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Related Experiment Videos

Diurnal changes in straight leg raising.

R W Porter1, I F Trailescu

  • 1Doncaster Royal Infirmary, England.

Spine
|February 1, 1990
PubMed
Summary

Diurnal changes in straight leg raising (SLR) indicate lumbar disc hydration. Most patients showed improved SLR after standing, suggesting hydration influences disc protrusion symptoms.

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Area of Science:

  • Orthopedics
  • Biomedical Engineering
  • Physiology

Background:

  • Lower lumbar disc protrusion is a common cause of back pain.
  • Straight leg raising (SLR) is a clinical test used to assess nerve root irritation.
  • Diurnal variations in symptoms are often reported but not well quantified for SLR.

Purpose of the Study:

  • To investigate diurnal changes in SLR range of motion.
  • To correlate these changes with patient characteristics and treatment outcomes.
  • To explore the physiological basis for observed diurnal variations in SLR.

Main Methods:

  • Twenty-eight patients with lower lumbar disc protrusion were recruited.
  • Intra-observer repeatability of SLR measurements was established using a precision goniometer.
  • SLR was measured after overnight recumbency and after 180 minutes in an upright posture.

Main Results:

  • Twenty out of 28 patients demonstrated a mean improvement of 16.9 degrees in SLR after being upright.
  • Most improvement occurred within the first hour of upright posture.
  • Eight patients showed minimal diurnal change; five had undergone discectomy and four had annular tears.

Conclusions:

  • Diurnal variation in SLR is a significant finding in patients with lumbar disc protrusion.
  • Improved SLR with upright posture suggests a role for disc hydration and proteoglycan content.
  • Greater diurnal change in SLR may correlate with a lower need for surgical intervention.

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