REIDER PART 2
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Chapter 9_Lumbar Spine 359

Figurę 9-28, cont'd.

Valsalva*s Manewer

The Valsalva maneuver is designed to inerease intrathe-cal pressurc and therefore exaccrbate pain that is due to pressure on the spinał ćord or its nerve roots. To perform the Valsalva maneuvcr, the patient is instructed to bear down as if attempting to have a bowel movement (Fig. 9-31). If pain is present owing to pressure on the spinał cord or the nerve roots, this maneuver usually exacerbates the pain. Pain from other causes should not be affected by the Valsalva maneuver.

Figurę 9-29. Femoral nerve stretch test.

Nonorganic Signs of Waddell

WaddelFs nonorganic signs, alrcady discussed in Chapter 8, Cervical and Thoracic Spine, werc actually originally described in conjunction with the lumbar spine. They are helpful signals to alert the examiner to the possibility of

Figurę 9-30. Single leg hyperextension test.