LOWER EXTREMITY

Routine Lower Extremity Back/Leg Pain and Lumbosacral Root Search

Nerve            Recording Sites        Stimulation Sites            F-Waves

Sural (s)        ankle                calf    
Sup Peron (s)    ankle                lat leg
Peroneal (m)        EDB                ankle and above knee    ankle
Tibial (m)        AH                ankle and knee        ankle
H-Reflex bilat        soleus                knee

Needle Examination

Perform needle exam on the symptomatic limb.  Test the minimum of one muscle innervated by the L2, L3, L4, L5 and S1 spinal roots (see Appendix C). Test the lumbosacral paraspinal muscles at one or more levels.

If abnormalities are detected, examine one or two additional muscles innervated by the suspected roots and different peripheral nerves.  Perform needle exam on the asymptomatic limb muscles for comparison as needed.