After being satisfied with inspection, a careful examination with the hand will detect any irregularity that the eye may overlook. The spines are the key to the situation, but tenderness in addition to abnormal position must be found. Each operator will have his preference for position of the patient. For a thorough examination several positions may be necessary. Patient sits erect , operator standing behind.
Patient leans forward, sitting squarely, hands on knees.
The patient is placed facing operator, first on rigplaht and then on left side. The operator carefully examines each spine and transverse process in succession. During this examination patient must thoroughly relax. The operator uses arms and legs of patient as levers for movement in examination. Patient on back, body straight so that nose, chin and point between feet are in straight line, arms at sides.