Physical Examination of Pain

Nyimas Fatimah
 Physical Examination on Site of Pain
• LOOK
• FEEL
• MOVE

• + PROVOCATION TEST
LOOK
 LOOK
• Deformity
• Inflammation sign
• Vasculer
• Muscle atrophy
Deformity
Deformity
Inflammation sign
Vasculer
Muscle atrophy
Muscle atrophy
FEEL
 FEEL
• Inflammation sign
• Vasculer
• Tender point and spasm
• Sensibility
Inflammation sign
Vasculer
Tender point (tendon)
Tender point and spasm (muscle)
 Tender point
(joint and adjaecent structure)
Entrapment point in PNES
 Sensibility
• The pattern of sensoric deficit  describe the
location site of the lession or any entrapment
Cortex
Spinal cord
Root
Plexus
Branch
MOVE
 MOVE
• Range of motion (A/P)
• Muscle strength
 ROM
• Case only consideration..!!
Shoulder VS Hip
 Muscle Strength

Consideration 0 1 2 3 4 5
Visible or palbable
contraction - + + + + +
Joint movement - + + + +
Gravity against - + + +
Minimal
- + +
resistance
Maximal
resistance
- +
 Provocation (special) test
• Nerve
• Musce and tendon
• Joint and ligament
 Nerve
Provocated by tapped, pressed, or lengthened
 Muscle or tendon
Provocated by lengthened or resistive contracted
 Joint and ligament
Provocated by lengthened or angulated
Patrick Test
Kontrapatrick Test