A patient shows up in the clinic with isolated extremity pain. No local spinal pain, no spinal history. The referring physician and the patient himself are convinced that this is an extremity issue. Nevertheless, this patient only receives physiotherapy for the spine - and the symptoms disappear.

Together with an international team, Georg Supp has shown in two studies with more than 300 patients that such an 'Extremity Pain of Spinal Source' (EXPOSS) occurs much more frequently than one would initially assume (Rosedale 2019) and which indicators in the history and clinical exam might help to identify patients that should receive a thorough spinal evaluation (Rastogi 2022). 

In his lecture, Georg will present the results of these studies, involve the audience in the analysis and give tips for everyday clinical practice.

Learning points

• You acknowledge that up to date, there is limited published evidence on the topic of isolated extremity pain and its possible connection to the spine. 
• You understand that isolated extremity pain might respond to exclusively ‘spinal’ intervention more often than expected. 
• You can identify relevant indicators of extremity pain of spinal source in the history and clinical exam. These indicators may allow you to supplement your decision-making process in regard to spinal and extremity differentiation so as to appropriately target your examinations and interventions.