by AceMedEd

Teach card · keep it in your scrub pocket

Low back pain

Ask in clinic

  1. Before a sciatica patient: "Paracentral disc at L4–5. Which root, and what will be weak, numb and hyporeflexic?"
  2. While you examine together: "Show me how you'd tell L5 from S1 in one minute, standing and on the table."
  3. After a new back-pain visit: "Which answers in that history would have made you interrupt me right away?"

Point at: the L4–5 axial MRI: the disc, the thecal sac, the facet and the traversing L5 root in the lateral recess, while they name each one.

End of day: "Redraw the L4–5 slice and show me where the L4 and L5 roots get pinched. Then walk me through the L4, L5 and S1 exam." Two minutes, no notes.

Where this kit and your technique differ, yours wins.

Send this to your students

The night before clinic. They learn the anatomy and practice the exam tonight, use it between patients, and get a cold check tomorrow. They won't see these questions.

Open the student page

Reviewed by Mehdi “AC” Talle, D.O., November 2026. Sources: Netter, Gray's Anatomy and Hoppenfeld's surgical exposures. Teaching schematic, not to scale; anatomy and technique vary. Management and indications are left to you on purpose.