Which tests can be used to confirm torsional diagnoses?

• A. Sphinx and spring
• B. McKenzie test
• C. Schober test
• D. FABER test

Answer: (A)

When evaluating a suspected torsional issue in the spine, you want tests that directly probe facet joint and segmental motion. The Sphinx test—asking the patient to extend the spine while prone—can reproduce facet-related pain and symptoms linked to rotational or torsional stress at a spinal segment. The spring test then assesses how a specific spinal segment responds to a gentle anterior or posterior impulse on a spinous process; a painful, exaggerated, or reduced spring indicates altered segmental mobility consistent with torsional involvement. Using both tests together helps confirm a torsional diagnosis because they target the mechanics at the affected segment rather than just overall flexibility or hip/SI joint pathology.

Other tests don’t fit this purpose as precisely. The McKenzie test emphasizes disc derangement and directional preference rather than facet-driven torsion. The Schober test measures lumbar flexion range, useful for conditions like ankylosing spondylitis but not for confirming torsional segmental pathology. The FABER test evaluates hip or sacroiliac joint pathology, which isn’t about spinal torsion.