J Manipulative Physiol Ther. 1994 Nov-Dec; 17(9): 591-5.

Interexaminer reliability of palpation for cervical spine tenderness.

Hubka MJ, Phelan SP.

Los Angeles College of Chiropractic, Whittier, CA.

OBJECTIVE: To assess the interexaminer reliability of manual palpation for cervical spine tenderness in neck pain patients. DESIGN: Interexaminer reliability was studied using a within-subjects (repeated measures) design. Seven joints on the symptomatic side of the neck were palpated for maximal tenderness. SETTING: Private chiropractic practice of the Los Angeles College of Chiropractic. PATIENTS: Thirty patients with unilateral mechanical neck pain, symptomatic at the time of examination, were recruited from a chiropractic practice. RESULTS: Good interexaminer reliability (kappa = .68, p < .001, percent agreement 76.6%). CONCLUSION: In this population, palpation for cervical spine tenderness is a highly reliable examination tool. The findings of this study are consistent with those of palpation of the lumbar spine. Further investigation is needed to assess the usefulness of spinal tenderness as an outcome measure, the behavior of tenderness over time, and the prevalence of tenderness in symptomatic and asymptomatic populations.