One of the two most common radiculopathies found with lumbar HNP, an L5 radiculopaty is present when one, two or all three of the findings of weak big toe extension, decreased pin prick sensation over the big toe, or a decreased posterior tibial reflex is found.
My study, as shown in the LOBAK app, found that in patients with low back and leg pain, this finding indicated a herniated disc in 70% of those patients. That would be enough to indicate an imaging study, either CT or MRI scan. of the lumbar spine. If conservative treatment has failed and the scan shows a HNP, then surgery would be expected to be more effective than further non-operative treatment. Of course if the CT or MRI failed to show a HNP, then surgery would not be indicated.