Diagnosing somatic dysfunction in the thoracic and lumbar spine begins with assessing the transverse processes. On palpation, when transverse processes are found to be more posterior (prominent) on one side, this indicates that these vertebrae are rotated to that side. The more posterior transverse process may also be described as “resisting posterior-anterior (PA) pressure.”

Since testing side bending is difficult in the thoracic and lumbar spine, we use Fryette laws to assume the side bending based on the rotation. If a group of vertebrae is rotated right, we assume that group is side bent left (type I mechanics). If a single vertebra is rotated right, we assume it is side bent right (type II mechanics). For type II somatic dysfunctions, we also ask the patient to flex and extend at that area while we palpate the transverse processes to assess for restoration of symmetry (ease of motion).