Indications

The Straight Leg Raise, associated with Lasègue’s Seated Test and Bradard’s Sign is test to help determine whether a patient with low back pain has an underlying herniated disk. Often located at L5 (fifth lumbar spinal nerve).

Procedure

  1. Patient supine, examiner places one hand under patient’s ankle & other hand over patient’s knee (to insure knee stays extended during action).
  2. Examiner then proceeds to passively elevate the straight leg.
Bradard’s Sign
To reproduce the Bradard’s Sign, the patient leg is then lowered to an angle just below the production of pain and the examiner then dorsiflexes the foot, to reproduce the pain.

Interpretation

Radicular leg pain Nerve root compression, intervertebral disc herniation, piriformis entrapment
Lower back pain Sacroiliac/lumbar sprain/strain
Degrees of Flexion Tissue Involved
0° to 35° Extradural involvement
35° to 70° Disc/nerve root involvement
Above 70° Sacroiliac/lumbar joint pain

Clinical Notes

First ask patient to perform an active straight leg raise as a measure of functional capability.
Criteria for Sciatica (From Disc Herniation)
  1. Leg pain is greater then back pain
  2. Dermatomal paresthesia
  3. SLR limited to 50% of normal
  4. Two of four neurological signs present (atrophy, motor weakness, decreased sensation, decreased deep tendon reflex)