Neurological Testing

Test for reflexes and note differences between the two sides. According to Magee (2006), these are the normal deep reflexes of the lumbar spine:

  • Patellar: L3-L4
  • Medial hamstring: L5-S1
  • Lateral hamstring: S1-S2
  • Posterior tibial: L4-L5
  • Achilles: S1-S2
Reflexes are tested with a reflex hammer, with the muscle and tendon in a relaxed position.
If neurological symptoms are found, check for the dermatome and myotomes of the nerve roots, as well as the peripheral sensory distribution of the peripheral nerves.
When testing the muscle power, you test for possible neurological weakness. Myotomes are tested with the peripheral joints in resting/neutral position, with an isometric resistance of at least 5 seconds (Magee 2006). According to Magee (2006) these are the myotomes of the lumbar spine:

  • L2: Hip flexion
  • L3: Knee extension
  • L4: Ankle dorsiflexion
  • L5: Great toe extension

(Magee 2006)

Location of pain and motor deficits in association with nerve root involvement at each lumbar disc level: