A positive straight leg raise test most commonly suggests herniation at which disc levels?

A positive straight leg raise test most commonly suggests herniation at which disc levels?

• A. L5 or S1
• B. L4-L5
• C. L2-L3
• D. T12-L1

Answer: (A)

The straight leg raise tests tension on the lumbosacral nerve roots as the leg is elevated, so a radicular pain pattern is reproduced when a disc herniation is compressing a nerve root. Among lumbar levels, herniation most commonly affects the L5–S1 space, irritating the S1 nerve root. This yields the classic radicular pain down the posterior leg into the heel or sole, which is why a positive straight leg raise most often points to a herniation at L5–S1. Herniations at higher levels are less common and produce different distributions, making them less likely to be the source when the test is positive.

The straight leg raise tests tension on the lumbosacral nerve roots as the leg is elevated, so a radicular pain pattern is reproduced when a disc herniation is compressing a nerve root. Among lumbar levels, herniation most commonly affects the L5–S1 space, irritating the S1 nerve root. This yields the classic radicular pain down the posterior leg into the heel or sole, which is why a positive straight leg raise most often points to a herniation at L5–S1. Herniations at higher levels are less common and produce different distributions, making them less likely to be the source when the test is positive.