DO WE NEED TO CHECK THE SPINE FOR ISOLATED EXTREMITY PAIN?

For many of the patients that come to us with extremity pain, we tend to assess and  target the affected area only. This can maybe make us overlook those cases of extremity pain which have spinal involvement and may delay their recovery. A study published in 2019 explored the prevalence of extremity pain with spinal involvement and they found that out of the 322 patients who were analysed, 43% had a spinal involvement.

This raises the question that, do we need to check the spine for isolated extremity pain?

First, let's see how common is isolated extremity pain with spinal involvement.

PREVALENCE OF EXTREMITY PAIN WITH SPINAL INVOLVEMENT:

POSTURE CHANGE AND EXTREMITY PAIN

Watch these clips which show how in some cases posture change affects extremity pain.

So now we know that in some cases of isolated extremity pain, they do respond to spinal interventions only.

But do we check the spine for all cases of isolated extremity pain?

PREDICTORS OF EXTREMITY PAIN WITH SPINAL INVOLVEMENT

Here are five predictors which can help us know whether the patient has any spinal involvement.

1. Posture change affects symptoms

2. Effect On symptoms when sitting/bending/turning neck/when still

3. Restriction Of spinal movement 

4. No restriction Of extremity movement 

5. Presence of paraesthesia

HOW SHOULD WE ASSESS ISOLATED EXTREMITY PAIN FOR SPINAL INVOLVEMENT?

Watch this clip to know more.

Sources:
1. Lecture ''Isolated extremity pain: Do we need to check the spine? by Georg Supp