Lumbar Spine Exam - Positives & Indicators

Question 1

Hoover Sign

Answer 1

Positive: Lack of counter-pressure on the healthy sideIndicates: Lack of organic basis for paralysis (Malingering/hysteria) With organic hemiplegia, the patient will still exert downward pressure with attempting to raise paralyzed leg

Question 2

Straight Leg Raiser (SLR)

Answer 2

Positive: Radiating pain and/or dull posterior thigh painIndicates: Sciatic radiculopathy or tight hamstrings. Positive between 35-70 degrees = possible discogenic sciatic radiculopathy> 70 degrees = tight hamstrings

Question 3

Goldthwait Sign

Answer 3

Positive: Localized pain, low back or radiating pain down the legIndicates: Lumbo-sacral or sacroiliac pathology. Pain occurring after the lumbar spinouses move = possible lumbo-sacral problem. Pain occurring before the lumbars move = possible sacroiliac problem

Question 4

Bragard Sign

Answer 4

Positive: Radiating pain in posterior thighIndicates: Sciatic radiculopathy

Question 5

Buckling Sign

Answer 5

Positive: Pain in the posterior thigh with sudden knee flexion (buckle)Indicates: Sciatic radiculopathy

Question 6

Bowstring Sign

Answer 6

Positive: Pain in the lumbar region or radiating painIndicates: Sciatic nerve root compression, helps rule out tight hamstrings

Question 7

Lasegue Test

Answer 7

Positive: Reproduction of sciatic pain before 60 degreesIndicates: Sciatica

Question 8

Milgram Test

Answer 8

Positive: Inability to perform test and/or low back painIndicates: Weak abdominal muscles or space occupying lesion

Question 9

Valsalva Maneuver

Answer 9

Positive: Radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar area of the spine)Indicates: Space occupying lesion (e.g. disc pathology)

Question 10

Bechterew Test

Answer 10

Positive: Reproduction of radicular pain or inability to perform correctly due to tripod signIndicates: Sciatic radiculopathy

Question 11

Neri Bowing Test(Neri Sign)

Answer 11

Positive: Pain accompanied by flexion of the knee on the affected side and body rotation away from the affected sideIndicates: Positive with a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response

Question 12

Anterior Innominate TestMazion Pelvic ManeuverAdvancement Sign

Answer 12

Positive: Inability to bend at the waist more than 45 degrees, because of either/orRadiating pain along the sciatic nerve, either unilateral or bilateral Indicates: Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathologyOr low back pain (lumbar or pelvic regions)Indicates: Anterior (rotational) displacement of the ilium relative to the sacrum

Question 13

Lewin Standing Test

Answer 13

Positive: Radiating pain down the leg causing flexion of the patient’s knee or kneesIndicates: Gluteal, lumbosacral or sacroiliac pathologies

Question 14

Heel Walk

Answer 14

Positive: Inability to perform testIndicates: L4-L5 disc lesion (L5 nerve root)

Question 15

Toe Walk

Answer 15

Positive: Inability to perform testIndicates: L5-S1 disc lesion (S1 nerve root)

Question 16

Ely Heel to Buttock Test

Answer 16

Positive: Inability to raise the thighIndicates: Iliopsoas spasmPositive: Pain in the anterior thighIndicates: Inflammation of lumbar nerve rootsPositive: Pain in the lumbar regionIndicates: Lumbar nerve root adhesions