The Test to Tell If Your Back and Leg Pain is Caused by Nerve Root Irritation

Good Morning! This is The Field Guide to Back and Neck Pain, the newsletter to stay up to date on treatments and symptoms of back pain, neck pain and other chronic pain conditions. Welcome to all new readers! To those that have been here before, thank you, it’s so good to see you again.

Here is what you can expect from today’s edition:

• What is the Straight Leg Raise (SLR) Test?

• What does a positive SLR Test mean?

• News: Exercises to AVOID with sciatica

What is the Straight Leg Raise Test?

The straight leg raise test is a physical examination maneuver commonly used by healthcare professionals to assess for signs of lumbar nerve root irritation, particularly in cases of suspected sciatica or lower back pain. The test helps determine if a patient has nerve compression or irritation in the lumbar spine (lower back) that may be causing pain, numbness, tingling, or weakness in the legs.

Here's how the straight leg raise test is typically performed:

1. The patient lies on their back on an examination table or bed with their legs fully extended.

2. The healthcare provider or examiner stands at the patient's side.

3. They gently lift the patient's relaxed leg (usually the affected leg) with the knee straight. The examiner should support the ankle and not the heel to avoid straining the ankle joint.

4. During the leg elevation, the examiner watches for the patient's response. They look for signs of pain, discomfort, or other symptoms. Typically, the test is considered positive if the patient experiences one or more of the following:

   1. Pain radiating down the back of the leg, which may mimic the patient's usual pain or discomfort

   2. Numbness or tingling in the leg.

5. In some cases, the examiner may measure the angle at which the leg is raised when symptoms occur. This angle can provide additional information about the severity of nerve compression.

   1. Generally, if the pain is reproduced at an angle less than 60 degrees from the horizontal, it is considered a positive test.

6. The test may be performed on the other leg to compare the results and gather more information about the condition.

Check out this video to see how the Straight Leg Raise Test is performed:

Keep reading to learn what a positive Straight Leg Raise Test means!

Laugh through the pain…

What Does a Positive Straight Leg Raise Test Mean?

The straight leg raise test is designed to put tension on the sciatic nerve, which runs down the back of the leg. If the patient experiences pain or other symptoms when the leg is raised, it may suggest that there is compression or irritation of the nerve roots in the lumbar spine, often caused by conditions such as herniated discs, spinal stenosis, or other spinal disorders.

It's important to note that a positive straight leg raise test is not definitive proof of a specific diagnosis but rather an indicator that further evaluation, such as imaging studies (e.g., MRI or CT scan), may be needed to determine the exact cause of the symptoms, which can include lumbar disc herniation or nerve root impingement. Additionally, the test should be performed carefully to avoid causing unnecessary pain or injury to the patient, and it should be interpreted in conjunction with the patient's medical history and other clinical findings.

Check out our recent article about Sciatica and Lumbar Radiculopathy to learn more about the conditions that the Straight Leg Raise Test can help to reveal!

In the news…

We’ve all seen articles about exercises to help with sciatica, but what about the exercises to avoid? Check out the article below for more info!

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About the Author

Les is an invaluable member of the team! He is the Lead Writer for the Field Guide to Back and Neck Pain newsletter. However, Les Payne is just a Pen Name to protect the identity of our expert Lead Writer who is an actively practicing, board-certified expert in the treatment and prevention of back and neck pain as well as other acute and chronic pain conditions. He has years of experience in this field and has treated over 15,000 patients with pain of all kinds!

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