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Getting in a Slump to Get Out of Back Pain

Posted on: 11/30/1999
We know that our joints move and have a certain range of motion. The nerves and their coverings also move and have some flexibility. This is most obvious when nerve tissue gets stiff or bound down. Painful symptoms are the result.

Physical therapists are health care specialists who work with bones, muscles, nerves, and other soft tissues. When a patient has back pain or back and leg pain, the therapist tests joint range of motion and nerve tissue motion. The amount of movement and flexibility in the nerve tissue is called neural tension.

Therapists have one test in particular for neural tension in the low back and legs. This is called the slump test. The patient sits up straight in a chair with back, legs, and feet supported. The therapist presses down through the top of the patient's head as the patient relaxes the neck, shoulders, and low back.

The test is continued as the patient tucks the chin into the chest and slumps while straightening the knee. The final step is for the patient to pull the toes toward the face with the knee still straight. The therapist releases the pressure and the patient sits back up. The therapist looks for a change in symptoms during and after the test.

A positive slump test brings on the patient's back and leg symptoms. It can also be a positive test if the patient can't straighten the leg fully. Both of these findings suggest increased neural tension as a possible cause of painful symptoms. False positives are common, so therapists use other tests to confirm these results.

The slump test is also a form of treatment. The therapist knows how to use this same test position to help stretch the nerve tissue. It must be done slowly and carefully over several weeks' time. Warm-up exercises and stretches must be done first. Therapists are studying who is helped the most by this treatment. The results will be reported in the coming months and years.

References:
Steven Z. George, PT, MS. Characteristics of Patients With Lower Extremity Symptoms Treated With Slump Stretching: A Case Series. In Journal of Orthopaedic & Sports Physical Therapy. August 2002. Vol. 32. No. 8. Pp. 391-398.

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