The Straight Leg Raise Test is a supine neurodynamic and symptom-response test commonly used when a client has low back pain with posterior thigh, calf or foot symptoms. It progressively loads the posterior lower limb and lumbosacral nerve roots by lifting the straight leg while monitoring symptom location, intensity and familiar symptom reproduction. A positive test may suggest increased neural mechanosensitivity when familiar symptoms are reproduced and modified by structural differentiation, such as ankle dorsiflexion, cervical flexion or reducing hip flexion. The test can support assessment reasoning, but it does not confirm disc herniation, radiculopathy or nerve compression on its own.
The Straight Leg Raise Test, also known as the SLR or Lasègue Test, is one of the most widely used lower-limb neurodynamic assessments. It is commonly used when a client presents with low back pain, posterior thigh symptoms, calf symptoms, foot symptoms or symptoms that appear to follow a sciatic-type distribution.
The test is performed with the client lying supine while the professional passively raises the straight leg. This increases mechanical load through the posterior thigh, sciatic nerve pathway, lumbosacral nerve roots and related tissues. The key finding is not simply hamstring tightness or discomfort, but whether the test reproduces the client’s familiar symptoms and whether those symptoms change when neural loading is modified.
Because the Straight Leg Raise Test can be positive in several presentations, interpretation must be careful. A positive result may support suspicion of neurodynamic sensitivity, but it does not diagnose a specific condition. The finding should be interpreted alongside history, pain distribution, neurological screening, lumbar movement testing, Slump Test results and functional assessment.
Test name: Straight Leg Raise Test
Also known as: SLR Test, Passive Straight Leg Raise, Lasègue Test
Body region: Lumbar spine, lumbosacral nerve roots, sciatic nerve pathway and posterior lower limb
Purpose: Assess symptom response to progressive lower-limb neurodynamic loading
Commonly associated with: Low back pain with leg symptoms, sciatic-type symptoms, lumbar radicular presentations and neural mechanosensitivity
Positive finding: Reproduction of familiar symptoms, especially when changed by structural differentiation
Negative finding: No familiar symptom reproduction or no meaningful symptom change with differentiation
Best used with: Slump Test, neurological screen, lumbar ROM, repeated movement testing and functional movement assessment
Key limitation: A positive SLR does not confirm disc herniation, radiculopathy or nerve compression.
The Straight Leg Raise Test is a passive assessment performed with the client lying on their back. The professional lifts one leg with the knee straight while monitoring symptom response. The movement increases hip flexion while maintaining knee extension, which places progressive load through the posterior thigh and neural tissues of the lower limb.
The test may be modified with ankle dorsiflexion, ankle plantarflexion, hip adduction, hip internal rotation or cervical flexion depending on the assessment goal and client tolerance. These modifications can help determine whether symptoms are more likely related to neural loading, muscular stretch or another tissue response.
The Straight Leg Raise Test is used to assess whether lower-limb symptoms are influenced by neurodynamic loading. It may be useful when a client reports symptoms such as posterior thigh pain, calf pain, foot symptoms, pins and needles, numbness, sciatic-type pain or low back pain that changes with leg movement.
The test may help guide further assessment by identifying whether a neurological screen, Slump Test, lumbar repeated movement testing or imaging referral discussion may be appropriate within the professional’s scope. It can also help monitor symptom response over time when recorded consistently.
The Straight Leg Raise Test assesses:
Symptom response to passive hip flexion with knee extension
Possible neural mechanosensitivity
Sciatic nerve pathway sensitivity
Lumbosacral nerve root symptom response
Posterior thigh and hamstring stretch response
Side-to-side range and symptom differences
Symptom change with structural differentiation
Familiar versus unfamiliar symptom reproduction
It does not directly confirm disc herniation, nerve root compression, sciatica, radiculopathy or a specific anatomical pain source.
The Straight Leg Raise Test may be useful for adults with low back pain and leg symptoms, posterior thigh pain, calf symptoms, foot symptoms, sciatic-type pain or symptoms influenced by sitting, bending, coughing, sneezing or lower-limb movement.
It may also be useful for professionals learning neurodynamic assessment and symptom differentiation. It should be modified or avoided when the client has highly irritable symptoms, worsening neurological signs, recent trauma, suspected fracture or cannot tolerate supine positioning.
Use the Straight Leg Raise Test when:
The client reports low back pain with leg symptoms
Symptoms appear influenced by lower-limb or spinal position
You want to compare neurodynamic response between sides
You can safely perform structural differentiation
A neurological screen is also being completed when indicated
You can clearly document symptom onset angle, location and quality
Use caution or avoid the test when there is suspected cauda equina syndrome, severe or worsening neurological deficit, recent spinal or lower-limb trauma, suspected fracture, severe acute disc presentation, high irritability, inability to lie supine, severe pain with minimal movement or symptoms requiring urgent medical review.
Stop the test if symptoms worsen sharply, neurological symptoms increase, pain spreads significantly, the client becomes distressed, or the response is strong enough that further loading is not appropriate.
The Straight Leg Raise Test requires:
Firm treatment table
Pain rating scale
Symptom-location recording method
Optional goniometer or inclinometer
Measurz app for structured documentation
Optional video for movement review
Optional MAT assessment notes for related lumbar and neurological findings
Within Measurz, the Straight Leg Raise Test can be recorded alongside Slump Test, lumbar ROM, repeated movement findings, neurological screen results, strength/endurance tests and functional assessments. Measurz tools such as video recording, inclinometer measures, stopwatch, rep counter and structured notes can help professionals improve repeatability and compare symptom response across sessions.
Explain that the test will involve slowly lifting the straight leg to monitor symptom response. Ask the client to report pain intensity, symptom location, symptom quality and whether the symptoms feel familiar.
Record baseline symptoms before testing, including pain score, current low back symptoms, leg symptoms and any numbness or tingling.
The client lies supine on a firm table. The pelvis and trunk should remain relaxed and aligned. The non-tested leg stays extended or in a comfortable neutral position unless a modification is required.
Stand beside the tested limb. Support the client’s heel or lower leg with one hand and monitor the knee position, hip movement and symptom response.
One hand supports the distal lower leg or heel. The other hand may monitor the knee to maintain extension or guide the limb. Avoid gripping aggressively or forcing the limb.
The pelvis should remain relatively still. Avoid allowing the tested leg to externally rotate excessively or the knee to bend unless intentionally modifying the test.
Slowly raise the straight leg into hip flexion while maintaining knee extension. Monitor the angle where symptoms begin, the type of symptom, and whether the response is familiar.
If symptoms appear, structural differentiation may include:
Slightly lowering the leg to reduce symptoms
Adding or removing ankle dorsiflexion
Adding or removing cervical flexion
Comparing with the opposite side
Differentiating hamstring stretch from familiar neural symptoms
Ask:
“Tell me when you first feel a symptom.”
“Where do you feel it?”
“Is this your familiar symptom?”
“Does it feel like stretch, pain, pins and needles, numbness or something else?”
“Tell me if the symptom changes when your ankle or neck position changes.”
A positive Straight Leg Raise Test is reproduction of the client’s familiar symptoms during passive straight leg raising, especially when symptoms change with structural differentiation such as ankle dorsiflexion, ankle plantarflexion, cervical flexion or reducing hip flexion.
A negative test is no familiar symptom reproduction, or symptoms that appear to reflect only non-familiar hamstring stretch and do not meaningfully change with structural differentiation.
Stop if symptoms worsen sharply, neurological symptoms increase, pain becomes intolerable, symptoms spread significantly, the client guards strongly or the client asks to stop.
Avoid forcing end range. Do not treat hamstring stretch alone as a positive neurodynamic finding. Record the angle or approximate range at symptom onset when possible.
A positive Straight Leg Raise Test may suggest increased neural mechanosensitivity when familiar symptoms are reproduced and modified by structural differentiation. The finding is more meaningful when symptoms match the client’s usual leg symptoms and occur at a clearly different range compared with the other side.
A positive test does not confirm disc herniation, lumbar radiculopathy, nerve root compression or sciatica. Symptoms during the test may also be influenced by hamstring tension, hip sensitivity, lumbar flexion sensitivity, general pain sensitivity, fear of movement or protective guarding.
A negative Straight Leg Raise Test may reduce suspicion of neurodynamic sensitivity in the tested position, especially when there is no familiar symptom reproduction and no meaningful side-to-side difference. However, a negative result does not fully exclude neural involvement, especially when symptoms are intermittent, position-dependent or not present during the assessment.
Interpretation is strongest when the Straight Leg Raise Test is considered alongside neurological screening, Slump Test, lumbar ROM, symptom distribution, reflexes, dermatomes, myotomes and functional tasks.
Diagnostic accuracy for the Straight Leg Raise Test varies depending on the target condition, population, positive-test criteria and reference standard.
A systematic review by Deville et al. (2000) reported that the Straight Leg Raise Test had high sensitivity but low specificity for lumbar disc herniation when compared with surgery as the reference standard. Commonly cited pooled values are approximately:
Condition/presentation: Lumbar disc herniation
Reference standard: Surgical findings
Sensitivity: 0.91
Specificity: 0.26
Key limitation: High sensitivity may make a negative result more useful for decreasing suspicion in some contexts, but low specificity means a positive result does not strongly confirm disc herniation.
In Majlesi et al. (2008), the Straight Leg Raise Test was compared with MRI findings in people with symptoms suggestive of lumbar disc herniation. The study reported:
Condition/presentation: Lumbar disc herniation
Population: People with low back pain, leg pain or both
Reference standard: Lumbar MRI
Sensitivity: 0.52
Specificity: 0.89
Key limitation: MRI findings do not always correlate with symptoms, and accuracy may vary by test criteria and population.
A recent systematic review of pain-provocation-based SLR testing concluded that clinical utility is variable and influenced by differences in reference standards, test criteria and target condition.
Overall, the Straight Leg Raise Test can support assessment reasoning, particularly when familiar symptoms are reproduced and differentiated, but it should not be used as a stand-alone diagnostic test.
The Straight Leg Raise Test can be clinically useful when the procedure and interpretation are standardised. Reliability is improved when the professional records the side tested, hip flexion angle, knee position, ankle position, symptom onset, symptom location and structural differentiation response.
Validity is stronger when the test reproduces familiar symptoms and those symptoms change predictably when neural load is modified. Validity is weaker when the response is vague, non-familiar, inconsistent or reflects only general hamstring stretch.
Because SLR findings can vary according to population and reference standard, the test should be interpreted as one part of a broader assessment rather than as a definitive finding.
Common errors include:
Calling hamstring stretch a positive SLR
Failing to use structural differentiation
Lifting the leg too quickly
Allowing the knee to bend without recording it
Not measuring or estimating the symptom onset angle
Ignoring symptom location and quality
Assuming a positive test confirms disc herniation
Failing to complete a neurological screen when symptoms suggest radicular involvement
Comparing sessions without using the same test setup
Limitations include variable diagnostic accuracy, overlap with hamstring symptoms, inconsistent positive-test criteria, symptom irritability, and possible mismatch between imaging findings and symptoms.
The Straight Leg Raise Test can help professionals assess whether lower-limb symptoms are influenced by neurodynamic loading. It is especially useful when combined with the Slump Test and a neurological screen.
The test can also be useful for monitoring change. If the same setup is used over time, Measurz can help track whether symptom onset occurs at a greater or smaller range, whether pain intensity changes, and whether structural differentiation becomes less provocative or more provocative.
In Measurz, record:
Test name: Straight Leg Raise Test
Side tested
Baseline symptoms
Pain score before, during and after
Symptom location
Symptom quality
Hip flexion angle or estimated range at symptom onset
Maximum tolerated range
Knee position
Ankle position
Cervical position if used
Structural differentiation response
Familiar versus unfamiliar symptoms
Comparison side
Result: positive, negative, unclear or unable to test
Irritability
Compensations or guarding
Reason for stopping
Confidence in result
Related Slump Test, neurological screen and lumbar ROM findings
Retest date if relevant
Recording these details improves repeatability, communication, client education, assessment reasoning, monitoring over time and reporting quality.
Slump Test
Lumbar Flexion Test
Lumbar Extension Test
McKenzie Side Glide Test
Neurological Screen
Seated Flexion Test
Standing Flexion Test
Hip ROM Assessment
Hamstring Flexibility Assessment
Functional Movement Assessment
It is used to assess symptom response to passive lower-limb neurodynamic loading, especially in people with low back pain and leg symptoms.
A positive finding is reproduction of familiar symptoms during straight leg raising, especially when the symptoms change with structural differentiation.
No. It may support assessment reasoning when it matches the clinical picture, but it does not confirm disc herniation or nerve compression.
A negative result means familiar symptoms were not reproduced, or the response appeared to be only non-familiar stretch without meaningful differentiation.
No. Hamstring stretch is common during the test and should not automatically be interpreted as a positive neurodynamic finding.
Yes, when safe and appropriate. Side-to-side comparison can help clarify whether the response is meaningful.
Record side, symptom onset angle, pain score, symptom location, ankle and neck differentiation response, comparison side and related neurological findings.
The Straight Leg Raise Test is a supine neurodynamic symptom-response test.
A positive result is more meaningful when familiar symptoms change with structural differentiation.
The test does not confirm disc herniation, radiculopathy or nerve compression on its own.
Diagnostic accuracy varies by population, reference standard and positive-test criteria.
Measurz should capture side, symptom onset range, pain score, symptom location, differentiation response and related findings.
Deville, W. L. J. M., van der Windt, D. A. W. M., Dzaferagić, A., Bezemer, P. D., & Bouter, L. M. (2000). The test of Lasègue: Systematic review of the accuracy in diagnosing herniated discs. Spine, 25(9), 1140–1147. https://doi.org/10.1097/00007632-200005010-00016
Majlesi, J., Togay, H., Ünalan, H., & Toprak, S. (2008). The sensitivity and specificity of the Slump and the Straight Leg Raising tests in patients with lumbar disc herniation. Journal of Clinical Rheumatology, 14(2), 87–91. https://doi.org/10.1097/RHU.0b013e31816b2f99
Rabin, A., Gerszten, P. C., Karausky, P., Bunker, C. H., Potter, D. M., & Welch, W. C. (2007). The sensitivity of the seated straight-leg raise test compared with the supine straight-leg raise test in patients presenting with magnetic resonance imaging evidence of lumbar nerve root compression. Archives of Physical Medicine and Rehabilitation, 88(7), 840–843. https://doi.org/10.1016/j.apmr.2007.04.016
Scaia, V., Baxter, D., & Cook, C. (2012). The pain provocation-based straight leg raise test for diagnosis of lumbar disc herniation, lumbar radiculopathy, and/or sciatica: A systematic review of clinical utility. Journal of Back and Musculoskeletal Rehabilitation, 25(4), 215–223. https://doi.org/10.3233/BMR-2012-0338
Verwoerd, A. J. H., Peul, W. C., Willemsen, S. P., Koes, B. W., Vleggeert-Lankamp, C. L. A. M., El Barzouhi, A., & Luijsterburg, P. A. J. (2018). Accuracy of clinical tests in detecting disk herniation and nerve root compression in subjects with lumbar radicular symptoms. Archives of Physical Medicine and Rehabilitation, 99(4), 726–735. https://doi.org/10.1016/j.apmr.2017.10.006
