Orthopedic Exam / Special Tests for Physical Therapy: HIP Tests / PELVIS Tests
Straight Leg Raise Test (SLR Test) aka Lasègue’s sign, Lasègue Test or
Back pain may be characterized as a dull ache, shooting or piercing pain, or a burning sensation. The pain may radiate into the arms and hands as well as the legs or feet, and may include tingling, weakness or numbness in the legs and arms. The most common area of pain is the lower back, or lumbar area.
Low back pain, also known as lower back pain or lumbago, is a common disorder involving the muscles and bones of the back. In most episodes of low back pain, a specific underlying cause is not identified or even looked for, with the pain believed to be due to mechanical problems such as muscle or joint strain. Some low back pain is caused by damaged intervertebral discs, and the Straight Leg Raise test is useful to identify this cause.
Spinal disc herniation, also known as a slipped disc, is a medical condition affecting the spine in which a tear in the outer, fibrous ring (anulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to bulge out beyond the damaged outer rings. Disc herniation is usually due to age-related degeneration of the anulus fibrosus, although trauma, lifting injuries, or straining have been implicated. Tears are almost always postero-lateral in nature owing to the presence of the posterior longitudinal ligament in the spinal canal.
SLR Test/ Straight Leg Raise Test:
- 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:
SLR Test/ Straight Leg Raise Test: Video Demo (Procedure below)
SLR Test/ Straight Leg Raise Test: PROCEDURE
- Patient is supine.
- 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 client’s affected foot ( this stretches their sciatic nerve)
SLR Test/ Straight Leg Raise Test: POSITIVE SIGNS:
- 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
- Sciatic Nerve Involvement – pain down the leg during
passive dorsiflexion Space Occupying Lesion or
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%