A right-sided disc herniation at the L5–S1 level typically may cause:

A. Low back pain and right sciatica.

C. A diminished or absent right ankle jerk.

DISCUSSION: A lumbar disc herniation at the L5–S1 or L4–L5 level typically causes low back pain and ipsilateral sciatica. If a ruptured L5–S1 disc causes weakness, it ordinarily involves plantar flexion of the ipsilateral foot. Although a diminished or absent ankle jerk can be caused by either an L5–S1 or an L4–L5 disc herniation, it is more common with the former. The L5–S1 disc herniation ordinarily affects the S1 nerve root, which supplies the lateral aspect of the foot, including the small toe.