Table 5 Glossary of Manual Palpation Tests in Accepted Articles

 Lumbar spinous palpation

Weiner et al., 2006 [29]

Palpation to identify pain

The examiner is behind patient and firmly palpates the spinous processes of L1–L5 using their dominant thumb. A positive test is pain on palpation.

 Passive intervertebral motion tests

Hicks et al. 2003 [23]

Lumbar palpation for segmental mobility and pain

With the subject lying prone the examiner applies AP pressure with their hypothenar eminence on each lumbar spinous process. Segmental mobility is judged as normal, hypomobile and hypermobile. Pain provocation is judged as pressure producing pain or not producing pain.

 Posterior/Anterior Glide Test

Alyazedi et al. 2015 [19]

Palpation for identify lumbar spinal mobility.

Subjects are lying prone and examiners performs PA glide on the lumbar spinous processes. Lack of segmental hypomobility, is considered a positive test.

 Prone Instability Test

Alyazedi et al. 2015 [19]

Hicks et al. 2003 [23]

Ravenna et al., 2011 [25]

Schneider et al., 2008 [26]

Lumbar springing palpation for pain

Patient prone with legs over the edge of table and feet resting comfortably on the floor. The examiner palpates for pain. The patient then raises their legs off the floor and examiner again palpates for pain. A positive test is indicated by painful segments in the first position becoming nonpainful with contraction of the back extensors.

 Prone Lumbar Palpation (comparable level and level identification)

Downey et al., 2003 [21]

Identification of spinal level most contributing to LBP and identification of that level

Palpation for the spinal level contributing most to the patients’ LBP symptoms (abnormal end-feel, abnormal quality of resistance to motion, and reproduction of pain, local or referred); patient prone, posterior to anterior pressure applied to spinal process and verbal communication between examiner and patient about reproduction of pain.

 Prone Mobility Test Schneider et al., 2008 [26]

Lumbar segmental mobility

Posterior to anterior joint springing palpation by examiners of SIJs, all lumbar spinous processes and all lumbar facet joints bilaterally. A positive test is the palpation of restricted motion.

 Prone Pain Provocation Test

Schneider et al., 2008 [26]

Lumbar spine pain

Patient notifies the examiner of pain or discomfort provoked while repeating prone mobility test

 Sacroiliac Joint Palpation

Weiner et al., 2006 [29]

Palpation of the sacroiliac joints for pain

The patient stands on floor with shoes removed and the examiner stands behind patient. The examiner exerts firm pressure over sacroiliac joint, palpation of right joint with right thumb while standing to left side of patient and palpation of the left joint with the left thumb while standing to the right of the patient. A positive test is the patient reporting pain in the back.

 Spinous Palpation for Stiffness

Koppenhaver et al., 2014 [31]

Joint springing of the lumbar spinous process

The spinous processes of L1-L5 are palpated with the subject lying prone. The participant was asked to relax as a posterior to anterior (PA) force was applied. Each vertebral segment was judged to be hypermobile, hypomobile or normal mobility.

 Gillet Test

Arab et al., 2009 [20]

Soleimanifar et al., 2017 [32]

Palpation for movement at the PSIS while patient raises knee

The subject is standing with the examiner palpating the PSIS as the subject raises that knee toward their chest.

A positive test is when the PSIS on the side of the knee flexion does not move or moves posterior-inferiorly only minimally or even paradoxically moves superiorly.

 Sacral Base Position Test

Tong et al., 2006 [27]

Palpation of the sacral base for position while the patient flexes then extends their spine

The subject is sitting, the evaluator palpates the sacral base with the subject’s trunk forward flexed and backward flexed. A positive test is when one side of the sacrum is more anterior or posterior when compared to the other side of the sacrum on the spine motions.

 Seated Flexion Test

Tong et al., 2006 [27]

Bilateral palpation for cephalad movement at the PSIS while patient forward bends spine

The evaluator palpates both PSISs. As the subject bends forward, the evaluator’s thumbs follow the motion of the PSIS cephalad. If one side moves more cephalad than the other side by more than 1 cm, the side that moves more is considered abnormal.

 Sitting Flexion Test

Arab et al., 2009 [20]

Soleimanifar et al., 2017 [32]

Palpation for movement at the PSIS while patient forward bends spine

The subject is sitting and the examiner palpates the PSIS as the subject bends forward. A positive result in this test indicates limited movement of the sacrum on the ilium.

 Standing Flexion Test

Arab et al., 2009 [20]

Soleimanifar et al., 2017 [32]

Tong et al., 2006 [27]

Palpation for movement at the PSIS while patient forward bends spine

The subject is standing and the examiner palpates the PSIS as the subject bends forward. A positive result in a standing flexion test indicates limited movement of the ilium on the sacrum.

Standing Stork Test

Tong et al., 2006 [27]

Palpation for movement at the PSIS while patient raises knee

The evaluator’s thumb palpates the unilateral PSIS, and the other thumb palpates the midline of the sacrum. The subject then flexes the left hip and knee to a minimum of 90 degrees. The same is repeated on the right PSIS with the subject flexing the right hip. The sacroiliac joint motion is considered normal if the thumb on the PSISs moves caudal and abnormal if the thumb on the PSISs does not move or if it rises.

 Palpation of Gluteal Muscle

Jensen et al., 2013 [24]

Gluteal muscle palpation for tenderness

Patient seated, tender points tested from right to left with 4 kg digital pressure on upper outer quadrants of buttocks. A positive test was pain on palpation.

 Multifidus Lift Test

Hebert et al., 2015 [22]

Palpation of the multifidus muscle for contraction while patient raises while lifting contralateral arm

Participants prone and contralateral arm lifted with/without a hand weight while multifidus muscle palpated immediately lateral and adjacent to the interspinous space of L4–L5 and L5–S1. A test was judged as normal or abnormal lumbar multifidus contraction.

 Palpation of Gluteal Muscle

Adelmanesh et al., 2016 [30]

Palpation of the superior-lateral quadrant of the gluteal muscle to identify GTrP.

Palpation of the superior-lateral quadrant of the gluteal muscle to identify GTrP representing the combination of tenderness, taut band and pain: With the patient prone the gluteal muscle was compressed with a flat thumb or index finger against the underlying tissue or bone. The points were considered GTrP when the combination of taut band, tenderness, and pain recognition were present.

 Palpation of Lumbar Paraspinal Muscles

Weiner et al., 2006 [29]

Lumbar paraspinal muscle palpation for pain

With the patient standing on the floor with shoes removed, the examiner stands behind to left side of patient and braces patient in front with left arm; palpate full extent of right paravertebral with right thumb. Exert approximately 4 kgf. The test is repeated on the other side. A positive test is when the patient reports pain when the muscle is palpated.

 Palpation of Piriformis Muscle

Weiner et al., 2006 [29]

Piriformis muscle palpation for pain

With the patient supine they flex their right hip and knee, keeping sole of foot on table. The bent leg is crossed over opposite leg and again the sole of the foot is placed on table. Mild pressure is exerted medially directed on the lateral aspect of knee to put piriformis in stretch. Exert firm pressure (4 kg) over middle extent of piriformis. The test is repeated on the other side. A positive test is when the patient reports pain when the muscle is palpated.

Palpation of Sciatic Nerve

Walsh et al., 2009 [28]

Sciatic nerve palpation for pain

With the patient lying prone they are asked if there is any pain or discomfort when the examiner applies gentle pressure at the sciatic nerve bilaterally at the midway point of a line from ischial tuberosity to the greater trochanter of the femur. A positive test is pain or discomfort over the sciatic nerve.