Diagnosis | L5 syndrome

Diagnosis

The L5 syndrome itself does not describe a disease but a symptom. An L5 syndrome can therefore be diagnosed by the attending physician with a detailed discussion of the symptoms and previous illnesses as well as a physical and neurological examination focusing on sensitivity, paralysis and reflexes. However, the cause of the pain syndrome often requires further diagnostic investigations.

In order to diagnose a herniated disc, a radiological examination in CT or MRI is often necessary. Also other spatial demands in the area of the spinal cord, for example cysts, tumors or spinal stenosis can be detected in this way. In rare cases, for example in the case of unclear tumors, a biopsy is also necessary.

This is an invasive diagnostic measure. To be able to diagnose possible damage to nerves or muscles, a so-called “electromyography” can be performed. This allows the function of the nerve in the muscle to be examined more closely.

What you might also be interested in on this topic: MRI of the lumbar spineThe so-called “Lasègue sign” describes a test that can be used to diagnose a slipped disc or other neurological diseases. It uses a motor maneuver to test whether nerve roots in the lumbar spine are irritated and have inflammatory changes. To do this, the patient lies flat on his back and slowly lifts the stretched leg.

As a rule, flexion of up to 90° in the hip joint should be possible without difficulty. If this exercise causes pain at an early stage, this indicates an inflammatory event of the nerve root as in a herniated disc. In the case of a herniated disc, neurological symptoms of failure are often only observed when the prolapsed disc is inclined in one direction.

The nerves of each individual segment emerge laterally from the spinal cord and the spinal canal, where they can be depressed and irritated by a herniated disc. In this case, the secondary symptoms occur on the respective affected side. Symmetrical complaints, on the other hand, are unlikely, since both nerve roots are rarely equally involved.

In this case, other neurological diseases must be included in the diagnosis. An identifying muscle is a specific muscle that can be clearly assigned to a vertebral segment. The nerve of this vertebral segment is thus the main responsible for the motor function of this one muscle.

In emergency medicine, the reference muscles play an important role in quickly localizing potential nerve damage. For segment L5, the characteristic muscle is the so-called “Musculus extensor hallucis longus”. This muscle can carry out an extension in the ankle joint as well as in the big toe joint and thus lift the foot and the big toe skywards.

Other muscles, for example the knee extensors, can also be affected in the case of L5 syndrome, but are usually supplied by other nerves, which is why no complete failure occurs. A failure of the muscle is a further indication of an L5 syndrome.