When you go to see a doctor—your regular doctor or a spine specialist—there are several steps he/she will go through in attempting to diagnose the cause of your back pain or neck pain. One of these steps is a physical exam.
As the name suggests, in a physical exam, the doctor physically examines your body; in the case of a spine physical exam, he/she pays special attention to the back, its joints, the muscles that support it, and what causes pain or other symptoms.
Before beginning the physical exam, the doctor will take a complete medical history. He or she will ask you questions about your current symptoms and previous medical issues; this is to get a picture of your overall health. The history can also give the doctor clues as to what may be causing your symptoms now.
For example, say you tell the doctor, "I have pain that shoots down my right leg, and it starts in my low back. If I arch my back like this, it seems to get better." Using those details, the doctor should pay particular attention to your low back during the physical exam.
Physical Exam Basics
In a physical exam of the spine, the doctor will look at your back and feel your spine. He or she will be looking for abnormalities.
The doctor will observe your posture, range of motion (how well and how far you can move certain joints, and physical condition. He or she will note any movement that causes you pain. Usually, the doctor will have you bend forwards, backwards, and to the side in order to figure out if certain movements hurt more than others.
The doctor will palpate your spine; that means he or she will feel your spine. By pressing his or her hands along the bones, the doctor will be able to identify areas of tenderness and pain. The palpation process can also help the doctor figure out if it's a muscle problem causing your pain; he or she will palpate the muscles supporting the spine (paraspinal muscles).
This is a general overview of what can happen in a physical exam. Your doctor may not do everything listed here.
Tip for the Physical Exam
During the physical exam, the doctor is relying on you to give feedback. Try to answer the doctor's questions as fully as possible, giving as much detail as you can. This helps the doctor better understand your pain and symptoms.
For example, if you notice that your pain gets a lot worse when the doctor has you arch your back, tell him or her. While the doctor may notice that you're in pain (from a grimace on your face, perhaps), it's helpful to have a description from you of intensity, location, etc.
A neurological exam is generally done at the same time as a physical exam, especially for spine problems. You can read more about what happens in a neurological exam here.