Spine
Lumbo-Sacral Spine
Evidence: confirmed
Spinous Process Tap Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Screening for serious spinal pathology like Fracture, Infection, or Disc Herniation.
How to Perform
- Position: Patient seated, spine slightly flexed forward.
- Action: Gently tap each spinous process with a reflex hammer.
Interpretation of Results
- Sharp Local Pain: Suggests Fracture or Infection (Osteomyelitis).
- Radiating Pain: Suggests Disc Herniation at that level.
Clinical Context & Limitations
The Spinous Process Tap Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Spine region, combining the Spinous Process Tap Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Clinical Tests for the Musculoskeletal 3rd Ed. Book
