Testing for the Cause of Back Pain When You Raise Your Leg

If you can't do a leg raise without getting either back pain, sciatica, or a combination of the two, your healthcare provider may suspect a herniated disc is responsible. The straight leg raise test is one common manual test used to determine if a herniated disc or another spine-related malady is at the root of your symptoms.

This article will discuss how doctors determine the cause of back pain. It explains the leg raise test that doctors use to diagnose your medical condition.

A doctor administers the straight leg raise test

Eliza Snow / Getty Images

Purpose of the Straight Leg Test

Sciatica is a pain that comes from a pinched or irritated nerve in your lower back near your butt. It has a number of possible causes, from a tight piriformis muscle to more common causes including herniated disc, spinal stenosis, or spondylolisthesis. For patients dealing with sciatica, the first step is diagnosis.

A straight leg raise test is one of several tools healthcare providers use to determine whether leg symptoms are due to a herniated disc, slipped disc, spinal instability, extra tight hip or back muscles, or something else. 

A manual exam procedure is one in which the healthcare provider uses their hands to:

  • Position you
  • Move you
  • Give pressure against which you resist

This is a much different approach to determining the source of pain or of a spinal problem than diagnostic imaging tests, which use machines. Generally speaking, both methods are used during the diagnostic process.

The straight leg raise test is one of the most common manual test procedures performed during a physical exam. Like many of its kind, the goal is to check for nerve movement and sensitivity of nerve tissue to compression.

In fact, there's a name for this type of manual test, which is neurodynamic. Neurodynamic testing includes not only the straight leg raise but others as well.

During the Straight Leg Raise Test

The straight leg raise test seeks to reproduce your pain or other symptoms. Be prepared to experience them for a moment or two while your provider evaluates you. The test is a passive one. You can help your doctor achieve the most accurate result by staying as relaxed as possible and giving an honest summary of what you feel as your leg is lifted.


  1. To start, the person examining you will ask you to lie on your back with your legs straight.
  2. They will then ask you to turn one of your legs in. It’s important to turn the entire lower extremity. This is so the examiner can accurately connect the position of your hip and low back with the symptoms you report. The examiner will also ask you to bring your leg in towards the center of your body.
  3. Next, the examiner will lift your straight leg up until you complain of pain. If you don’t have pain during the straight leg raise, great. But if the maneuver does cause discomfort, this may be a sign that a herniated disc is responsible for your back or leg symptoms.
  4. Depending on the angle of your hip when your symptoms start as you're being tested, your healthcare provider may determine that something other than a herniated disc is the cause.
  5. Both legs are tested in a straight leg raise test, so the steps are repeated with the other leg.


The examiner may repeat the test with your ankle in a dorsiflexed position. Dorsiflexion is the movement that occurs at your ankle joint when you raise your foot. It is the opposite of pointing your toes. The examiner will also repeat the test with your chin tucked into your chest.

These variations may help the examiner check for nerve involvement in specific locations, including the dura mater, or covering, of the spinal cord and/or the spinal cord itself.

A positive sign for nerve involvement from the spinal cord or its covering would present itself as your usual pain in your back or leg, but not in your chin, neck, or foot.


If you are unable to lift your leg up while it's straight, or you have difficulty lying on your back, try not to worry. The straight leg raise test has modifications. This is why it’s extremely important to speak up and let the examiner know your limitations. Another reason to speak up is to avoid an injury during the testing.


Unfortunately, not much research has been done on neurodynamic tests in general.

A 2017 review looked at the accuracy of neurodynamic tests on predicting radiculopathy. Radiculopathy are symptoms that most of us call sciatica. But they are only caused when a spinal nerve root is compressed or irritated in some way. The study found that researchers have yet to reach a consensus as to whether the straight leg raise test is effective for detecting herniated disc and/or spinal nerve root compression.

The straight leg raise test is also widely used to determine how stiff a patient's hamstrings are. But a 2018 study published in the International Journal of Sports Medicine found that hamstring stiffness is not actually an underlying factor in the results of most or all straight leg raise test results.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciaticaBMJ. 2007;334(7607):1313–1317. doi:10.1136/bmj.39223.428495.BE

  2. Camino Willhuber GO, Piuzzi NS. Straight Leg Raise Test. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing 

  3. Cleveland Clinic. Sciatica: Causes, symptoms, treatment, Prevention & Pain Relief.

  4. Allegri M, Montella S, Salici F, et al. Mechanisms of low back pain: a guide for diagnosis and therapyF1000Res. 2016;5:F1000 Faculty Rev-1530. doi:10.12688/f1000research.8105.2

  5. Baselgia LT, Bennett DL, Silbiger RM, Schmid AB. Negative neurodynamic tests do not exclude neural dysfunction in patients with entrapment neuropathiesArchives of Physical Medicine and Rehabilitation. 2017;98(3):480-486. doi:10.1016/j.apmr.2016.06.019

  6. Pande K. The use of passive straight leg raising test: a survey of cliniciansMalays Orthop J. 2015;9(3):44–48. doi:10.5704/MOJ.1511.012

  7. Young R, Nix S, Wholohan A, Bradhurst R, Reed L. Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysisJ Foot Ankle Res. 2013;6(1):46. doi:10.1186/1757-1146-6-46

  8. Venne G, Rasquinha BJ, Kunz M, Ellis RE. Rectus capitis posterior minor: histological and biomechanical links to the spinal dura mater. Spine. 2017;42(8):E466-E473. doi:10.1097/BRS.0000000000001867

  9. Ellis RF, Hing WA. Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacyJ Man Manip Ther. 2008;16(1):8–22. doi:10.1179/106698108790818594

  10. Miyamoto N, Hirata K, Kimura N, Miyamoto-mikami E. Contributions of Hamstring Stiffness to Straight-Leg-Raise and Sit-and-Reach Test Scores. Int J Sports Med. 2018;39(2):110-114. doi:10.1055/s-0043-117411

Additional Reading
  • Magee DJ. Orthopedic Physical Assessment. 4th ed. St. Louis, MO: Elsevier Saunders

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.