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What is a Straight Leg Raise Test?

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Updated August 31, 2010

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Question: What is a Straight Leg Raise Test?
If you live with back pain accompanied by pain down your leg (sciatica), your doctor may suspect that a herniated disc is to blame. A common test to determine if a herniated disc is causing back and leg pain is the straight leg test.
Answer:

The straight leg test is one of the most common manual tests performed during a physical exam. Like many manual tests, it is used to check for nerve involvement. The straight leg raise test specifically checks to see if pain down your leg is due to a herniated disc in your back. The straight leg test is a passive test, meaning you should be relaxed and the examiner will lift your leg for you. The test seeks to “reproduce your pain.” So your job is to report what you feel once your leg has been lifted.

What Happens During a Straight Leg Raise Test

To start, the person examining you will have you lie on your back with your legs straight. She will then ask you to turn one of your legs in. It’s important to turn the whole leg. This is so the examiner can accurately correlate the anatomical position you are in with what you report. The examiner will also ask you to bring your leg in towards the center of your body.

Next, the examiner will lift your straight leg up until you complain of pain. If you don’t have pain during the straight leg raise, great! If you get pain in your back or leg from this maneuver, it’s likely you have a positive sign for a herniated disc. This means that your usual pain is caused by a disc herniation in your back. Both legs are tested in a straight leg raise test.

The examiner may repeat the test while you flex your foot. She then may repeat the test again while you tuck your chin to your chest. These variations of the straight leg raise test check for nerve involvement in the dura mater (covering) of the spinal cord or the spinal cord itself. A positive sign for nerve involvement from the spinal cord or its covering would present itself as your usual pain in your back or leg, but not in your chin, neck or foot.

If you have difficulty lying on your back or lifting your leg up when it’s straight, there straight leg test modifications. This is why it’s important to speak up and let the examiner know your limitations. Another reason to speak up is to avoid an injury during the testing.

Source:

Magee, D. Orthopedic Physical Assessment. Enhanced Edition. 4th ed. Elsevier. St. Louis. 1997.

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