When dealing with low back pain patients, special tests are often employed to help diagnose specific causes.
1. Straight Leg Raise (SLR) Test:
- Procedure:
- Patient lies supine.
- Lift the patient's straightened leg, keeping the knee extended.
- Purpose:
- Evaluate for sciatic nerve irritation or herniated disc.
- Positive if pain radiates down the leg (radicular pain).
2. Crossed Straight Leg Raise (Lasègue's Test):
- Procedure:
- Similar to SLR but performed on the unaffected leg first.
- Then repeated on the affected leg.
- Purpose
- Assess for nerve root irritation on the contralateral side.
- Positive if raising the unaffected leg reproduces pain in the affected leg.
3. Bragard's Test
- Procedure:
- Performed after a positive SLR.
- Lower the leg slightly and dorsiflex the foot.
- Purpose
- Differentiate between sciatic nerve irritation and lumbar nerve root compression.
- Positive if pain is reproduced with dorsiflexion.
4. Patrick's (FABER) Test:
- Procedure:
- Patient lies supine; one ankle is placed on the opposite knee, forming a figure-four position.
- Gentle pressure applied to the flexed knee.
- Purpose:
- Assess for hip joint or sacroiliac joint pathology.
- Positive if there is pain in the hip or sacroiliac joint.
5. Valsalva Maneuver:
- Procedure:
- Patient sits or stands, takes a deep breath, and bears down as if having a bowel movement.
- Purpose:
- Evaluate for increased intrathecal pressure.
- Positive if it reproduces radicular pain.
6. Prone Instability Test:
- Procedure:
- Patient lies prone; examiner lifts the legs and pelvis off the table.
- Purpose:
- Assess for signs of lumbar instability.
- Positive if reproduction of pain or muscle spasm indicates instability.
7. Lumbar Compression Test:
- Procedure:
- Apply axial compression on the spine.
- Rotate and laterally flex the spine.
- Purpose:
- Evaluate for facet joint pathology.
- Positive if pain is reproduced during compression and rotation.
8. Schober's Test:
- Procedure:
- Measure the lumbar spine's flexion ability during forward bending.
- Purpose:
- Assess for ankylosing spondylitis or limited lumbar flexion.
- Positive if there is limited flexion compared to normal.
9. Slump Test:
- Procedure:
- Patient sits and slumps forward.
- Neck flexion is added, and the ankle is dorsiflexed.
- Purpose:
- Assess for neural tension or irritation.
- Positive if it reproduces leg pain or paresthesia.
10. Gillet (Stork) Test:
- Procedure:
- Patient stands; examiner palpates the PSIS while patient lifts one knee.
- Purpose:
- Evaluate for sacroiliac joint dysfunction.
- Positive if PSIS does not move with knee flexion.
11.Femoral nerve stretch test:
-Procedure:
1. The patient lies on their stomach.
2. The examiner bends the knee of the leg being tested, bringing the heel towards the buttocks.
3. The examiner then extends the hip of the tested leg, lifting the thigh off the table.
-Purpose :
- To evaluate the femoral nerve for any signs of compression or irritation, often related to conditions affecting the lumbar spine. A positive test may elicit pain or discomfort along the anterior thigh and could indicate femoral nerve involvement.
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