History and Physical Examination for the Interventional Pain Physician

Explore the principles and practice of performing thorough histories and exams that yield actionable insights.

This streaming video set includes the following lectures on the evidence and step-by-step demonstrations of how to perform 21 key examinations:

• Strengths and Shortcomings of Physical Examination

• Inspection, Palpation, ROM of Lumbar and Thoracic Spine

• Special Tests for Lumbar Zygapophysial Joint Pain
   • Extension Rotation Test

• Neurological Exam of the Lower Extremities and Special Tests for Lumbar Radicular Pain
   • Straight Leg Raise
   • Seated Slump Test
   • Femoral Stretch Test

• Clinical Examination of Pelvis, Hip, and Sacroiliac Joint
   • Thigh Thrust Test
   • Gaenslen’s Test
   • Distraction Test
   • Compression Test
   • Sacral Thrust Test
   • Patrick's / FABER Test
   • FADIR Test

• Inspection, Palpation, ROM of Cervical and Thoracic Spine

• Special Tests for Cervical Z-Joint, AA, and AO Joint Pain
   • Extension Rotation Test
   • Paraspinal Tenderness Test / Manual Spinal Exam
   • Palpation, Motion Testing
   • Cervical Flexion Rotation Test - Seated
   • Cervical Flexion Rotation Test – Supine Option 1
   • Cervical Flexion Rotation Test – Supine Option 2

• Neurological Exam of Upper Extremities and Special Tests For Cervical Radicular Pain/Radiculopathy
   • Spurling’s Classic Lateral Bend Test
   • Spurling's Modified / Maximum Foraminal Compression Test
   • Spurling’s Self Test
   • Neck Traction Test

• Physical Examination of the Shoulder

Speakers
David J. "D.J." Kennedy, MD Professor and Chair, Department of PM&R, Vanderbilt University Medical Center
Nashville, Tennessee

Edvin Koshi, MD Halifax Spine and Pain Institute
Halifax, Canada

Joshua Rittenberg, MD Clinical Associate Professor, Stanford University
Oakland, California

Matthew Smuck, MD Chief, Physical Medicine & Rehabilitation; Professor, Orthopaedics; Director, Wearable Health Lab, Stanford University
Stanford, California

Special Thanks to Test Demonstrators
• Mamie Air, MD
• Shannon Chain, MD
• Joshua Rittenberg, MD
• Amy Strouse, DO

© 2021 International Pain & Spine Intervention Society – All Rights Reserved
Materials presented in this activity have been made available by the International Pain & Spine Intervention Society for educational purposes only. IPSIS reserves all rights to such material.

Educational Objectives
Upon completion of this course, participants should be able to:

• Identify the shortcomings and strengths of the physical exam as a diagnostic screening tool;
• Discuss the evidence-base behind physical examination for spine pathology;
• Describe the sensitivity and specificity of provocation tests that are used to screen for pain generators in the cervical and lumbosacral spine;
• Apply specific provocation tests to screen for lumbosacral and cervical procedures;
• Perform technically correct lumbosacral and cervical physical exam tests that are used to screen for interventional spine procedures.

Disclosure Information
Activity Reviewer: Scott Naftulin, DO
Nothing to disclose

Accreditation Statement
The International Pain & Spine Intervention Society (IPSIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement
IPSIS designates this live internet activity for a maximum of 2.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Commercial Support
No commercial support was received for this activity.

Original Release Date: 08/03/2021 
RELEVANT FINANCIAL RELATIONSHIPS WITH ACCME-DEFINED INELIGIBLE COMPANIES
Matthew Smuck, MD - Speaker
Consultant: Sollis Therapeutics
Advisory board: BlueJay Mobile Health; Spine Biopharma
Research grant: ReWalk; Relievant

None of the other planners, speakers, or reviewers had relevant financial relationships with ACCME-defined ineligible companies.
All relevant financial relationships have been mitigated.

Renewal Date: 08/03/2024
Expiration Date: 08/04/2027