The slump test is an excellent provocation test for lumbosacral pain and is more sensitive than the straight leg raising test. It is a screening test for a disc lesion and dural tethering. It should be performed on patients who have low back pain with pain extending into the leg, and especially for posterior thigh pain.
A positive result is reproduction of the patient's pain, and may appear at an early stage of the test (when it is ceased).
1. The patient sits on the couch in a relaxed manner.
2. The patient then slumps forward (without excessive trunk flexion), and then places the chin on the chest.
3. The unaffected leg is straightened.
4. The affected leg only is then straightened (Fig 33.6).
5. Both legs are straightened together.
6. The foot of the affected straightened leg is dorsiflexed.
Note: Take care to distinguish from hamstring pain. Deflexing the neck relieves the pain of spinal origin, not hamstring pain.
Significance of the slump test
• It is positive if the back or leg pain is reproduced.
• If positive, it suggests disc disruption.
• If negative, it may indicate lack of serious disc pathology.
• If positive, one should approach manual therapy with caution.
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