signs and symptoms - IV disc herniation - fern

- may be asymptomatic even when visible with imaging techniques
- when painful, most common signs are:
• sciatica
• pain, numbness or weakness in the lower back and one leg
• low back pain that worsens with sitting, coughing or sneezing

- Disk level – weakness – altered reflex – sensory loss – pain
• L3-4 – quads, tibialis anterior – knee jerk – medial knee and shin – anterior thigh
• L4-5 – extension of big toe – none – big toe – back of thigh, lateral calf
• L5-S1 – gastrocnemius, ankle plantar flexion – Achilles – lateral foot and heel – back of thigh and calf

- Weakness or numbness in both legs as well as loss of bladder or bowel control suggests cauda equina syndrome, a medical emergency.