Next, ask the patient to stand on the platform of the Hi-Lo table. I have found this to be the best position for cervical algometry, although the cervical spine can also be examined in the prone position with the headpiece put into moderate flexion. Since I work from the left, I prefer to begin the examination by testing the left side of the cervical spine, in the region of the articular facets. After testing the cervical spine, lower the Hi-Lo table and test the thoracic spine. I prefer to first test the left thoracic spine near the costo-transverse junctions, then the spinous regions, and then the right side.
Care is taken to ensure the algometer is held perpendicular to the skin along the thoracic kyphosis.
It is advised that when examining the spinous regions of the thoracic and lumbar spines the algometer stylus be stabilized on the spinous processes using the indifferent hand. Stabilization prevents the algometer from slippping off the bony processes and irritating the patient. The data from algometric testing can be taperecorded, or an assistant in the room can write down the information. You can also jot down the results yourself. Once you become proficient, all 43 points can be tested and documented in less than seven minutes without a recorder or an assistant.