Lasègue Drop Test: Purpose, Procedure, Positive Sign & Diagnostic Accuracy

Published October 28, 2026 Read time 10 min read Readers 91

The Lasègue Drop Test, also known as the Lasègue Rebound Test or Straight Leg Drop Test, is an orthopedic physical examination maneuver used to evaluate pain originating from the lumbar spine and potentially the sacroiliac (SI) joint.

This test is a variation of the traditional Lasègue Test (Straight Leg Raise Test). However, unlike the standard Straight Leg Raise (SLR) Test, which primarily assesses lumbosacral nerve root irritation, the Lasègue Drop Test uses a sudden release of the elevated leg to provoke a reflexive muscular response.

The maneuver has traditionally been described in the clinical assessment of lumbar spondylarthritis, spondylitis, lumbar disc herniation, and sacroiliac joint disorders.

Although the test may provide additional information during a musculoskeletal examination, its findings must be interpreted alongside the patient’s symptoms, neurological examination, and other clinical tests.

What Is the Lasègue Drop Test Used For?

The Lasègue Drop Test is used to assess lumbar spine pain and possible sacroiliac joint involvement by provoking a sudden muscular response around the lower back and pelvis.

It has traditionally been associated with several musculoskeletal conditions:

Lumbar spondylarthritis: Degenerative changes affecting the lumbar facet joints that may contribute to localized lower back pain and restricted spinal mobility.
Spondylitis: Inflammatory disorders involving the vertebral structures that can cause spinal pain and stiffness.
Lumbar disc herniation: Displacement of intervertebral disc material that may produce lower back pain, sciatica, or neurological symptoms.
Sacroiliac joint disorders: Pain arising from the joint between the sacrum and ilium, which may be experienced in the lower back, buttocks, or posterior pelvis.

The Lasègue Drop Test should be regarded as a supplementary examination maneuver rather than a definitive diagnostic test for any of these conditions.

How to Perform the Lasègue Drop Test

The test is performed with the patient lying on an examination table in a supine position.

Step-by-Step Procedure

Patient positioning: Ask the patient to lie supine (face upward) on a firm examination table, with both lower extremities extended and the muscles relaxed.
Examiner positioning: The examiner stands beside the affected lower extremity and supports the patient’s leg, maintaining knee extension.
Passive straight leg raising: The examiner slowly raises the affected leg by flexing the hip while keeping the knee extended, similar to the traditional Lasègue Straight Leg Raise Test.
Identify the onset of discomfort: Continue raising the leg until the patient reports the beginning of discomfort. The examiner notes the location and character of the symptoms.
Release phase: In the traditional description, the examiner suddenly and unexpectedly releases the elevated leg from the position at which discomfort begins. This causes a rapid muscular reaction intended to control the falling limb. Any clinical performance should prioritize patient safety and prevent an uncontrolled or injurious impact.
Evaluate the response: Observe the patient’s reaction and ask whether the maneuver reproduces pain in the lumbar spine, buttocks, or sacroiliac region.

Clinical precaution: The test should only be considered by a qualified healthcare professional after evaluating its potential risks. It is not recommended as a self-examination maneuver.

What Is a Positive Lasègue Drop Test?

A positive Lasègue Drop Test is traditionally described as the reproduction or intensification of pain in the lumbar spine or sacroiliac region immediately after the elevated leg is suddenly released.

The rapid movement produces a reflexive contraction of muscles around the lower back, pelvis, and hip.

Mechanism of a Positive Test

The traditional explanation emphasizes the role of the iliopsoas muscle, a major hip flexor that attaches to the lumbar vertebral bodies and transverse processes.

During the sudden release:

The elevated leg begins to descend rapidly.
Muscles around the hip, pelvis, and lower back react to the unexpected movement.
The iliopsoas may contract reflexively to control hip movement.
This contraction can transmit mechanical forces to the lumbar spine.
Patients with painful lumbar or sacroiliac conditions may experience an increase in their usual symptoms.

This proposed mechanism is a traditional clinical explanation, not a separately validated diagnostic mechanism.

Interpretation of Positive Findings

Pain reproduced during the test may suggest irritation of structures associated with the lumbar spine or sacroiliac region.

However, a positive Lasègue Drop Test does not independently confirm lumbar disc herniation, spondylitis, facet joint disease, or sacroiliac joint dysfunction.

The pain location, associated neurological symptoms, and results of other examination maneuvers are necessary for an appropriate clinical interpretation.

Lasègue Drop Test vs. Straight Leg Raise Test

Although the two tests share a similar starting position, they have different examination objectives.

Feature	Lasègue Drop Test	Straight Leg Raise Test
Patient position	Supine	Supine
Main movement	Passive leg elevation followed by sudden release	Passive leg elevation with the knee extended
Primary assessment	Provocation of lumbar or sacroiliac pain	Assessment of lumbosacral nerve mechanosensitivity
Traditional positive finding	Reproduction of lower back or sacroiliac pain during release	Reproduction of characteristic radiating leg pain
Diagnostic accuracy	Not adequately established	Investigated in multiple clinical studies

The traditional Straight Leg Raise Test evaluates symptoms related to sciatic nerve and lumbosacral nerve root irritation. It is particularly useful as part of the clinical examination of suspected sciatica.

According to OrthoFixar, the standard Lasègue Test requires careful evaluation of reproduced symptoms, particularly pain radiating into the lower extremity, rather than relying on lower back discomfort alone.

The Lasègue Drop Test instead emphasizes the pain response following sudden muscular contraction.

Lasègue Drop Test and Sacroiliac Joint Pain

The sacroiliac joints connect the sacrum to the pelvic bones and play an important role in transmitting forces between the spine and lower extremities.

Sacroiliac joint pain can resemble pain arising from the lumbar spine, making clinical differentiation challenging.

A painful response during the Lasègue Drop Test may raise suspicion of sacroiliac involvement, but the maneuver cannot reliably identify the SI joint as the specific source.

Other clinical examinations, including the thigh thrust, sacral thrust, compression, distraction, and Gaenslen tests, may be used as part of a more comprehensive assessment.

A 2021 systematic review and meta-analysis found that even clusters of sacroiliac joint pain provocation tests have limited ability to confirm SI joint pain. Negative test clusters were generally more useful for reducing the likelihood of SI joint involvement than positive clusters were for confirming it.

Therefore, the Lasègue Drop Test should not replace a comprehensive sacroiliac joint examination.

Differential Diagnosis and Clinical Considerations

An important limitation of the Lasègue Drop Test is that the pain response is not necessarily specific to lumbar spine pathology.

Several conditions may produce or worsen discomfort during movement of the hip and pelvis.

These include:

Lumbar degenerative disc disease
Lumbar facet joint disorders
Sacroiliac joint pain
Hip or pelvic muscular disorders
Inflammatory spinal conditions
Non-musculoskeletal causes of abdominal or pelvic pain

Can the Lasègue Drop Test Cause Pain in Appendicitis?

The traditional description notes that the maneuver may increase visceral pain, including pain associated with appendicitis.

This possible response is relevant because the iliopsoas lies close to abdominal and pelvic structures.

Appendicitis can sometimes produce pain associated with irritation of the psoas muscle. However, the Lasègue Drop Test has not been established as a diagnostic examination for appendicitis.

A PubMed-indexed review of acute appendicitis discusses the role of findings such as right lower quadrant tenderness and the psoas sign in clinical assessment, while emphasizing that no single examination finding can reliably exclude appendicitis.

Patients with suspected acute abdominal pathology require appropriate medical evaluation rather than orthopedic provocation testing.

Lasègue Drop Test Accuracy: Sensitivity and Specificity

The diagnostic accuracy of orthopedic examination maneuvers is commonly evaluated using two measures:

Sensitivity: The proportion of patients with a particular condition who receive a positive test result.
Specificity: The proportion of patients without that condition who receive a negative test result.

Is the Lasègue Drop Test Reliable?

Specific, validated sensitivity and specificity values for the Lasègue Drop Test itself are not established in the PubMed literature reviewed for this article.

Importantly, diagnostic accuracy values reported for the conventional Straight Leg Raise Test should not be applied directly to the Lasègue Drop Test.

A 2026 systematic review and meta-analysis examined diagnostic accuracy studies involving the standard Straight Leg Raise and Crossed Straight Leg Raise tests.

The review included 24 studies and reported that pooled sensitivity and specificity for the conventional Straight Leg Raise Test were typically below 80%, with generally low or very low certainty of evidence. The authors concluded that these tests produced only small or clinically unimportant changes in the probability of lumbosacral radicular pain.

These findings highlight the limitations of relying on isolated orthopedic examination maneuvers.

Clinical Implications

The Lasègue Drop Test should be considered an adjunctive clinical maneuver with uncertain diagnostic accuracy.

A positive response requires correlation with:

The patient’s medical history and distribution of pain
Lumbar spine range of motion
Lower extremity neurological examination
Conventional Straight Leg Raise Test findings
Sacroiliac joint provocation tests when indicated
Diagnostic imaging when clinically appropriate

No single physical examination test should independently determine a diagnosis of lumbar spine pathology.

Clinical Significance of the Lasègue Drop Test

The Lasègue Drop Test provides a traditional method of provoking pain associated with movements and muscular contraction around the lumbar spine and pelvis.

Its potential clinical value lies in identifying whether a rapid muscular response reproduces the patient’s familiar symptoms.

Nevertheless, its diagnostic usefulness remains uncertain because condition-specific validation studies and established accuracy measurements are lacking.

For clinical decision-making, healthcare professionals should prioritize a comprehensive assessment that combines the patient’s history, neurological findings, validated physical examination maneuvers, and appropriate investigations when required.

Frequently Asked Questions (FAQ)

1. What is the Lasègue Drop Test?

The Lasègue Drop Test is a clinical orthopedic maneuver used to evaluate lumbar spine and possible sacroiliac joint pain. It involves passively raising the patient’s straight leg until discomfort begins and then suddenly releasing it to assess the resulting pain response.

2. What does a positive Lasègue Drop Test indicate?

A positive test is traditionally characterized by reproduction or worsening of lower back or sacroiliac pain following the sudden release of the elevated leg. This may be associated with painful lumbar or pelvic structures, but it does not establish a specific diagnosis.

3. What is the difference between the Lasègue Test and the Lasègue Drop Test?

The standard Lasègue Test, or Straight Leg Raise Test, assesses symptoms associated with lumbosacral nerve root irritation during passive leg elevation. The Lasègue Drop Test introduces a sudden release of the leg to provoke a muscular response and assess lumbar or sacroiliac pain.

4. Can the Lasègue Drop Test diagnose lumbar disc herniation?

No. Although lumbar disc herniation is among the conditions traditionally associated with a painful response, the Lasègue Drop Test alone cannot confirm the diagnosis. Neurological findings, symptom patterns, and appropriate imaging are considered when clinically indicated.

5. Does the Lasègue Drop Test assess the sacroiliac joint?

Yes. The test has traditionally been used to assess possible sacroiliac joint pain. However, the result is nonspecific and should be combined with other clinical examination findings.

6. Which muscle is primarily involved in the Lasègue Drop Test?

The iliopsoas is emphasized in the traditional explanation of the test. Its contraction may transmit mechanical forces to the lumbar spine. Other muscles surrounding the pelvis and lower back may also participate in the response.

7. What are the sensitivity and specificity of the Lasègue Drop Test?

Reliable sensitivity and specificity values specifically for the Lasègue Drop Test have not been established in the references reviewed. Reported diagnostic accuracy figures for the conventional Straight Leg Raise Test should not be attributed to the drop variant.

8. Can the Lasègue Drop Test be positive in appendicitis?

The maneuver has traditionally been described as potentially intensifying abdominal pain, including pain related to appendicitis. However, it is not a validated appendicitis test and should not be used to confirm or exclude the condition.

9. Is the Lasègue Drop Test safe to perform?

Sudden release of an elevated leg can provoke pain and potentially cause injury if not adequately controlled. The maneuver should be considered only by trained healthcare professionals following an assessment of the patient’s condition, and it should not be performed as a home self-test.