Patients presenting to our Boulder Physical Therapy clinic often present with arm or leg symptoms including pain, numbness, and pins and needles. Our well trained and educated Physical Therapists utilize a patient’s history and their objective examination to determine the source of the symptoms and what is contributing to their onset. Importantly, the source of the pain must be identified to properly treat the symptoms and restore normal function. A common question for both patients and clinicians includes determining if the spine or the limb is responsible for the current symptoms. A recent study published information on helping determine when the spine may be the current pain generator.
Rastogi and colleagues published their study in the Journal of Manual and Manipulative Therapy (2022). 369 patients with arm and/or leg symptoms were placed through a subjective and objective examination to determine if their symptoms were driven from the spine or extremity. Authors then worked backward to determine which patient factors or subjective examination findings best predicted the spine as the source of the symptoms. They reported 5 indicators made the spine more likely with 2 indicators having the highest diagnostic utility. Most predictive was the change in symptoms with postural changes followed by a change in arm or leg with changes in spinal posture or position while sitting. Other indicators presence of pins and needles, restriction in spinal movements, and no restrictions in extremity movements.