Neural Dynamic Testing for the Lumbar Spine

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Lower Back Pain

Neural Dynamic Testing

The neural tissue must be capable of mobility and elongation, which is achieved through it gliding or sliding. Often when compromised for physiological, pathological, or other reasons, it becomes sensitized. This can be indicated with various neural dynamic techniques, which should be considered in terms of tensioning and sliding—not stretching—which is sometimes how they are described because of the mistaken understanding of tension.

A nerve is mobile and can slide along its course, but it can also be tensioned as it passes over a joint that bends or straightens, especially if there is a large excursion of movement. Subsequently, this can lead to a movement dysfunction if the nerve becomes sensitized for whatever reason. These could include physiological disruptions, pathology, trauma, or even central sensitization because of yellow flags.

The tests or techniques (if used during treatment) must always be used with caution, as they can be very provocative. The most utilized techniques are:

Straight Leg Raise (SLR)
Lasègue test
Bragard’s test
Bowstring test
The Slump

Prior to carrying out neural dynamic tests, it is advised to carry out the nerve conduction tests first. These include cervical and lumbar tests. Obviously, not all the tests for both cervical spine and lumbar spine are carried out together unless, of course, there is a reason.

Here Paul Townley explains neural dynamic testing in more detail;