This topic contains 2 replies, has 2 voices, and was last updated by 
Christopher Stepien March 16, 2018 at 5:17 pm.
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Christopher Stepien
8 years into practice and I think I’m just grasping something I should’ve learned in 5th tri. I’d like to double-check my reasoning.
Generally,
mid-line disc injuries will cause pain in lower nerve root patterns.
lateral disc injuries will cause pain in higher nerve root patterns.It’s not possible for a lateral disc injury to cause pain in a, say, S4 or S5 distribution pattern because those nerves are more midline than any other nerves. I can’t imagine this isn’t correct, but is it?
Therefore, if I have a patient who has been diagnosed with bilateral medial hamstring “strains” for years with MRIs that are clean, no bruising, a decent SLR, a shitty QLF, it makes sense that this would be an S2 nerve root issue, which would be a midline pathology (also confirmed by the bilateral symptoms)?
Carl Nottoli, DC
Generally speaking your two points are correct.
However, it would not be possible to assume your scenario at the end your post without going through the specifics of the case in strict ID format.
Christopher Stepien
Understood. TY Carl.
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