Slump Test: How to Check for Sciatica & Disc Herniation

The Slump Test is a progressive neurodynamic test used to evaluate the sensitivity of the spinal cord and nerve roots. It is one of the most common tests for detecting lumbar disc herniations and sciatic nerve tension.

1. Purpose

The primary purpose of the Slump Test is to **assess the mechanosensitivity** of the neuromeningeal tract. It is a key neurodynamic test for the lumbar spine, used to detect nerve root tension (sciatica) or lumbar disc herniation.

2. How to Perform

The test is performed in sequential steps. Stop the test as soon as the patient's symptoms are reproduced.

1. The patient sits on the edge of the table with hands behind their back.
2. The patient slumps forward (flexing the thoracic and lumbar spine) while keeping the head upright.
3. The patient flexes their neck (chin to chest). The examiner applies gentle overpressure to maintain this position.
4. The patient actively extends one knee.
5. The patient dorsiflexes the ankle of the extended leg.
6. Differentiation: If pain is felt, the patient is asked to extend their neck (look up) while keeping the leg extended to see if the pain subsides.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test is indicated by:

• Reproduction of the patient's pathological symptoms (e.g., shooting pain down the leg or numbness).
• Symptoms are increased by sensitizing maneuvers (knee extension/dorsiflexion).
• Crucially, symptoms are DECREASED by releasing the neck flexion. This confirms the pain is neural (connected to the spinal cord) rather than just tight hamstrings.

Negative Sign (Test is NEGATIVE):
A negative test is when there is no reproduction of symptoms, or if the symptoms are not altered by neck movement.