Which test finding would most strongly suggest nerve root tension involvement when performing straight leg raise?

• A. Reproduction of radicular symptoms with leg raising
• B. No pain during test
• C. Pain localized to the knee only
• D. Pain relieved with ankle movement

Answer: (A)

The test is designed to reveal neural tension in the lumbosacral nerve roots and sciatic nerve. When you raise the leg and the patient experiences a shooting, radiating pain that follows a dermatomal pattern down the leg, it indicates that the neural structures are being tensioned or irritated. This radicular pain is the strongest sign that nerve root involvement is present, such as from a disc herniation compressing a root.

If there’s no pain at all, or if the pain is confined to the knee or local tissues, it points away from nerve root tension and toward non-neural problems like meniscal or joint issues. Pain that is relieved with ankle movement doesn’t fit a neural tension picture because neural tension usually worsens with additional stretch or load, not improves.