Spine tests: a complete guide to assessing the cervical, thoracic, and lumbar spine (14 tests)

Back pain (cervical, thoracic, or lumbar) is probably the most common reason for seeking physiotherapy, and one of the most common in the gym as well. The problem is that "back pain" tells you nothing about its origin: it could have a neural component (a trapped or irritated nerve), a joint component (sacroiliac, facet joints), a muscular component (weak deep neck flexors), or even a vascular component (thoracic outlet syndrome).

That's why a spine assessment shouldn't rely on a single test, but on a battery of specific tests that, combined, give you a much clearer picture of what's going on and which treatment or training approach makes sense.

In this guide, we cover the 14 most relevant spine tests, organized by region (cervical, lumbar, and sacroiliac), so you know which one to use in each case.

Why assess the spine with specific tests?

A well-done spine assessment lets you:

1. Differentiate mechanical from neural origin (low back pain radiating down the leg isn't treated the same as a local muscular overload)
2. Detect red flags that require medical referral before continuing training
3. Justify progressing or regressing a program with objective data, not just "because the client says so"
4. Track real progress: repeating the same test a few weeks later tells you whether the plan is working

None of these tests replace a medical diagnosis, but they are validated, quick screening tools that any trainer or physio should have in their toolkit.

The 14 spine tests, organized by region

Lumbar and neurodynamic region

Test	What it detects	When to use it
Slump Test	Tension in the nervous system (sciatic/dural) while seated	Low back pain with suspected neural component, especially if it worsens when sitting
Straight Leg Raise (Lasègue) Test	Lumbar nerve root irritation (L4-S1)	Low back pain radiating down the leg, suspected disc herniation
Bragard's Test	Confirms neural origin of a positive Lasègue	When Lasègue is positive and you want to rule out pure muscle tension
Valsalva Test	Increased intrathecal pressure (herniation, space-occupying lesion)	Low back pain that worsens with coughing, sneezing, or straining
Modified Schober Test	Lumbar spine flexion mobility	Suspected lumbar stiffness (spondyloarthritis, chronic low back pain)

Cervical region

Test	What it detects	When to use it
Adson's Test	Thoracic outlet syndrome (vascular/nerve compression)	Tingling or loss of pulse in the arm when moving the neck/shoulder
Lhermitte's Sign	Cervical spinal cord involvement ("electric shock" sign)	Electric shock sensation down the spine when flexing the neck, suspected myelopathy
Cervical Distraction Test	Relief of radicular symptoms when "opening" the joint space	Neck pain radiating to the arm, to confirm a radicular component
Cervical Compression Test (Spurling)	Reproduces radicular pain by "closing" the foramen	Suspected cervical herniation or foraminal stenosis
Craniocervical Motor Control Test	Ability to activate deep neck flexors without compensating	Chronic neck pain, tension headaches, prolonged screen time
Deep Neck Flexor Strength Test	Endurance/strength of the deep cervical musculature	Tracking a cervical strengthening program

Sacroiliac region

Test	What it detects	When to use it
Gillet Test	Asymmetric sacroiliac joint mobility	Unilateral glute/low back pain, suspected SI dysfunction
Gaenslen's Test	Shear stress on the sacroiliac joint	Unilateral low back pain that doesn't improve with classic lumbar tests
Sacroiliac Distraction/Compression Test	Reproduces SI pain via pelvic compression or distraction	Confirming or ruling out a sacroiliac origin alongside Gillet and Gaenslen

How to choose the right test for your context

With 14 tests available, what matters isn't running all of them every time, but knowing where to start based on what the client or patient describes:

• Pain radiating down the leg: start with Lasègue and, if positive, confirm with Bragard. Add Slump if the pain mainly appears when sitting for long periods.
• Low back pain that worsens with coughing, laughing, or straining: try Valsalva, which may indicate an intradiscal pressure component.
• Unilateral low back pain in the glute area: suspicion shifts to the sacroiliac joint: combine Gillet, Gaenslen, and the sacroiliac distraction/compression test. The more positives that align, the more likely an SI origin.
• Generalized lumbar stiffness, difficulty bending forward: the Modified Schober test gives you an objective measure of flexion mobility for tracking.
• Neck pain radiating to the arm, with tingling: use Spurling (compresses) and cervical distraction (relieves) as a pair; if there's also an electric sensation when flexing the neck, check Lhermitte.
• Tingling or loss of pulse when raising the arm or turning the neck: think Adson (thoracic outlet).
• Chronic neck pain, headaches, lots of screen time: here the issue is usually motor control, not structural. Start with the craniocervical motor control test and, to program training, measure deep neck flexor endurance.
• First visit with no clear pattern: run a short battery (Slump or Lasègue for lumbar, Spurling for cervical, Gillet for sacroiliac) and dig deeper only in the area that turns out positive.

A general recommendation: don't interpret a single positive test in isolation. A combination of 2-3 tests with the same positive pattern gives you much more confidence than one test on its own.

From tests to real tracking

The value of this whole battery of tests is lost if it isn't recorded in a way you can compare over time. Did Schober improve after 8 weeks of lumbar mobility work? Is cervical motor control still deficient, or has it already been consolidated?

With Movalytics you can record each of these 14 tests per client, log the result (positive/negative, degrees, seconds of endurance...), and see the progress automatically in charts, without relying on scattered spreadsheets or memory.

Frequently asked questions

Do I need to run all 14 tests on every client? No. These tests are specific: they're chosen based on the area and type of symptom the person reports. An initial assessment usually includes 3-5 indicative tests, expanding only if something comes back positive. Does a positive test mean there's a disc herniation or a serious injury? Not necessarily. A positive test means further investigation is needed, it's not a diagnosis on its own. Many tests produce false positives, especially when applied outside the appropriate clinical context. Are these tests useful for both physios and trainers? Yes, though with nuances: a physio can use them for clinical reasoning and referral, while a trainer mainly uses them as screening, to spot warning signs and decide whether a client needs medical evaluation before continuing to train normally. How often should these tests be repeated? It depends on the goal. If you're working on a specific dysfunction (for example, cervical motor control or lumbar mobility with Schober), repeating every 4-8 weeks is usually reasonable to see real progress. What if several tests from different areas come back positive at the same time? That's common: for example, a sacroiliac dysfunction can cause compensations that also affect lumbar tests. In these cases, prioritize treating the area where the pattern of positives is most consistent, and reassess the rest afterward.