General features of lateral disc protrusion:
- sciatic pain - i.e. pain in buttock, and down the back of the thigh and the leg. This is aggravated by coughing, sneezing and straining, and is more intense that any associated backache.
- numbness or tingling in the distribution of the affected root
Neurological features depend upon the nerve affected:
- L4 - quadriceps wasting and weakness; impaired knee jerk; sensory impairment over medial calf.
- L5 - wasting and weakness of dorsiflexors of foot (with some degree of foot drop), extensor digitorum longus and extensor hallucis longus; wasting of extensor digitorum brevis; sensory impairment over lateral calf and dorsum of foot.
- S1 - sensor impairment over outer aspect of the foot; impaired ankle jerk; possible wasting and weakness of the plantar flexors, but may remain strong due to S2 supply.
Mechanical features of lateral disc protrusion:
- positive femoral stretch test
- positive straight leg raising test