Slump Test for Sciatica

Tingling in feet and legs

Keywords; slump test for sciatica.

This orthopaedic examination for a pinched nerve in the lower back is a complex manoeuvre that comes in a simpler form called Flip which you can do at home to discover if your paresthesias in the lower limb could be coming from your spine.

The lower back supplies two main nerves that can cause tingling in the lower extremity. It's the onset of leg pain that gets the surgeon excited, and that you don't want.

At our femoral nerve page you will appreciate that the pain and tingling from the lower back may radiate to the groin and top of the thigh, and the slump test will be negative. Instead we use a different stretch test, which is far more difficult to administer, and has no place in a self help site such as this. It's best left to your chiropractor.

Micro discectomy

There's plenty of combined medical and chiropractic research for pinched nerves. 

In interesting research, three neurosurgeons and a chiropractor evaluated the effectiveness of micro discectomy versus manipulation in a pilot study for patients with pain and tingling in the feet and legs from a pinched nerve in the lower back. 

All forty patients had first undergone three months of conservative medical and physiotherapy without relief of the leg pain.

Actually, even that is an over simplification because the Flip and Slump tests are only for a pinched SCIATIC NERVE.


After three months there was clear benefit in

  1. 85% of the the micro diskectomy group.
  2. 60% of the chiropractic research group.
  3. Seven of the eight patients who did not respond to chiropractic treatment responded well to a subsequent micro diskectomy, at the same rate and degree of benefit as the primary group. Nothing was lost by the delay of surgery.
  4. After twelve months there was little difference between the two groups.
  5. The recommendation of the researchers was that all patients with a pinched nerve in the back should first, because of the cost and risks, consider manipulative treatment before going on to surgery.

The cost of the chiropractic care was less than 10 percent of the surgery, with zero risks and side effects.

The Flip is a simplified version of the slump test for sciatica.

In the Flip test, you can assess an impingement of the sciatic nerve at home. Sit in an ordinary upright chair, and somebody else raises first your good leg parallel to the ground, then lower it, remembering the pull behind your thigh and calf.

Now ask your examiner to raise the naughty leg. Is it significantly tighter or more painful than the other? If it hurts only in the back, not the lower limb, then you have no frank sciatica, only the first stage.

In the full slump test for sciatica, progressively more stretch is placed on the sciatic nerve but that is best left to an experienced chiropractor.

Micro diskectomy is a far less invasive procedure than normal back surgery; the surgeon is able, using an operating microscope, to remove a part of the facet joint that may be pinching the nerve root and any disc material from under the nerve root.

Under risks, mention is made of recurrent herniations, immediately or later, cerebrospinal fluid leaks due to damage to the dura, nerve root damage, bladder and bowel incontinence, bleeding and infection. The authors assure that these risks are relatively low; quite rare, they exclaim.

How soon should you rush off to the doctor or chiropractor? 

It depends. Pain on the left side of the chest? I'd phone the emergency rooms right now. An old niggle in the back that you've had for years? No rush.

Having said that, last week my wife bent over, and twisted to lift a corner of the carpet for sweeping. She felt what she described as "a bottle exploding at the bottom of her back". Not good. She was stuck forwards in what we call an antalgic posture. The sign of Pisa. Because the swelling and inflammation hadn't yet started, the Slump Test for sciatica was negative. But wait three days... and I would have had drama on my hands, in the bosom of the family.

The long and the short of it is that I reduced that bulging disc within three hours of the injury, she spent the rest of the day in bed with an ice pack and doing half-hourly lower back exercises ...

A second treatment two days later, and within five days she is almost pain free during the day, except for prolonged sitting and early morning discomfort. Of course, I'm exhorting her to follow the 50 percent less pain rule. Today we'll start the rehab exercise program.

If there is any suggestion of leg pain muscle weakness then careful testing should be done. The progression from grade 3 to 4 or 5 can be insidious. Herniated disc foot drop.

Lower back exercise at Slump test for sciatica

For more details, Chiropractic Research ...

Chiropractic Help

In normal circumstances, if you wait a few weeks with leg pain before seeking the advice of your chiropractor, you will probably be in for extended treatment.

What's my point? When you know you've done a mischief to some part of your body then it's better not to wait. Dealing with a disc herniation when it's become swollen and inflammation has set in, is immeasurably more difficult.

Ringing in the changes before it starts referring down the leg, and the Slump test for sciatica is strongly positive, makes good sense. Likewise if you have a bad dose of bronchitis don't wait for the pleurisy before contacting your doctor.

I see little point in writing a story about Mr John who hurt his back, went to the chiropractor, who performed a miracle and he's again playing championship golf or tennis.

Such things do happen; actually quite regularly. But I prefer to write about the bizarre, funny and tragic things that happen at the chiropractic coalface. For such, I make no apology, take my books for what they are; controversial and fun.

My first three novels have been described by one fan as gems, both funny and healthful, from the life and work of a chiropractor.  Such was not actually my intent but he has indeed hit the nail on the head. A patient with a brachial neuralgia turns out to be a blood diamond trader. A woman with acute low back pain is helped to the clinic by her lover, the parish priest.

A head on confrontation with a gynaecologist who refused to accept a referral from a chiropractor because he thought it would be unethical is typical. The reason for the referral is pertinent? An xray of her pelvis revealed an ancient IUD that a previous doctor had inserted some twenty years previously, and couldn't find to remove; titivating stories, you'll love them.

And now a new genre that I and many other people, Christian and those without religion, find difficult; homosexuality. A Family Affair is my take after a ten year search on the subject. Unless you're very straight, you'll love it; promise. It turned out to be so long that it's split into a trilogy; only 99c on Kindle, Nook, tablet or your smartphone. If you find it boring you can demand your money back and you'll get it; all 99c.

Dr Barrie Lewis DC = Dr Bernard Preston DC

Straight leg raise

The traditional test for sciatica is the straight leg raise of Lasegue. It has certain advantages, and some disadvantages; it complements the slump test for sciatica.

USEFUL LINKS @ Slump Test for sciatica


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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Mrs T looked like the leaning tower of Pisa; she had a slipped disc at L5 making her lean towards the opposite side. It's called the postero lateral disc hernia; she's much better after two weeks of treatment and will go back to work next week, part time. Lateral discs are more difficult; both take a minimum of six weeks to heal. In my opinion, antalgic patients need what I call exercising bed rest. Sit and it won't get better.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months. He has a pincer deformity in the hip causing the groin pain, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your lower back is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her hip, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Hypermobility is more difficult that too stiff in my opinion. Chiropractic is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?

Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.

Interesting questions from readers