If your painful leg is weaker than the other leg, you may have nerve root compression at the second, third, or fourth lumbar vertebrae L2, L3, or L4 region. Ankle dorsiflexion. While you are in the sitting position, your doctor pushes down on your feet while you try to pull your ankles upward. If there is weakness in one leg, the ankle will give way to the downward pressure. This is a sign of possible nerve root compression at the level of the fifth lumbar vertebra L4 or L5 region.
Great toe extension. While you are in the sitting position, your doctor pushes down on your big toes while you try to extend them bend them back toward you. If there is weakness in one leg, its big toe will give way to the pressure. This is a sign of possible nerve root compression at the level of the fifth lumbar vertebra L5 region. Plantar flexion power. You stand and rise up on your toes on both feet and then on each foot separately.
Toe raises are difficult, if not impossible, to do if a particular nerve region is compressed. This is a sign of possible nerve root compression at the level of the first sacral vertebra S1 region.
Sensory testing Just as your muscles receive signals through certain nerves, other nerves carry signals back to your spinal cord from specific sections of your skin and other tissues. Areas that send messages through particular nerves Area of skin Nerve level The front of your thigh L1, L2, L3, L4 The inside of your lower leg, from the knee to the inner ankle and arch L4 The top of your foot and toes L5 The outside of your ankle and foot S1 Reflexes Tendons attach the muscles to the bones.
Patellar tendon reflex. You sit on the exam table with your knee bent and your foot hanging down, not touching the floor. Your doctor will use a rubber hammer to tap firmly on the tendon just below your kneecap. In a normal test, your knee will extend and lift your foot a little. A decreased or absent reflex may mean that there is compression in the L2, L3, or L4 region. Achilles tendon reflex. You sit on a table with your knees bent and feet hanging down, or you may be asked to lie down on your stomach with your legs straight and your feet off the edge of the exam table.
Your doctor will use a rubber hammer to tap firmly on the Achilles tendon, which connects the muscle at the back of your calf to your heel bone. A patient presents with foot pain and these chronic findings? This patient presents with chest pain.
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