The L4-L5 Disc Bulge & Disc Herniation
Herniated and bulging lower back discs are most common in the L4-L5 and L5-S1 motion segments of the lumbar spine. The L4-L5 and L5-S1 are the last two motion segments in the spine. Collectively they responsible for 95% of bending and twisting motions involving the waist. Moreover, they are the most heavily burdened spinal segment, as they provide load-bearing functions that support the upper body. Due to the excessive stress placed on them, the L4-L5 and L5-S1 sections are common sites for spinal disc bulges, herniations, protrusions, prolapses, extrusion, and fragmentations. In this article, we will provide in-depth information on the L4-L5 and L5-S1 spinal segments to help you understand and recover from back pain faster.
The L4-L5 and l5-S1 spinal segments are a common cause of acute and chronic lower back pain. A slipped disc at the L4-L5 or L5-S1segment can impinge nerves that run down the legs, causing sciatic-like symptoms. The L5-S1 slip-disc is only second to the L4-L5 slip-disc disorder of the spine. The L4-L5 vertebrae or spinal disc is at the beltline. Before we get started as to the type of care given, our chiropractors would like to provide you with a brief description of the lumbar spine, so that you may have a better understanding of your condition.
The Function Of The Lumbar Spine
The lumbar spine also referred to as the lower back. It is a complex structure. There are a total of 5 vertebral bones in the lumbar spine. Each attached to an intervertebral: working closely with surrounding muscles, joints, and nerves to provide a dynamic range of movements and weight-bearing. The L4-L5 spinal disc is the second-lowest disc space, and the lowest segment is the L5-S1. The lower lumbosacral spine (L4 to S1) accounts for up to 95% of bending at the waist, and as such, they are the two most commonly injured spinal segments. Hence, it has a higher chance to undergo degenerative changes, and eventual disc herniation (slip-disc or slipped disc). A herniated disc is the leading cause of spinal canal stenosis and disability. Let our expert clinical non-surgical teams provide you with the exceptional care you need today.
How The Spinal Disc Gets Damaged?
Intervertebral discs are made up 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 (nucleus pulposus) 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 discs, and fragmented disc.
A slipped disc can causes impingement on the exiting nerve root or nerve roots. In severe cases, an L4 disc herniation can impinge multiple traversing nerve roots: L5 and even the S1 nerve root. In other words, one slip-disc can pinch several nerve roots and even spinal cord. Nerve root impingement and compression of the spinal cord are the main reasons why so many opt for L4-L5 surgery. However, before we provide 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.
Common Problems Involving The L4-L5 & L5-S1 Spinal Segments
To help you understand the cause of your low back pain, we have listed some of the most common disorders that involve the L4-L5, and L5-S1 spinal segments include:
- Muscular and ligamentous disorders
- Disorders of the spinal joint or facet joints
- Slipped disc (slip-disc)
- Spinal canal stenosis
- Foraminal stenosis
Muscle & Ligament Disorders At L4-L5 & L5-S1
Muscular and ligamentous issues involving the L-S1 segments are relatively common. They are present in almost all persons over the age of 40. However, having muscles or ligament issues alone will not cause significant pain. A Muscular or ligamentous source of back pain occurs when they are damaged. Injury, damage, or disorders of the ligamentum flavum is a common muscular and ligamentous issues that are a cause for concern. Ligamentum flavum is ligament with muscle characteristics. In other words, it has contractile abilities. Damage to ligamentum flavum leads to hypertrophy of ligamentum flavum that compress the nerve and spinal cord.
Spinal Joint Disorders
As mentioned, the L4-L5 and L5-S1 spinal segments are the most mobile and most burdened segments. Moreover, the weight-bearing activities during sitting put excessive burdens on the joints of these segments. Spinal joints or facet joints of the spine are lined with cartilage that contains synovial membranes. Stress during standing or sitting can lead to inflammatory changes where fluids accumulate within the joints. Excessive accumulation of fluids is the leading factor in joint degeneration (facet hypertrophy) and bone spurs (arthritis).
L4-L5 & L5-S1 Slip-Disc (Slipped-Disc)
Bulging, herniated, protruded, and prolapsed discs or slip-disc results when the spinal discs degenerate or wear out. The l4-L5 and the L5-Sq spinal discs are the two most common discs that undergo degenerative changes that lead to a bulging or herniated disc (slip-disc or slipped disc.
Spondylolisthesis At L4-L5 Or L5-S1
Spondylolisthesis is a congenital or at times, an acquired condition (degenerative spondylolisthesis) where one vertebra slips forward to the vertebrae below. Both degenerative and the acquired forms of spondylolisthesis are treatable without surgery. Spondylolisthesis is most common at L5-S1 and L4-L5 motion segments.
Spondylosis At L4-L5 & L5-S1:
Spondylosis is a relatively loose term describing a combination of the spinal disc and spinal joint disorders leading to nerve root irritation. The L4-L5 and L5-S1 are common sites of involvement in the low back. Patients with spondylosis complain of back pain, pain in the buttocks or legs.
Spinal Canal Stenosis
Spinal stenosis is a common cause of pain and disability. It results from premature wear and tear of spinal joints, muscles, ligaments, and spinal discs. Spinal canal stenosis results when the spinal canal shrinks in size. Any reduction of the spinal canal is a cause for concern. They concern us because it leads to weakness or paralysis of lower limbs, impotence, infertility, and loose of bowel and balder control. The lower lumbar (L4-L5 and L5-S1) are common sites of spinal canal stenosis.
Canal stenosis refers to shrinkage of the spinal canal (housing of the spinal cord). Foraminal stenosis is a reference to the narrowing of the opening between spinal segments. The opening (foramina) shrinks with spinal disc degeneration, joint degeneration (facet hypertrophy), ligamentous issues (ligamentum flavum hypertrophy), or bone spurs (arthritis). Foraminal stenosis at L4-L5 and L5-S1 are the leading cause of pain, numbness, and weakness in legs.
Symptoms Of 4th & 5th Lumbar Spinal Segment (L4-L5 & L5-S1)
Most patients may experience lower back pain that radiates to one side of the lower limb, or sometimes even both sides. Tingling, numbness (pins and needles), 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 referred to as “foot drop.”
In patients with foot drop, they 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 our collaborative chiropractic and physical therapy (physiotherapy).
What Are The Treatment Options For The 4th & 5th Segments Of The Low Back?
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 of the targeted, extensive measures for lumbar discs of acute or chronic nature is through integrative methods of chiropractic, physical therapy, and physiotherapy. 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 means of chiropractic treatment for acute lower back pain or chronic lower back pain.
Physical therapy involves manual procedures provided by physical therapists or physiotherapists. Manual methods such as joint mobilizations, soft tissue mobilizations, and strengthening programs are all classified and an integral part of physical therapy. Physiotherapy is the process of providing treatments through therapeutic devices specific to the spine. In our centers, our patients receive both physical therapy and physiotherapy. In addition to the physiotherapy and physical therapy treatments, we provide targeted chiropractic. But, the most distinguishing aspect of the care you get from us for an L4-L5 or L5-S1 slipped disc is treatments via breakthrough technology.
Our combined collective and collaborative nonsurgical treatments incorporate the best principals of lumbar disc treatments as provided through chiropractic, physical therapy (physiotherapy), and breakthrough devices (the RxDecom®) through the NSD Therapy® protocols. To summarize, NSD Therapy® is the gold standard in conservative treatments for acute or chronic lower back pain.
Can Pressure On The Nerves From A Slipped Disc Be Relieved Through Non-Surgical Treatments?
The L4-L5 and L5-S1 Lumbar discs often place 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 at either destroying the nerve through a Radiofrequency Ablation (RF Neurotomy) 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 or L5-S1 disc often return for additional surgeries.
Pressure on the nerves from a 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 (pinched nerves). Our non-surgical treatments for the L4-L5 or L5-S1 are not patches that spine surgeons offer. They are to fix the damaged joints, muscles, ligaments, and lumbar discs through our nonsurgical treatments.
So, the answer is a definite yes, our nonsurgical treatments for lumbar discs, joints, muscles, and ligaments can take the pressure of the nerves.
So, before opting for the recommended surgical intervention, call us. We can help.
Should You Opt For L4-L5 Or L5-S1 Spine Surgery?
L4-L5 or L5- S1 lumbar fusion or minimally invasive spine surgery is not as effective as some would have you believe. Spine surgery is just that: surgery! So, when they use terms such as the “minimally invasive spine surgery,” they do so the decrease your surgical fears by making it sound minimalistic. In other words, it is a play-on-words. Ye, it is not as intense as fusion surgery (lumbar fusion), bone graft, discectomy, foraminotomy, or laminectomy, but it is invasive. Even the most minimally invasive spine surgery carries risks and as such, better avoided, especially when effective conservative measures are available right here in town. It is just that simple!
We are even opposed to an l4-L5 spinal injection, such as steroidal injections on the L4-L5 or L5-S1. Steroidal injections or any other type of injection into the spine have complications. Besides, under the best scenarios, spinal injection only provides limited improvement at best. But, when it comes to spine surgery, the failure rate and risks of complications are even higher. Steroidal injections, facet joint injections, and spine surgery are invasive means that offer short-term gains. Our advice is to opt for nonsurgical treatments from our clinical experts.
The L4-L5 and L5-S1 spine surgery, like the steroidal injections, is temporary solutions, often requiring additional surgical interventions. So, they are not the fix; some would have you believe. If you have a lumbar spine condition for which the surgeons recommend surgery, call our center. Visit our clinical research-based teams for effective chiropractic and physiotherapy (physical therapy) options enhanced with spine specific technology. We have helped thousands of patients that the surgeons recommended lumbar surgical intervention. We are confident that our non-surgical treatments will provide you with better options when compared to L5-S1 or L4-L5 surgery.
The Best Non-Surgical Treatments For L4-L5 & L5-S1 Spinal Discs & Joints
If you are seeking the best conservative treatment options for an L4-L5 or L5-S1, visit our center and receive targeted nonsurgical treatments today. Our clinical teams have the most comprehensive treatment programs for mechanical spine conditions, including slipped disc, facet joints, and spinal nerve damage. Best of all, the care you get from us will help you avoid the necessary spine surgery or spinal injections. Spine surgeons dedicate their time and energy on invasive procedures, while we concentrate on non-surgical options. So, if you are looking for non-surgical fixes or repairs, we are the better options. Your surgeon is an expert in spine surgery, and may not be familiar with the latest trends in the non-surgical intervention. That could be the reason why they are so adamant about having you go through spine surgery.
As far as we are concerned, the L4-L5 surgery is an option best avoided. We have been treating many severe lower back cases, such as a slipped disc with a higher than 90% success rate. In short, almost every patient we have treated has improved. If you or any of your friends are experiencing similar symptoms, please do not hesitate to give us a call today! Centers have provided non-invasive treatment for the L4-L5 slipped disc through the efforts of the best research-based chiropractors in Malaysia, advanced clinical physiotherapists, and specific methods and technology-specific for a slipped disc. If you have an L4-L5 slipped disc, or an L5-S1 slipped disc, we are your best bet for a speedy recovery. Our methods and technology have helped thousands. Visit one of our centers for the best and most effective alternatives for an L4-L5 surgery through comprehensive non-surgical treatment.