Bowstring Sign is often used to apply pressure on the sciatic nerve and reproduce radicular pain, indicating lumbar root compression or sciatic nerve tension (sciatica).
- Patient supine, examiner flexes patient’s hip with knee slightly flexed; examiner then applies pressure with thumbs on hamstring muscles
- If no pain is elicited, examiner then proceeds to apply pressure to the popliteal fossa (traction on the sciatic nerve).
- Patient is instructed to repeat motion of touching toes.
Bowstring Sign can be used to differentiate between radiculopathy, sciatica and local muscular and/or ligamentous sprain.
Positive Bowstring Sign
There are two signs to show a positive Bowstring test.
- Leg pain: Radiculopathy, interventricular foramen encroachment, space-occupying lesion, nerve root tension, sciatica
- Local Back or Hamstring Pain: Consider local muscle strain or ligamentous sprain
Lasègue’s Seated Test is the same manoeuvre as Bowstring Sign, without the application of traction to the sciatic nerve at the popliteal fossa.