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The straight leg raise is a test that can be performed during a physical examination, with the leg being lifted actively by the patient or passively by the clinician. If the straight leg raise is done actively by the patient, it is a test of functional leg strength, particularly the rectus femoris element of the quadriceps (checking both hip flexion and knee extension strength simultaneously).
Distraction tests: positive tests are rechecked when the patient's attention is distracted, such as a straight leg raise test; Regional disturbances: regional weakness or sensory changes which deviate from accepted neuroanatomy; Overreaction: subjective signs regarding the patient's demeanor and reaction to testing
A positive test indicates the increased likelihood that the abdominal wall and not the abdominal cavity is the source of the pain (for example, due to rectus sheath hematoma instead of appendicitis). [ 3 ] [ 4 ] A negative Carnett's sign is said to occur when the abdominal pain decreases when the patient is asked to lift the head; this points ...
Knee to chest stretch - Lying down on the back, bring one leg up and pull it towards the chest and hold for 30–45 seconds. Posterior pelvic tilt (bridges) - Lying on the back, bend both legs and place your feet on the floor. Raise stomach from the ground, lifting the back and pelvis, until the back is straight. Hold for 5–10 seconds and relax.
While this test is positive in about 90% of people with sciatica, approximately 75% of people with a positive test do not have sciatica. [4] Straight leg raising of the leg unaffected by sciatica may produce sciatica in the leg on the affected side; this is known as the Fajersztajn sign. [15]
Diagnostic signs such as the straight leg raise test may be negative even if real pathology is present. [ 60 ] [ 65 ] The presence of a positive myelogram may represent a new disc herniation, but can also be indicative of a post operative scarring situation simply mimicking a new disc.
A variation is to lift the leg while the patient is sitting. [41] However, this reduces the sensitivity of the test. [42] A Cochrane review published in 2010 found that individual diagnostic tests including the straight leg raising test, absence of tendon reflexes, or muscle weakness were not very accurate when conducted in isolation. [43]
The straight leg raise test is almost always positive in those with disc herniation, [5] and lumbar provocative discography may be useful to identify a specific disc causing pain in those with chronic high levels of low back pain. [47] Therapeutic procedures such as nerve blocks can also be used to determine a specific source of pain. [5]