Valsalva Maneuver

What is the "Valsalva Maneuver" used for?

• The Valsalva Maneuver for lumbar spine is used to increase intrathecal pressure and thereby exacerbate pain due to spinal cord or nerve root compression. 
• It is also used for assessment of autonomic function status, as a marker for heart failure, for termination of arrhythmias, murmur differentiation, and various other indications.

How to perform the "Valsalva Maneuver"?

• With the patient sitting, and the examiner is standing within arms’ reach in front of the patient.
• The patient is asked to put the thumb in his mouth and attempts to push the thumb out by blowing out hard.
• or, the patient takes and holds a deep breath while bearing down similar to performing a bowel movement.

What is the positive result?

• Bearing down in this manner increases the intraspinal pressure, revealing the presence of space occupying masses such as extruded intervertebral disks, tumors, narrowing due to osteophytes, and soft tissue swelling. 
• This leads to radicular symptoms entirely confined to the respective dermatome or dermatomes.

Test Accuracy

• Sensitivity: 73%
• Specificity: 95%