11/13/24, 7\:10 PM Guide | Slump test

Slump test

Table of contents

Background

The slump test is a neural tension test to aid in the diagnosis of radicular pain or radiculopathy originating from the lumbar
spine\:
Radicular pain is caused by nerve root irritation, typically causing sharp, stabbing, or shooting-type pains along the course
of the nerve
Radiculopathy is also caused by nerve root irritation, although this term encompasses pain and altered sensation, including
numbness and 'pins and needles'
Radicular pain and radiculopathy have similar causes. A nerve root may be subjected to mechanical (e.g. prolapsed disc or
direct trauma) or chemical (e.g. injury-induced in
The slump test can be used when a patient complains of lower back pain accompanied by neural symptoms, typically felt
within the buttock and lower limbs, either unilaterally or bilaterally.
The slump test is designed to reproduce the patient’s symptoms by stretching the irritated nerve root. This is accomplished
through combined movements of the spine and lower limbs.
While the slump test may aid in diagnosing radicular pain or radiculopathy, it is not a standalone tool. A thorough history and
examination are necessary to establish a diagnosis and the underlying cause of symptoms.
Before conducting the test, it is essential to exclude symptoms of cauda equina syndrome and other red
indicate a serious pathology, such as infection or malignancy. For more information, see the Geeky Medics guide to back pain
history taking.

Introduction

Wash your hands and don PPE if appropriate.
Introduce yourself to the patient, including your name and role.
Con
Brie
Explain the test aims to reproduce their symptoms, and they should inform you when their symptoms (e.g. pain,
paresthesia) occur
Explain you can stop the test at any time
Gain consent to proceed with the examination.
Position the patient sitting upright towards the edge of the examination couch, ensuring that the couch is elevated so the
patient's feet are suspended from the
Ask the patient if they have any pain before proceeding with the clinical examination.

Perform the slump test

1. Ask the patient to clasp their hands together behind their lower back, then lower their chin down to their chest and slump
forwards, allowing the spine to
f o r w a r d s" )
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2. Ask the patient to keep their spine in that position and slowly extend their knee on the a
l e t m e k n o w i f y o u r s y m p t o m s o c c u r" )
Ensure the patient’s spine remains in a
of the spine during these movements can either increase or reduce tension within the lumbar nerve roots and obscure the
test results.
3. If this does not reproduce symptoms, ask the patient to slowly dorsi
t o e s u p t o w a r d s y o u r c h e s t" )
4. When symptoms are
posterior thigh at -20°
of knee extension")
If the patient cannot perform the lower limb movements actively, you may do so passively by guiding the knee into extension
and the ankle into dorsi
discomfort.
The slump test can also be performed in a reverse sequence by moving the knee into extension and the ankle into
dorsi

Interpretation of

A positive slump test is when pain is reproduced.
A negative slump test is when pain is not reproduced.
To con
alleviates their pain, this further con
nerve roots.
Remember that an increased stretch sensation does not indicate the test is positive unless symptoms are reproduced.

To complete the examination...

Explain to the patient that the examination is now
Thank the patient for their time.
Dispose of PPE appropriately and wash your hands.
Summarise your

Reviewer

Dr Richard Armitage
General Practitioner

References

1. Jensen RK, Kongsted A, Kjaer P, Koes B. Diagnosis and treatment of sciatica. B M J . 2019;367\:l6273.
2. Manchikanti L, Hirsch JA. Clinical management of radicular pain. E x p e r t R e v i e w o f N e u r o t h e r a p e u t i c s . 2015;15(6)\:681-693.
3. NICE CKS. S c i a t i c a ( l u m b a r r a d i c u l o p a t h y ) . Published February 2022. Available from\: [LINK]
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