Schepelmann’s sign is a thoracic spine examination procedure that tests for intercostal neuritis or intercostal strain. The pain or discomfort increases when the patient bends on the unaffected side while in intercostal neuralgia, the pain increases when the patient bends on the affected side.


Patient should be awake and cooperative in assessing for Schepelmann’s Sign.

  1. Patient may stand or sit during the procedure.
  2. The patient abducts her shoulders at 180 degrees and flexes her spine from side to side.
  3. The examiner assists the patient in assuming the position and observes for uniform motion and any signs of discomfort or pain.

The patient laterally flexes the spine from side to side.


PositiveĀ Schepelmann’s Sign

There is positive Schepelmann’s Sign when the patient complains of rib pain. Concave side pain could indicate intercostal neuritis while convex side pain could indicate myofascitis or intercostals strain.

Clinical Notes

Schepelmann’s Sign is an efficient way to screen the thoracic spine. It can also help localize the injured area.