3-2-1: The Spine You Thought You Ruled Out

I. You cannot rule out the spine without a baseline
Active pain may not show up during the eval, so you need a functional marker you can track. Pain after sex, pain after sitting, pain after standing, urgency, frequency, penile or testicular pain. Write the problem list before you move anything.

II. A real spinal screen has three layers
Posture modification, then range of motion, then repeated movements. One rep does not count. Many men need 20 to 30 reps before you see change. Add diagnostic overpressure at the thoracic lumbar junction or lumbar sacral area when symptoms map to those regions.

III. Centralization tells you you are on the right track
When distal pain fades and moves toward the back, that is progress, not failure. A temporary increase in back soreness often means the true driver is finally showing itself. Adjust reps, frequency, or pressure, but do not abandon the direction too early.

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I. “All models are wrong, but some are useful.” - George Box
Your spinal screen is a model. It does not need to explain everything. It just needs to help you choose the next right test.

II. “Information is the resolution of uncertainty.” - Claude Shannon
Baselines, repetition, and retesting turn a messy pelvic case into a clear clinical decision.

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Before moving to the pelvic or neuro-horseman, will you confirm you truly ruled out the spine with enough reps, enough overpressure, and a baseline that actually matters?

With care,

Team IPC