disk, IVD, lumbar, lumbar shear, lumbar shear test, lumbar spine, ortho, pain, shear, special test, spine, vertebral disk

Purpose

Shear test is used to identify the specific level of a disc pathology that is suspected from previous neurologic and other special test findings (such as a positive Cram’s test).

Technique

Patient is positioned in sidelying.

Clinician stand facing the patient making sure the patient is near the edge of the table.

Clinician stands in staggered stance position with the leg forward corresponding to the side the patient is laying on. For example, the patient is in left sidelying so the Clinician would have left leg forward. Clinician flexes the patient’s legs up to rest on the Clinician’s forward thigh giving the Clinician control of the patient.

Clinician next palpates and finds the sacrum with caudal hand and then palpates and finds L5 spinous process with cranial hand.

Clinician then uses his forward thigh to move the patient’s legs into further hip flexion to take the slack up at L5-S1.

Clinician moves caudal hand on top of cranial hand so both hands are on L5 spinous process.

Clinician then does a bumping AP motion with the forward leg producing an AP shearing of sacrum on L5.

Clinician moves hands cranially to the next segment so caudal hand is on L5 spinous process and cranial hand is on L4 spinous process.

Clinician then uses his forward thigh to further flex the hips and take up the slack.

Clinician places caudal hand on top of cranial hand on L4 spinous process and using forward thigh does a bumping AP motion to produce AP shearing of L5 on L4.

Clinician continues testing cranially up the lumbar spine.

Positive

Pain and/or radiating symptoms into the LE.

Interpretation

Positive test indicates a disc lesion at the level(s) that produce(s) symptoms.

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