What Are The Symptoms
Symptoms will depend on which disc is injured. They include back pain, leg pain, neural symptoms as well as bowel and bladder problems. Most of lumbar spine herniations occur at either L4/L5 or L5/S1. Where the herniation and so spinal cord compression occurs, dictates the symptoms the individual will feel. In most cases, some degree of lower back pain will be felt and this may be accompanied by:
The Hip Spine Ligaments And Pelvic Tilt
Publishing in August 2022 in the Journal of anatomy and international team of researchers found the hip spine ligaments to be important factors in stabilizes the pelvis and suggested that release surgeries to even out the pelvis tilt may not be a good idea. This is what they wrote:
The alteration in mechanical properties of posterior pelvis ligaments may cause a biased pelvis deformation which, in turn, may contribute to hip and spine instability and malfunction. . . The deformation of the lumbopelvic complex relative to a given load was predominant in the medial plane . The effect of unilateral resection , suggesting that ligaments have the ability to redistribute load and that they play an important role in the mechanics of the lumbopelvic complex.
How Can Exercises Help
Exercises and physiotherapy are often important parts of recovery from a herniated disk. A doctor will usually recommend a few days of rest after experiencing a herniated disk.
Doing gentle activities and exercises will strengthen the muscles that support the spine and reduce pressure on the spinal column. They will also promote flexibility in the spine and may help reduce the risk of a herniated disk from recurring.
A doctor may suggest starting small and building up the level of activity slowly. They will discuss specific exercises that a person should and should not perform during the recovery period.
Gentle activities that can help with a herniated disk include:
Perform all exercises in a slow and controlled manner, especially when bending or lifting. Exercises should not hurt. If a person feels pain, they should stop doing the exercises and speak with their doctor.
Below, we discuss exercises that can help treat a herniated disk pain in the neck and back.
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Certain Sleep Positions Help Relieve Herniated Disc Pain
Pain from a lumbar herniated disc can worsen during the night. You may find comfort sleeping in a position that relieves pressure from the spine. A couple good options include:
Your preferred sleeping position and pillow placements will likely be determined by the location of your herniated disc. Try a few different pillow and positions to see what works best for you.
See Best Pillows for Different Sleeping Positions
What Are The Dangers Of An Canal Stenosis At The L4
Spinal stenosis is a common cause of pain and disability. The L4-L5 level is the most common site for spinal canal stenosis in the lower back. Spinal stenosis results from premature wear and tear of spinal joints, muscles, ligaments, and spinal discs. The shrinkage or stenosis of the spinal canal is a progressive disorder. What this means is once the shrinkage starts, it progresses.
The danger with progression is complete or partial impairment of nerves or spinal cord. Any reduction of the spinal canal is a cause for concern, especially if the reduction is at the L4-L5 level. They concern us because it leads to weakness or paralysis of lower limbs, impotence, infertility, and loss of bowel and bladder control Common sites of spinal canal stenosis.
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How Is A Herniated Disc Diagnosed
Typically, doctors perform a physical exam to find the source of the pain. And, based on that visit, they may want further testing to rule out any other issues.
The most common imaging for this condition is an MRI. MRI, magnetic resonance imaging, produces 3-D images of body structures using powerful magnets and computer technology.
MRI will show the spinal cord, nerve roots, and surrounding areas and allow the doctor to see any abnormalities in the spine.
At CORE Orthopedics, we use an Open MRI machine. An Open MRI machine is open on all sides and is configured with magnets above and below the patient. This allows for a far less claustrophobic experience than a traditional MRI.
The primary benefit is patient comfort during the procedure.
Using MAGNETOM Esprees revolutionary technology, we can give our patients the comfort and space of an open MRI with the imaging power of a traditional closed unit.
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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What Is A Diffuse Disc Bulge At L4
Many people ask about the terminology given on MRI scans. One of the common findings is a diffuse disc bulge at L4-L5.
This means that the area of the disc bulge is large and spread out. A smaller disc bulge often means the bulge comes out further, but it is less spread out, while a diffuse disc bulge at L4-L5 means the opposite.
Leg Pain And Or Weakness
The leg pain that is often felt with an L4-L5 disc problem in conjunction with or separate from lower back pain is often categorized as sciatica. Its also one of the most obvious signs that the back pain youre feeling could be the result of a disc problem. Pain radiating down the leg along the sciatic nerve is unpleasant, to say the least, and is often the reason a back pain sufferer picks up the phone to call a back doctor in the first place.
But thats not the only way sciatica pain presents. The symptoms may be described as dull, sharp, burning, aching or stabbing, said DISC Spine Institute. It may worsen as you are sitting for an extended amount of time or if you are laughing, sneezing, or coughing. Walking may also aggravate the situation.
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What Is Lumbar Disk Disease
The vertebral column, or backbone, is made up of 33 vertebrae that are separated by spongy disks. The spine is divided into 4 areas:
Cervical spine: The first 7 vertebrae, located in the neck
Thoracic spine: The next 12 vertebrae, located in the chest area
Lumbar spine: The next 5 vertebrae, located in the lower back
Sacral spine: The lowest 5 vertebrae, located below the waist, also includes the 4 vertebrae that make up the tailbone
The lumbar spine consists of 5 bony segments in the lower back area, which is where lumbar disk disease occurs.
Bulging disk. With age, the intervertebral disk may lose fluid and become dried out. As this happens, the spongy disk becomes compressed. This may lead to the breakdown of the tough outer ring. This lets the nucleus, or the inside of the ring, to bulge out. This is called a bulging disk.
Ruptured or herniated disk. As the disk continues to break down, or with continued stress on the spine, the inner nucleus pulposus may actually rupture out from the annulus. This is a ruptured, or herniated, disk. The fragments of disc material can then press on the nerve roots located just behind the disk space. This can cause pain, weakness, numbness, or changes in sensation.
Most disk herniations happen in the lower lumbar spine, especially between the fourth and fifth lumbar vertebrae and between the fifth lumbar vertebra and the first sacral vertebra .
Contained Disc Vs Non
Contained Discs: The disc has not broken through the outer wall of the intervertebral disc, which means the inner gel-like material remains contained.
Non-Contained Discs: The inner gel-like material has broken through the outer wall of the intervertebral disc. To complicate matters, sometimes fragments from the annulus may break away from the parent disc and drift into the spinal canal.
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The Most Common L4 L5 Pain Symptoms
Disc problems are one of todays most frequent back issues, and they can also be among the most painful. Thats especially true of the L4-L5 disc area, as it can create additional, painful symptoms that can interrupt your life and have you running to the doctor. Not sure if what youre suffering through is an L4-L5 slipped disc problem or something else? Here are three telltale signs to look out for.
Herniated Disc Hip Pain
Herniated disc hip pain is one of the many symptoms diagnosed as stemming from bulging intervertebral disc issues in the lumbar spine. The tissues stemming from nerve roots from T12 through S1 pass through the hip area, making this type of pain easily blamed on a wide range of possible causative conditions, including spinal stenosis and foraminal stenosis. Other common diagnostic conclusions formulated to explain hip pain may include piriformis syndrome, sacroiliac joint pain and hip bursitis. Of course, hip issues can also be completely nonstructural and may be related to the mindbody process in some patients. This is always worth considering.
This dialog will investigate the origin of hip pain symptoms and how these complaints might be related to herniated disc pathologies in the lower back.
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What Are The Risks For Lumbar Disk Disease
Although age is the most common risk, physical inactivity can cause weak back and abdominal muscles, which may not support the spine properly. Back injuries also increase when people who are normally not physically active participate in overly strenuous activities. Jobs that require heavy lifting and twisting of the spine can also cause back injuries.
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Prolotherapy Injections For Correcting Spinopelvic Instability And Pelvic Tilt
Prolotherapy is an injection treatment that stimulates the repair of connective tissues such as tendons and ligaments. It causes a mild inflammatory response which initiates an immune response. This mimics what the body does naturally to heal soft tissue injuries.
The most common pelvic instability is sacroiliac instability, caused by injuries to the stabilizing ligaments of the sacroiliac joint. These ligaments are typically injured through the combined movements of spinal flexion and rotation.
The Pelvic Tilt In Advanced Hip Osteoarthritis
When there is a loss of range of hip motion, specifically hip extension , as is common in cases of advanced osteoarthritis of the hip, an exaggerated anterior pelvic tilt of the pelvis occurs. During walking, when the foot on the side of the osteoarthritic hip hits the ground and it is time for the hip to extend and the heel to lift to begin the next step, the lumbar spine goes into excessive lumbar lordosis to compensate for the loss of hip extension.
This loss of mobility of one hip can put the same side knee, lumbar spine/pelvis, and other hip at risk for instability. This is why it is important to correct the initial cause of hip pain and stop this progression from occurring. Conversely, a posterior pelvic tilt accompanied by a flattening of the lumbar spine, which provides apparent hip flexion, can compensate for a lack of hip flexion or weakness in the hip flexors. The balance of the mechanics of the lower extremities, how they move in concert with each other, and how they compensate when instability is present is complex. Determining how and what part of the puzzle to treat starts with diagnosis.
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What Are The Best Treatment Options For L4
Of course, the best option is a non-surgical route. Acute lower back pain or chronic lower back pain treatment is always better with nonsurgical treatments as provided by our comprehensive methods. The best targeted, extensive measures for lumbar discs of acute or chronic nature are integrative chiropractic, physical therapy, and physiotherapy.
Chiropractic Specialty Center® offers combined treatments from clinical and experts teams of chiropractors and physiotherapists. Our physio-zone provides focused L4-L5 physiotherapy through manual or highly specialized machines. The care you will get from our chiro-zone will include spinal adjustments and flexion-distraction therapy. Therapy devices such as spinal decompression therapy, shockwave therapy, high-intensity laser therapy are among some of what you will get at our physio-zone.
Chiropractic treatment of the L4-L5 or L5-S1 consists of the realigning of malpositioning spinal segments, stabilizing joints, and depressurizations of spinal discs. The best and most effective treatment for L4-L5 slipped disc is through a non-rotatory method of chiropractic.
Rotatory chiropractic adjustments such as Gonstead or Diversified can further damage a slipped disc. As such, our chiropractors provide treatments through an Activator. The Activator is the best and most targeted chiropractic treatment for acute lower back pain or chronic lower back pain.
Many People Come In With A Tilted Pelvis However For Many Of These Patients That Is Not What Is Causing Their Pain
In this brief video Danielle R. Steilen-Matias, MMS, PA-C. Caring Medical Florida explains.
The summary transcript:
- What is interesting about the diagnosis of the tilted pelvis is that we see a lot of patients without that diagnosis and they in fact do have a tilted pelvis. So the question is, is the tilted pelvis the cause of their hip and back pain or not?
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Herniated Disc Hip Pain Problems
The hip joint is known to be the site of common arthritic process activity and may be the subject of medical scrutiny in many cases of chronic pain. Some degeneration of the hip is normal and even advanced cases of joint or socket deterioration are typical in older patients. Many of these instances are not painful or symptomatic in any way.
Statistics show that many patients with severe hip deterioration do not have any pain, while other patients with minor and expected degeneration have terrible intractable symptoms. Likewise, some lumbar herniated discs can cause hip pain in rare instances, although most herniations do not create any pain at all.
The sacroiliac joint is incredibly strong and perfectly designed, but it is also one of the possible subjects of investigation in hip pain syndromes.
Finally, piriformis syndrome might enact pain deep inside the hip region in some patients.
All these factors make achieving an accurate diagnostic conclusion especially difficult, even considering the low standards set by the back pain industry. Since so many of these possible causes of pain are universal or nearly so, it may be challenging to link the actual source process to every symptomatic expression.
How The Spinal Disc Gets Damaged
Intervertebral discs are composed of two essential parts, the annulus fibrosis on the outer rim and the nucleus pulposus in the inner portion. However, repetitive trauma, constant axial loading of the spine, injury, or weakness of the lower back muscles can cause the inner part to protrude through the outer ring. This can result in different types of slipped disc, such as disc bulge, disc herniation, prolapsed disc, or sequestrated disc, extruded disc, and fragmented disc.
A slipped disc can causes impingement on the exiting nerve root or nerve roots. An L4 disc herniation can impinge multiple traversing nerve roots in severe cases: L5 and even the S1 nerve root. In other words, one slip disc can pinch several nerve roots and even the spinal cord. Nerve root impingement and spinal cord compression are the main reasons why so many opt for L4-L5 surgery. However, before providing information on an L4-L5 operation or other forms of spine surgery or lumbar fusion, we like to go over some of the common symptoms associated with an L4-L5 nerve root impingement.
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What Is A Slipped Disc
A slipped disc is a general term used to describe what is actually a prolapsed disc in the spine. Of course, it doesnt actually slip out.
The intervertebral discs are roughly round pads of cartilage that sit between each spinal vertebra . Their job is to provide shock absorption and to allow the movements of the spine. The spine has a huge range of movement, bending forwards, backward, sideways, and rotating. Whilst lumbar disc herniations can occur at any point in the spine, they are most common in the lumbar .
Here there are 5 lumbar vertebrae, separated by 5 intervertebral discs. Each vertebra has a body and three bony processes which protrude out the back. These are the two transverse processes and the central spinous process. Between the body and these processes is a circular hole, which together with the vertebrae above and below, forms a column through which the spinal cord passes.
The intervertebral disc is made up of three parts. The vertebral endplates, the annulus fibrosus, and in the centre, the nucleus pulposus. It is this central part that may herniate, through a weakened, degenerated wall .
If the disk herniates far enough it can put pressure on the spinal column where it passes behind the discs and vertebral bodies. It is this pressure on the spinal cord which refers to pain and other symptoms into the legs.