A confirmatory test following a positive Straight Leg Raise Test. Confirms suspicion of lower lumbar radiculopathy or sciatic nerve irritation.
- Bragard’s Sign
- Low back pain with unilateral radiation of symptoms to the posterior thigh, calf, or foot
- Symptoms may include pain, tingling, or numbness
Patient Position
- Supine
Examiner Position
- Standing at the side of the affected leg
Steps of Performance
Note: After a positive Straight Leg Raise Test has been established…
- Lower the patient’s leg to the point at which symptoms subside
- Passively dorsiflex the patient’s foot looking for recreation of symptoms
Alternative Methods
Recreation of radiating nerve-type symptoms between ~30°–70° of hip flexion during a Straight Leg Raise Test can be associated with stretching of the posterior nervous structures. By lowering the leg slightly, tension on the nerve is reduced, leading to a decrease of radiating symptoms. With reduced symptoms, passively dorsiflexing the patient’s foot tenses the nervous structures (primarily the tibial branches) at a distal location around the malleoli. If symptoms are recreated by de-tensioning the irritated nerves at the hip and re-tensioning them with passive foot dorsiflexion (Bragard’s Test), suspicion of neurologic irritation is increased and suspicion of local tissue damage around the hip is decreased.
General
Positives
Recreation of nerve-type symptoms down the affected leg
- Radiculopathy or peripheral nerve irritation
Recreation of symptoms in a dermatomal pattern
- Increased suspicion of radiculopathy of the corresponding nerve root
Recreation or symptoms in a peripheral nerve distribution
- Peripheral neuropathy of the sciatic nerve or one of its branches
Pertinent Negatives
Local foot/ankle pain
- local joint dysfunction, soft tissue damage, or muscle tension
A confirmatory test following a positive Straight Leg Raise Test. Confirms suspicion of lower lumbar radiculopathy or sciatic nerve irritation.
- Bragard’s Sign
- Low back pain with unilateral radiation of symptoms to the posterior thigh, calf, or foot
- Symptoms may include pain, tingling, or numbness
Patient Position
- Supine
Examiner Position
- Standing at the side of the affected leg
Steps of Performance
Note: After a positive Straight Leg Raise Test has been established…
- Lower the patient’s leg to the point at which symptoms subside
- Passively dorsiflex the patient’s foot looking for recreation of symptoms
Alternative Methods
Recreation of radiating nerve-type symptoms between ~30°–70° of hip flexion during a Straight Leg Raise Test can be associated with stretching of the posterior nervous structures. By lowering the leg slightly, tension on the nerve is reduced, leading to a decrease of radiating symptoms. With reduced symptoms, passively dorsiflexing the patient’s foot tenses the nervous structures (primarily the tibial branches) at a distal location around the malleoli. If symptoms are recreated by de-tensioning the irritated nerves at the hip and re-tensioning them with passive foot dorsiflexion (Bragard’s Test), suspicion of neurologic irritation is increased and suspicion of local tissue damage around the hip is decreased.
General
Positives
Recreation of nerve-type symptoms down the affected leg
- Radiculopathy or peripheral nerve irritation
Recreation of symptoms in a dermatomal pattern
- Increased suspicion of radiculopathy of the corresponding nerve root
Recreation or symptoms in a peripheral nerve distribution
- Peripheral neuropathy of the sciatic nerve or one of its branches
Pertinent Negatives
Local foot/ankle pain
- local joint dysfunction, soft tissue damage, or muscle tension