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Telehealth examination of the lumbar spine
Rock P Vomer1,1, George G A Pujalte2,3, Thomas A Waller2
1Department of Family Medicine, Eastern Virginia Medical School, Norfolk, VA, USA.
Background:
Telehealth evaluations of musculoskeletal conditions have increased due to the stay-at-home policies enacted during the COVID-19 pandemic. Back pain is one of the most common complaints in primary care. While telehealth may never supplant in-person evaluation of back pain, it is imperative in a changing world to learn to perform this evaluation via telephone or video. Virtual visits rely on history-taking and patient self-reported descriptions of pain elicited from self-palpation or specific movements while on the telephone with the clinician. Video examinations provide a unique way of evaluating the lower back compared to telephone because of the ability to visualize the actions of the patient.
Objective:
To create an evaluation pathway for examination of the lumbar spine via telehealth.
Methods:
Our group has created a step-by-step evaluation pathway to help physicians direct their patients through typical lumbar examination elements, including inspection, palpation, range of motion, and strength, special, and functional testing.
Results:
We have developed a table of questions and instructions and a glossary of images of each maneuver to facilitate lumbar spine examination via telemedicine.
Conclusions:
This paper provides a guide for extracting clinically relevant information while performing telemedicine examinations of the lumbar spine.
