Indications

Kemp’s Test is a useful examination to differentiate between Lumbar nerve root compression and local lumbar spine sprain/strain. Kemp’s test is a test to assess the lumbar spine facet joints (zygapophyseal joints). It is a provocative test to detect pain , which can be local, referred or radiculair.

Procedure

  1. Patient seated, examiner stabilises lumbar spine with one hand and supports patient’s contralateral shoulder with the other hand.
  2. Patient leans away from examiner then is twisted into forward flexion and eventually brought back into lateral flexion and extension.
Kemps Test

Kemp’s Test – Patient leans away from examiner

Kemp's Test Orthopaedic test

Kemp’s Test – patient is assisted to lateral flexion and extension.

Modifications

  1. Kemp’s Test can also be performed with the patient standing in an upright position. Take care that the patient does not lose balance.
  2. You can apply downward pressure on the patients shoulders to increase pressure on the facet joints.

Interpretation

Local lower back pain on the tested side usually indicates a facet cause, while radiating pain into the leg is more suggestive of nerve root irritation. Pain on the contralateral side can suggest a lumbar strain or sprain.

Positive Kemp’s Test

There are two signs to show a positive kemp’s test.

  1. Leg pain: Typically indicates nerve root compression, radiculopathy.
  2. Local lower back pain: Local lesion (sprain/strain, facet syndrome, meniscoid entrapment)

Clinical Notes

As with all orthopaedic tests, you must state what the positive finding reveal in your clinical notes, for example, “Kemp’s test was positive for radiating right L5 dermatomal pain, indicating L5 nerve root compression”