What is Schepelmann Test?
Schepelmann test is used for the differential diagnosis of chest pain. There are several different reasons of chest pain like
- Compression on the intercoastal nerve (intercoastal neuralgia),
- The strain on the intercoastal muscles,
- Rib fracture or a Rib subluxation.
- Inflammation of the pleura (pleuritis)
- Strain or stretching of the muscles present in the chest area.
The procedure of Performing The Schepelmann Test?
This Schepelmann test can be performed in two positions one is in a seated position, and the other is in a standing position.
Let me first demonstrate this test in a seated position. Don’t worry about the standing position procedure. You can perform the below-mentioned procedure in a standing position, also. Therefore, the patient’s position will change from seated to standing rest all the procedures will remain the same.
Position of the Patient – The patient is in a seated position with their arms resting by their side.
Now the examiner will ask the patient at which side they feel pain.
Let’s suppose a patient is a man, and he says he is having pain on the right side of the rib cage.
Right Side Bending
So the first thing the examiner will do is he will watch how the patient actively bends towards the right side. The patient will bend as far as he can. And after bending towards the right side, the examiner will ask him to straighten up.
Left Side Bending
After straightening up the spine, the examiner will ask him to bend towards the left side (opposite side) of the pain.
Assessment of The Schepelmann Test
Once bending towards the left and right sides got completed, the examiner will ask the patient specifically where he felt the pain.
Did he feel the pain when he bent towards the pain side (right side)? or did he feel the pain when he bent away from the pain side (left side).
What type of pain did he feel? And how to point to that area where he felt the pain? This could be a couple of different things.
A positive schepelmann test is an increase in pain or if the pain is evoked during moving either to the left side or the right side.
If the patient is moving towards the pain side (right side) and if the pain increases, it can be due to
- Compression on the intercoastal nerve (intercoastal neuralgia) or
- it could be due to the strain on the intercoastal muscles or
- It can be a rib fracture or a rib subluxation.
If the pain increases when the patient moves away from the side of pain (left side), then it can be
- An indication of costochondritis,
- It can also be an inflammation of the pleura (pleuritis). So you want to be very careful. or
- It could be a strain or stretching of the muscles present in that area. Or
- It could be a rib fracture.
Therefore rib fractures are painful on any movement of the spine. Therefore, if you move any side of the spine, either the left side or right side, if there is a rib fracture, then it would be painful. A video demonstration of Schepelmann’s test (above-explained procedure) is mentioned below.
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Clinical Tests for the Musculoskeletal System: Examinations-Signs-Phenomena by K. Buckup
My self Ritvik Verma and I am a Physiotherapist and the founder of www.physio-study.com. I completed my bachelor’s of physiotherapy from Integral University Lucknow and an internship at KMC Hospital Meerut.
Then I worked in the Physiotherapy Department of Lovee Shubh Hospital (Lucknow) for one year. Then I joined Holistic Touch Physical Therapy & Wellness Clinic and worked there for more than six months.
I am running my clinic and writing blogs on my website, www.physio-study.com, in my hometown, Lakhimpur Kheri.