Back pain When patients describe pain in the hip, they generally mean pain in the buttock.

. It is necessary to get the patients to point to where they have the pain Referred pain is rarely felt below the knee, whereas pain due to root irritation may spread to the calf or even into the foot pain shooting down the leg as a result of coughing or sneezing is highly suggestive of root compression Pain from L1 & L2 root involvement is easily confused with hip disease because it concentrates around the groin. Pain resulting from compression of L3 &L4 roots radiates down the front of the thigh. Sensation: o o o o o L2 thigh L3 knee L4 medial shin L5 lateral calf & dorsum of foot S1 lateral side of foot

L4 S1

L5

Motor weakness Sensory loss Reflex depression

Knee extension Ankle dorsiflexion; EHL Ankle plantar flexion: FHL Medial shin to knee Knee Dorsum of foot and lateral calf Tibialis posterior Lateral border of foot and posterior calf Ankle