Term
| Raise the extended leg, internally rotate the foot and then adduct the extended limb. If this action causes pain to radiate into the leg = piriformis syndrome |
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Definition
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Term
| If the Straight Leg Raise test causes radiating pain into the leg in the supine patient, the angle at which the pain is felt is noted. Now lower the affected limb 50 below the point at which the pain was felt and sharply dorsiflex the foot. If this action causes the pain to increase = irritation of the roots of the sciatic nerve. |
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Definition
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Term
| Lift the affected leg of the supine patient with the knee flexed until it is above your shoulder. Apply firm pressure on the hamstring muscles and then in the popliteal fossa. If either of these actions causes leg or back pain = nerve root compression. |
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Definition
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Term
| Raise each leg of the supine patient separately noting the angle at which pain is produced. Now raise both legs together noting the angle at which the pain is reproduced. If the angle at which pain occurs when both legs are lifted together is less than when either leg is raised = lumbosacral joint involvement. |
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Definition
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Term
| Grasp the heel of the affected extended limb of the supine patient in one hand and place the other hand on the knee. Flex the hip while the knee is flexed. Slowly extend the knee while the leg is elevated. If extension of the elevated knee severely limited because of pain = sciatic nerve or nerve root irritation. |
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Definition
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Term
| Stabilize the supine patient’s thighs or legs on the table and then ask the patient to attempt to sit up without using the hands. Pain or inability to do this action = sciatica or lumbosacral pathology. |
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Definition
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Term
| Passively flex the patient’s head then the neck on to the chest of the patient. If this action causes pain along the lumbar spine and along the sciatic nerve distribution [back of thigh and back of leg] = sciatica due to disc herniation. |
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Definition
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Term
| Ask the supine patient to raise both of their extended legs so that both heels are six inches off the table and to hold them there for 30 seconds. Pain or inability to hold this position for more than 30 seconds = disc lesion or raised intrathecal pressure. |
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Definition
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Term
If the straight leg raise test is positive, lower the leg to just below the point of pain. Quickly extend the big toe of the affected foot.
If this action duplicates or increases the pain = sciatic nerve root compression. |
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Definition
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Term
| Place one hand below the heel of the supine patient’s extended affected limb and the other hand on the knee. With the knee extended, lift the patient’s leg. Note the angle at which the patient first experiences pain radiating into the back of the leg. If this action causes pain in the leg to be felt between 00 and 350 = extradural nerve root irritation. If the pain is perceived between 350 and 700 = disc herniation causing sciatica. Pain beyond 700 = lumbosacral joint disease [no further stretch on nerve]. |
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Definition
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Term
| Raise the asymptomatic extended leg of the supine patient as in the straight leg raise test and then dorsiflex the foot. If this action causes pain in the affected leg = disc compression of the roots of the sciatic nerve [medial disc protrusion on contralateral side] or dural sleeve adhesions. |
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Definition
| Well Leg Raise [aka Fajersztajn] |
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Term
| Flex the knee of the prone patient to bring the heel to touch the opposite buttock. After knee flexion, the thigh is hyperextended. If you are unable to fully flex the knee towards the buttock = iliopsoas pathology or inflamed roots of the femoral nerve. If after full knee flexion, you are unable to hyperextend the hip = hip lesion. |
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Definition
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Term
| Stabilize the hip by placing one hand on the ilium of the prone patient. Passively flex the knee and extend the hip. If extension of the hip causes pain along the anterior thigh = femoral nerve irritation. |
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Definition
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Term
| Passively flex the knee of the prone patient to the same buttock while exerting downward pressure on the pelvis to prevent buckling at the hips. If this action causes pain in the lumbosacral or sacroiliac regions = lumbosacral pathology. |
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Definition
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Term
Ask the standing patient to bend forward and the doctor notes when the pain occurs. Brace your hip against the patient’s sacrum and stabilize the patient’s pelvis by holding onto the patient’s ASIS’s.
Ask the patient to bend forward again and note when the patient experiences pain. If there is pain after the second maneuver = lumbar problem. If the pain disappears after the second maneuver = pelvic problem. |
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Definition
| Adam supported [aka Belt test] |
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Term
Observe the posture of the patient. If the patient’s backache is caused by a disc herniation lateral to the nerve root, the patient will lean away from the side with the lesion. This pulls the nerve towards the midline and away from the disc herniation.
If the herniation is medial to the nerve root, the patient will lean into the side with the lesion. This pulls the nerve away from the disc herniation. With a posterior central disc herniation, the patient will stand very straight and stiff with the back in slight flexion. |
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Definition
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Term
Anchor the patient’s pelvis on the affected side of the standing patient. With the other hand, grab the opposite shoulder of the patient. Lean the patient backward into lumbar extension, aiming the shoulder towards the affected side.
If this action causes localized pain = facet syndrome. If the pain radiates into the thigh and leg = nerve root compression. |
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Definition
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Term
| Mark two spots: one- 5 cm below the posterior superior iliac spine [PSIS] and the other 10 cm above the PSIS in the midline. Ask the patient to bend forwards and attempt to touch the toes without bending the knee. Measure the difference between the two marks and subtract 15 from this measurement. If the increase is less than 5 cm = ankylosing spondylitis. |
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Definition
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Term
| Ask the seated patient to extend the affected leg first and then both while you exert downward pressure on the patient’s thighs. If this action causes pain to radiate into the affected leg = disc lesion or sciatica. |
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Definition
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Term
Instruct the patient to lean forward to the affected side and then around so that the patient moves the opposite shoulder obliquely backwards.
If this action causes localized pain = strain/sprain. If the pain radiates into the thigh and leg = nerve root compression due to disc herniation. |
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Definition
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Term
| Ask the seated patient to stand up. If the patient has to support himself by placing one hand on the healthy thigh or knee, while keeping the affected side bent over = lumbosacral pathology. |
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Definition
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Term
| Place your hands over the dorsum of the iliac bone of the prone patient and thrust bilaterally towards the midline. If this produces pain over the sacroiliac area = sacroiliac joint pathology. |
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Definition
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Term
| A positive test is when a patient points to an area of pain that is just medial and inferior to the PSIS = sacroiliac pathology |
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Definition
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Term
Ask the patient to lie facing upwards with the affected side close to the edge of the table. Passively flex the hip and knee of the unaffected side towards the abdomen of the patient with one hand. Allow the affected leg to hang off the send of the table slightly.
Place your other hand on the knee of the affected side and then apply downward pressure on both knees.
If this action results in an increase in pain in the sacroiliac region = sacroiliac pathology. |
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Definition
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Term
| Slowly raise the affected leg of the supine patient with one hand while your other hand is under the lumbar region of the patient. If this action causes pain before the lumbar spine starts to move [between 0-300] = sacroiliac pathology. If the pain occurs between 300and 600 = lumbosacral joint pathology. If the pain occurs between 600 and 900 = lumbar region pathology. |
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Definition
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Term
| Place one of your hands firmly on the dorsum of the iliac bone to stabilize the prone patient’s pelvis. Flex the opposite knee to 900 and slowly push the patient’s leg laterally. This causes internal rotation of the head of the femur. Repeat this on the other side. If this action causes pain in the sacroiliac region = sacroiliac pathology. If there is pain in the hip = hip pathology. |
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Definition
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Term
Have the patient lie on the unaffected side. Place both of your hands on the superior ilium of the patient and applies downward pressure.
If this action causes pain in the region of the sacroiliac region = sacroiliac pathology. |
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Definition
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Term
| Place the external malleolus of one limb over the patella of the opposite limb with the patient in the supine position and apply downward pressure. If this causes pain in the sacroiliac region = sacroiliac pathology. |
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Definition
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Term
| With the patient prone, place one hand over the affected sacroiliac joint to stabilize the pelvis. Flex the knee of the affected side, place your other hand underneath the affected thigh and lift the knee off of the table. If this action increases pain in the sacroiliac region = injury of the anterior sacroiliac ligament. |
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Definition
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