Figure 2. Instructions for the Straight Leg Raising (SLR) Test

(1) Ask the patient to lie as straight as possible on a table in the supine position.

(2) With one hand placed above the knee of the leg being examined, exert enough firm pressure to keep the knee fully extended. Ask the patient to relax.

(3) With the other hand cupped under the heel, slowly raise the straight limb. Tell the patient, "If this bothers you, let me know, and I will stop."

(4) Monitor for any movement of the pelvis before complaints are elicited. True sciatic tension should elicit complaints before the hamstrings are stretched enough to move the pelvis.

(5) Estimate the degree of leg elevation that elicits complaint from the patient. Then determine the most distal area of discomfort: back, hip, thigh, knee, or below the knee.

(6) While holding the leg at the limit of straight leg raising, dorsiflex the ankle. Note whether this aggravates the pain. Internal rotation of the limb can also increase the tension on the sciatic nerve roots.