National Physical Therapy Examination (NPTE) Practice Exam

When passive overpressure causes back and leg symptoms during extension, which condition is most consistent with these findings?

1. Lumbar disk lesion

2. Lumbar muscle strain

3. Sacroiliac joint sprain

4. Spinal stenosis

The correct answer is: Spinal stenosis

The scenario described—where passive overpressure during extension leads to back and leg symptoms—aligns well with the characteristics of spinal stenosis. In spinal stenosis, there is a narrowing of the spinal canal, which can create pressure on the spinal cord or nerve roots. When the spine is extended, as in the case of passive overpressure, this extension can exacerbate the pressure on already compromised neural structures, leading to symptoms radiating into the legs. Symptoms often include pain, numbness, or weakness in the lower extremities, which occur due to the irritation or compression of nerves as they exit the spinal column in the lumbar region. The extension movement can aggravate these symptoms because it further narrows the space available for the nerves. The other conditions—such as a lumbar disk lesion, lumbar muscle strain, and sacroiliac joint sprain—tend to produce symptoms differently. For example, a lumbar disk lesion may cause symptoms primarily during flexion or when there's a significant load on the spine, rather than during extension. A lumbar muscle strain typically results in localized pain rather than radiating symptoms. Similarly, a sacroiliac joint sprain might result in pain that is localized to the lower back or buttocks but doesn’t