How is the Nachlas Test performed?

• A. The patient sits and extends the knee
• B. The patient bends at the waist
• C. The patient is prone while the doctor flexes the knee and brings the heel to the ipsilateral buttock
• D. The patient stands on one leg

Answer: (C)

The Nachlas Test is specifically designed to assess the integrity of the lumbar spine and the hip joints, particularly focusing on the function of the sacroiliac joint. The correct method for performing the Nachlas Test involves the patient lying in a prone position while the examiner flexes the knee, bringing the heel toward the ipsilateral buttock. This movement puts stress on the hip joint and the lumbosacral area, allowing the examiner to evaluate for pain or discomfort that might indicate issues such as sciatica or problems within the sacroiliac joint.

By placing the patient in a prone position and performing this action, the test allows for a clear assessment of the range of motion and any potential restrictions or pain. Such a position is crucial because it facilitates a deeper assessment of the hip flexors and the lower back without the complications that other positions might introduce. Along with the testing movement, a positive response can indicate pathologies such as lumbar nerve root irritation or other underlying musculoskeletal issues.