Choosing To Relieve L4 L5 Pain Symptoms
When its time to see a doctor for treatment for back pain, seek out a leader in minimally invasive spine procedures. Advances in minimally invasive spine treatments mean treating back pain is easier than ever. Between outpatient treatments and minimally invasive surgical procedures using small incisions, you can expect a quicker recovery time instead of a long hospital stay.
Want to learn more about the most effective medical procedures to treat and eliminate back pain? For more information, contact the DISC Spine Institute, experts in minimally invasive spine treatments.
Moderate Physical Activity Releases Endorphins
While it may seem counterintuitive, staying active can provide pain relief if you have a lumbar herniated disc. When you exercise the body releases endorphins, which can naturally improve your mood3 and reduce the perception of pain.
Most people with lumbar herniated discs are able to tolerate low-impact activities such as:
- Walking outside or on a treadmill
- Using an elliptical trainer
Read more about Low-Impact Aerobic Exercise
If your pain is more severe, you may want to try a water-based activity, such as hydrotherapy. Water-based activities are often recommended because the buoyancy of water counteracts gravity and decreases the load bearing placed on your spinal discs. Your health care provider may suggest a dedicated water physical therapy program or swimming.
Beware Of Wrong Protocol
Wrong protocol in approaching the patients with LDH can be classified into preoperative, intraoperative, and postoperative stages, although according to the specific surgical technique it may be somewhat varied. Wrong preoperative protocols comprise inappropriate patient preparation for the surgical procedure , improper patient positioning to protect the sensitive organs like the eyes, peripheral nerves, and testicles in male patients, and failure to take the necessary measures for full dependence of the abdomen to reduce epidural veins engorgement. Nowadays, there is no hard evidence to support routine preoperative hair removal in spine surgery .
Wrong intraoperative protocols include using a non-standard suction tube with rough edges, advancing discectomy instruments more than 2.5 to 3 cm from the posterior disc border, rush in the process of surgery, and harsh usage of surgical instruments . Postoperative wrong protocols comprise inappropriate rehabilitation, improper timing for returning to previous job, failure to change harmful patient’s life style and gaining appropriate body mass index .
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What Is A Herniated Lumbar Disc
A herniated disc occurs when the gel-like center of your disc ruptures out through a tear in the tough disc wall .The gel material is irritating to your spinal nerves, causing something like a chemical irritation. The pain is a result of spinal nerve inflammation and swelling caused by the pressure of the herniated disc. Over time, the herniation tends to shrink and you may experience partial or complete pain relief. In most cases, if low back and/or leg pain is going to resolve it will do so in about 6 weeks.
Different terms may be used to describe a herniated disc. A bulging disc occurs when the disc annulus remains intact, but forms an outpouching that can press against the nerves. A true herniated disc occurs when the disc annulus cracks or ruptures, allowing the gel-filled center to squeeze out. Sometimes the herniation is so severe that a free fragment occurs, meaning a piece has broken completely free from the disc and is in the spinal canal.
Most herniated discs occur in the lumbar spine, where spinal nerves exit between the lumbar vertebrae, and then join together again to form the sciatic nerve, which runs down your leg.
How Can I Avoid Getting A Herniated Disk
It’s not always possible to prevent a herniated disk. But you can reduce your risk by:
- Using proper lifting techniques. Dont bend at the waist. Bend your knees while keeping your back straight. Use your strong leg muscles to help support the load.
- Maintaining a healthy weight. Excess weight puts pressure on the lower back.
- Practicing good posture. Learn how to improve your posture when you walk, sit, stand and sleep. Good posture reduces strain on your spine.
- Stretching. Its especially important to take stretching breaks if you often sit for long periods.
- Avoiding wearing high-heeled shoes. This type of shoe throws your spine out of alignment.
- Exercising regularly. Focus on workouts that strengthen your back and abdomen muscles to support your spine.
- Stopping smoking. Smoking can weaken disks, making them vulnerable to rupture. Consider quitting smoking.
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Lumbar Pain Or Low Back Pain Is Alarmingly Commonand A Major Cause Of Lost Productivity And Activity Restriction So What Are The Causes Of Lumbar Pain And What Should You Do If You’re Suffering
The lumbar spine is strong and flexible but can become weakened by a wide variety of causes. Lumbar pain can arise from sprains and strains, disc problems, spinal stenosis, and osteoarthritis, among other factors.
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Low back pain is extremely common and affects most people at some point in their lifetime. Estimates show that up to 36 percent of us will suffer from a new or recurrent episode of low back pain in a given year. Much of it originates in the lumbar area. If youve experienced lumbar pain, you know it can have a significant effect on quality of lifethe ability to work and participate in family and community routines.
Many environmental and personal factors influence your risk for developing lumbar pain. The incidence increases with age up to the age of 60, after which it declines.
A Bulging Vs Herniated Disc
Bulging and herniated discs are sometimes interchangeable terms to define a condition that affects the intervertebral discs. However, they are several differences between these two conditions.
A bulging disc is not a broken disc, meaning the outer wall of the intervertebral disc remains intact but bulged. Whereas for a herniated disc, there has been a partial rupture or complete collapse of the outer wall of the intervertebral disc and the gel-like material inside the disc has spilled out causing pressure on the spinal cord or spinal nerves.
In the end, the primary difference between a bulging and a herniation comes down to whether they are contained or non-contained.
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When Steroids And Prolotherapy Are Needed
When disc material prolapses or herniates through the annulus, a severe inflammatory reaction occurs, which affects the lumbar nerves and causes excruciating pain. This is one time when steroids are needed to resolve the pain. With appropriate treatment using steroids injections onto the nerve and Prolotherapy treatment to the lower back, it is possible to strengthen the ligaments through which the disc herniated. Anyone this debilitated by pain would likely need to come into the office in a wheelchair or be in obvious discomfort but after treatment often would be able to leave walking out much happier.
If you have been diagnosed with a bulging disc, slipped disc, herniated disc, Prolotherapy is safe, effective, and cost-friendly. It is a low-risk procedure that treats a herniated disc symptoms.Questions about our treatments?
If you have questions about Spinal fusion surgery complications and how we may be able to help you, please contact us and get help and information from our Caring Medical staff.
Brian Hutcheson, DC | Ross Hauser, MD | Danielle Steilen-Matias, PA-C
Symptoms Of Herniated Lumbar Disc:
Lower back pain Leg pain Leg numbness or tingling Pain is worse from sitting Restricted trunk flexionSciatica pain
Please note, a herniated disc DOESNT always cause pain, so you must get a proper diagnosis.
Lower back pain is typically the first symptom of a lumbar disc herniation. Often this pain will last for a few days and then subside, but leg pain, numbness or tingling, and/or weakness of the lower extremity often follows.
Typically the leg pain eventually travels below the knee and can even affect the ankle and foot.
How long does the pain last?
Most patients with a lumbar disc herniation will improve gradually over a period of days to weeks, with most patients being symptom free within 3 to 4 months.
Patients that actively participate in an exercise program often report a significant reduction of pain and improved ability to perform their activities of daily living.
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Exercises For Facet Joint Pain Relief In Low Back:
Please try the following at your own discretion. If you feel more pain from these exercises, then you should seek medical help.
In many cases, lower back pain caused by facet joints can mimic other conditions such as herniated discs and compressed nerve roots. If conservative treatment methods fail to reduce symptoms, consider consulting with a physiotherapist or chiropractor to determine if something else is causing your symptoms.
Will I Need To Have Spinal Surgery
Herniated disks get better on their own over time or with nonsurgical treatment for 9 out of 10 people. If other treatments dont relieve your symptoms, your healthcare provider may recommend surgery. There are multiple surgical techniques for relieving pressure on the spinal cord and nerves, including:
- Diskectomy to remove your herniated disk.
- Laminectomy to remove part of the bone around a herniated disk and expand your spinal canal.
- Artificial disk surgery to replace a damaged herniated disk with an artificial one.
- Spinal fusion to directly join two or more vertebrae together to make your spine more stable.
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Percutaneous Disc Decompression For Herniated Discs
Decompression is a term used to describe the treatment of a compressed disc that is causing bulging or herniation. Percutaneous disc decompression involves dissolving or removing parts of a herniated disc to alleviate back pain. This therapy is used for patients who present with low back pain and numbness with pain radiating down one or both legs. Most patients who undergo this procedure have an MRI that shows a modest herniated disc. In other words, this treatment is not for people with severely herniated discs.
The treatment involves placing a needle into the herniated disc using X-ray guidance. Depending on the type of decompression therapy, excess disc tissue is either dissolved through radio waves or removed by a revolving needle. The result is decreased pressure on the disc and adjacent nerves. Although some studies show effective pain relief, we believe the long-term effects of removing tissue are not worth the short-term pain relief.
Diagnosis Of Disc Problems
- taking a medical history to:
- determine predisposing risk factors and conditions
- identify any associated spinal nerve involvement
Investigations are carried out if:
- symptoms persist for more than six weeks despite remaining active, or
- there is concern the disc is affecting a spinal nerve.
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Symptoms Of Lumbar Spinal Segment
Most patients may experience lower back pain that radiates to one side of the lower limb or even both sides. Tingling, numbness , and an aching or burning sensation in the leg and on top of the foot are widespread. In severe cases, an L4-L5 slipped disc leads to weakness in the legs or feet. Some may even have an inability to walk, leading to an inability to stand. Those who cannot walk or stand may have a condition called foot drop.
Patients with footdrop frequently present with a high steppage gait where they exaggeratedly raise the thigh while walking as if they are climbing the stairs. They also have a slapping gate, where the foot strikes the ground as they walk. A drop foot is a severe condition resulting in damage or degenerative changes in the nerves that control leg and foot movements. The degree of injury is relative to the severity of a slipped disc. Therefore, those with a slipped disc should do their utmost best to obtain the needed non-surgical care as soon as possible. While surgeons recommend surgery for foot drop, we recommend our conservative treatment through collaborative chiropractic and physical therapy .
More Detailed Procedure Does Not Necessarily Mean More Effective
In the surgical approach for a patient with a spine problem, the general rule is that the preferred surgical intervention is the one with the least invasion and greatest benefit. A complex detailed surgery is not necessarily more effective. Performing a long complicated operation, such as transforaminal lumbar interbody fusion with pedicular screw and rod fixation for simple LDH not associated with Modic endplate changes, can be inappropriately complex for the intended goal . The procedure of choice for simple LDH is partial microscopic discectomy, preferably with minimally skin incision. Performing additional measures like posterolateral or interbody fusion and instrumentation in order to obtain additional surgical outcome have only been proposed for those herniated discs accompanied with Modic endplate changes and predominantly LBP .
A 32-year-old man with low back pain and left sciatic pain. Sagittal and axial magnetic resonance imaging scans showed extruded left sided simple L5S1 lumbar disc herniation. Plain postoperative lumbosacral radiographs of the same patent underwent transforaminal lumbar interbody fusion and fixation.
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Can Pressure On The Nerves From A Slipped Disc Be Relieved Through Non
The L4-L5 Lumbar disc often places varying degrees of pressure on the nerves when they bulge, herniate or protrude. In other words, a slipped disc or slip-disc can impinge or put significant amounts of pressure on the nerves that exit the spine. Spine surgeons often attempt either destroying the nerve through a Radiofrequency Ablation or other forms of spine surgery to alleviate the pressure on the nerves. However, surgical interventions have not proven well in the long term. Sufferers who sought surgical interventions for an L4-L5 disc often return for additional surgeries.
Pressure on the nerves from herniated, bulging, or extruded lumbar discs are best treated without surgery. In our center, our primary goal is to take away the pressure on the nerves by correcting issues that led to nerve impingements or nerve pressure . Our non-surgical treatments for the L4-L5 are not patches that spine surgeons offer. They fix the damaged joints, muscles, ligaments, and lumbar discs through our nonsurgical treatments.
Beware Of Wrong Tactic
It is very important that the type of surgery should be selected according to the type of the disease, evidencebased medicine, existing facilities, and experience of the surgeon. Although a variety of treatment modalities exist for disc surgery, the standard operation currently recommended for simple LDH is microscopic partial discectomy . Laser disc surgery is a relatively effective and safe manner to treat broad base, bulged or even protruding disc that still contains LDH . This minimally invasive surgery does not have any place in treatment of extruded or sequestrated LDH. It is also contraindicated in the patients with underlying spinal instability like spondylolysis and can create iatrogenic spondylolisthesis .
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> > > Back Pain & Sciatica Watch Here
Other back pain causes include lumbago and cauda equina syndrome. Your physician will ask about your symptoms, examine your back, and conduct an examination. The diagnosis will be based on the severity of your pain, but your symptoms should subside within two months. If the pain persists, you should consult a doctor to make sure it isnt something more serious. The best treatment for back pain is to rest and avoid physical activity.
If your back pain persists after a few weeks, you should consider a more serious diagnosis. There are many different types of back pain. Some people have a spinal disorder, which is more severe than others. Its important to get proper diagnosis and treatment for back pain. You should also make a lifestyle change that promotes your health and keeps you from experiencing pain. You can also see a physical therapist if you have a specific type of injury or if your back problems are recurring.
In addition to exercising, you should do light physical activities. Gentle exercise can help alleviate back pain. Yoga and pilates are both excellent exercises. The best exercises for backache are those that increase muscle tone and flexibility. You can also try over-the-counter pain relievers or heat to reduce the pain. If youre experiencing severe pain, your doctor may recommend a stronger medication to ease your symptoms. If the pain persists, you should consult with a medical professional and make an appointment with a physician.
Imaging Of The Herniated Disc
The major finding on plain radiographs of patients with a herniated disc is decreased disc height. Radiographs have limited diagnostic value for herniated disc because degenerative changes are age-related and are equally present in asymptomatic and symptomatic persons.10 Neurodiagnostic imaging modalities reveal abnormalities in at least one third of asymptomatic patients.11 For this reason, computed tomography also has limited diagnostic value for herniated disc.
The gold standard modality for visualizing the herniated disc is magnetic resonance imaging , which has been reported to be as accurate as CT myelography in the diagnosis of thoracic and lumbar disc herniation.12 T1-weighted sagittal spin-echo images can confirm disc herniation however, the size of herniation is underestimated because the low signal of the anulus merges with the low signal of the cerebrospinal fluid. Conventional T2 and T2-weighted fast spin-echo images are used in the diagnosis of degenerative disc disease. MRI also has the ability to demonstrate damage to the intervertebral disc, including anular tears and edema in the adjacent end plates. As with CT scans, MRI can reveal bulging and degenerative discs in asymptomatic persons therefore, any management decisions should be based on the clinical findings corroborated by diagnostic test results.11
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How Are Herniated Discs Diagnosed
To figure out if you have a herniated disc, you can see an orthopedist or your primary care doctor. A herniated disc will be suspected if low back pain is accompanied by radiating leg pain.
Your doctor will likely have you do the straight leg raise test. Lying down, youll lift one leg straight up. If you have a herniated disc compressing on a nerve, that movement will increase the compression and cause pain throughout that leg. Your doctor will also ask about numbness, weakness, and slow reflexes.
From there, imaging studies are usually ordered. You may need:
Magnetic resonance imaging
This technology reveals the spinal cord, surrounding soft tissue and nerves. It is the best imaging study to support the diagnosis of a herniated disc.
MRIs are the diagnostic tool of choice for herniated discs because they can show soft tissue.
Nerve conduction studies and electromyogram
These studies use electrical impulses that measure how much your nerves might be affected by compression from a herniated disc. NCS and EMG are not routine tests to diagnose herniated disc, and are only used if you have symptoms of nerve trouble like numbness and radiating pain. These studies are typically only used if MRIs and a physical exam are inconclusive and your doctor thinks other conditions are a possibility.