Daily Bolus of LR: Straight Leg Raise

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September 22, 2011 by dailybolusoflr

Straight Leg Raise

* The straight leg raise is a diagnostic test used to diagnose radiculopathy, most commonly related to a herniated disc at the L4-L5 or L5-S1 level. This is commonly referred to as “sciatica”
* The distribution of findings of sensory/motor can be found here http://www.dailybolusoflr.com/2011/03/daily-bolus-of-lr-lumbar-disc.html

* The straight leg raise is performed by passively raising the affected leg and seeing if the radicular symptoms are reproduced
* This maneuver stretches the sciatic nerve and reproduces pain/paresthesias in the affected nerve distribution
* A Cochrane review in 2010 yielded a high sensitivity (92%) but low specificity (28%) for the straight leg raise
* NOTE: Isolated back pain is NOT a positive test

* A crossed straight leg raise is performed by passively raising the opposite (unaffected) leg and seeing if symptoms are reproduced on the affected side
* This maneuver, which stretches the sciatic nerve on the unaffected side, pulls on the affected side as well and leads to symptoms
* The same review shows a much higher specificity (90%) but lower sensitivity (28%)

Ref: Cochrane Database Syst Rev.<http://www.ncbi.nlm.nih.gov/pubmed/20166095#> 2010 Feb 17;(2):CD007431

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