Orthopedic Exam / Special Tests for Physical Therapy: HIP Tests / PELVIS Tests
Lasegue Test aka Lasègue’s Sign, Straight Leg Raise Test
Lasegue Test is done to help find the reason for low back and leg pain. To do this test, a patient lies on their back with both legs straight. The therapist raises the affected leg upward, keeping the knee straight. Lasegue test stretches the sciatic nerve and the nerve roots that lead to it. Compression or irritation of the nerve roots leading to the sciatic nerve can have several causes, but the most common is a herniated disc (lower discs).
http://www.webmd.com/a-to-z-guides/evaluating-low-back-pain-topic-overview
Lasegue Test / Lasègue’s Sign:
PURPOSE:
- to determine the cause of low back pain
- to determine whether a patient with low back pain has an underlying herniated disk, often located at L5 (fifth lumbar spinal nerve).
Video Demo Instructions, Procedure, Positive Test:
Lasegue Test / Lasègue’s Sign: Video Demo (Procedure below)
Lasegue Test / Lasègue’s Sign: PROCEDURE
- Patient is supine.
- The examiner lifts the patient’s leg while the knee is extended.
- Place their affected leg in adduction and internal rotation
- Raise the affected leg by grasping it around the heel and flexing the hip (their affected knee should be extended).
- Flex the hip until the patient feels pain (usually around 70-80 degrees of flexion)
- Slowly lower the leg until no pain is felt by the client.
- Dorsiflex the patient’s affected foot (this stretches their sciatic nerve, nerve root, or dura and makes the test more specific).
Lasegue Test / Lasègue’s Sign: POSITIVE SIGNS:
If patient has pain at the posterior leg and knee while the affected leg is raised, the test is positive. It means that one or more of the nerve roots leading to the sciatic nerve may be compressed or irritated.
If doing this test on the unaffected leg causes pain in the affected leg, it helps to confirm that one of these nerve roots is compressed or irritated.
- Herniated Disc – If the patient experiences sciatic pain when the straight leg is at an
angle of between 30 and 70 degrees. - Disc Herniation – pain down the unaffected leg.
- Hamstring Tightness – pain in the back of their thigh and knee during hip flexion
- Lumbar or SI Joint Dysfunction – pain in the low back after 70 degrees of hip flexion only (no foot dorsiflexion)
- Sciatic Nerve Involvement – pain down the leg during passive dorsiflexion Space Occupying Lesion.
Interpretation:
A meta-analysis reported the accuracy as:
- sensitivity 91%
- specificity 26%
If raising the opposite leg causes pain (cross or contralateral straight leg raising):
- sensitivity 29%
- specificity 88%