Relationship between the cervical component of the slump test and change in hamstring muscle tension

SUMMARY. The slump test has been used routinely to differentiate low back pain due to involvement of neural structures from low back pain attributable to other factors. It is also said to differentiate between posterior thigh pain due to neural involvement from that due to hamstring injury. If changes in cervical position affect the hamstring muscles, differential diagnosis is confounded. Posterior thigh pain caused by the cervical component of the slump could then be caused either by increased tension on neural structures or increased tension in the hamstrings themselves. The aim of this study was to determine whether changing the cervical position during slump altered posterior thigh pain and/or the tension in the hamstring muscle. Asymptomatic subjects aged between 18 and 30 years were tested. A special fixation device was engineered to fix the trunk, pelvis and lower limb. Pain levels in cervical flexion and extension were assessed by visual analogue scale. Fixation was successful in that there were no significant differences in position of the pelvis or knee during changes in cervical position. Averaged over the group, there was a 40% decrease (P < 0.05) in posterior thigh pain with cervical extension. There were no significant differences in hamstring electromyographic readings during the cervical movements. This indicated that: (1) cervical movement did not change hamstring muscle tension, and (2) the change in experimentally induced pain during cervical flexion was not due to changes in the hamstring muscle. This conclusion supports the view that posterior thigh pain caused by the slump test and relieved by cervical extension arises from neural structures rather than the hamstring muscle. Copyright 1997 Harcourt Publishers Ltd.