal nerve connects with specific muscle groups in the extremities. A periodic screen of isolated muscle function will help detect weakness that may occur secondary to spinal nerve compromise. This type of screening is important for those who have known spinal nerve (radiculopathy) problems. A periodic check of muscle strength and muscle endurance will help detect progressive nerve compromise. Not all muscle weakness is secondary to nerve compromise. There are five basic tests that can be performed on the upper extremities to screen for spinal nerve compromise in the neck. The spinal nerve levels are listed in parentheses after each test. The upper extremities screening tests are elbow flexion (C5, C6), elbow extension (C7, C8), wrist flexion (C7), wrist extension (C6) and grip (C7, C8). Each of these actions can be evaluated with resistance. Testing can be applied with resistance bands, gripping devices or dumbbells. A self-screening test consisting of 10-20 repetitions will provide a basis for measuring performance.
There are also a few screening tests for balance and strength in the legs to assess the integrity of the nerves in the low back. The first example is the step test. You should be able to rise onto one leg in a step fashion 20 times with body weight. This should be performed only on the lower step of a staircase while holding onto a rail. This screening maneuver tests the strength and endurance of the quadriceps muscles (L2, L3, L4). A good test for the L5 and S1 spinal nerve level is the heel-toe walk (L5, S1), repetitive heel raises (S1, S2) and repetitive toe raises (L4, L5). Repetitive heel raises can be performed on one leg at a time to improve test sensitivity. These are weight-bearing tests.
Tension Tests: Compression of the spinal cord or a spinal nerve restricts the ability for spinal nerve roots to glide during spinal and extremity movements. There are a series of tension tests that can be used to evaluate the capacity and tolerance for nerve movement and stretch. These tests may help detect an early problem. One such test for the spinal cord in the neck requires that the head/neck be flexed while sitting. This would normally be associated with a mild strain along the back of the neck. If this movement is associated with a shock-like sensation or pain that radiates along the spine into the extremities it suggests the possibility of spinal cord or spinal nerve compression/impingement.
A nerve stretch test for the upper extremities can be performed by raising an extended arm to 90 degrees followed by extension of the hand with the palm facing away and laterally bending the head to the opposite side. These three maneuvers all apply tension onto the spinal nerves of the neck on the side of the elevated arm. If this is associated with radiating pain and/or numbness extending into the arm below the elbow it suggests possible nerve compression at the spine.
In the lower extremity a simple tension test can be performed in the sitting position by straightening each leg at the knees one at a time. You should be able to fully straighten each leg without radiating pain or numbness in the leg or foot. If you do experience symptoms below the knee, check with your physician because there may be a low back problem.
There are also a few screening tests for balance and strength in the legs to assess the integrity of the nerves in the low back. The first example is the step test. You should be able to rise onto one leg in a step fashion 20 times with body weight. This should be performed only on the lower step of a staircase while holding onto a rail. This screening maneuver tests the strength and endurance of the quadriceps muscles (L2, L3, L4). A good test for the L5 and S1 spinal nerve level is the heel-toe walk (L5, S1), repetitive heel raises (S1, S2) and repetitive toe raises (L4, L5). Repetitive heel raises can be performed on one leg at a time to improve test sensitivity. These are weight-bearing tests.
Tension Tests: Compression of the spinal cord or a spinal nerve restricts the ability for spinal nerve roots to glide during spinal and extremity movements. There are a series of tension tests that can be used to evaluate the capacity and tolerance for nerve movement and stretch. These tests may help detect an early problem. One such test for the spinal cord in the neck requires that the head/neck be flexed while sitting. This would normally be associated with a mild strain along the back of the neck. If this movement is associated with a shock-like sensation or pain that radiates along the spine into the extremities it suggests the possibility of spinal cord or spinal nerve compression/impingement.
A nerve stretch test for the upper extremities can be performed by raising an extended arm to 90 degrees followed by extension of the hand with the palm facing away and laterally bending the head to the opposite side. These three maneuvers all apply tension onto the spinal nerves of the neck on the side of the elevated arm. If this is associated with radiating pain and/or numbness extending into the arm below the elbow it suggests possible nerve compression at the spine.
In the lower extremity a simple tension test can be performed in the sitting position by straightening each leg at the knees one at a time. You should be able to fully straighten each leg without radiating pain or numbness in the leg or foot. If you do experience symptoms below the knee, check with your physician because there may be a low back problem.
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