An L4-L5 disc bulge or slip-disc (slipped disc) pinches and leads to serious health issues, including impotence, reproduction issues, infertility, loss of bowel and bladder control, or paralysis in one or both legs.
Referred pain from L4-L5 usually stays within the lower back and is typically felt as a dull ache. The back may also feel stiff. Depending on the type and severity of the underlying cause, the L4-L5 motion segment may cause lumbar radicular pain of the L4 and/or L5 spinal nerves, also called sciatica.
L2, L3 and L4 spinal nerves provide sensation to the front part of your thigh and inner side of your lower leg. These nerves also control hip and knee muscle movements. L5 spinal nerve provides sensation to the outer side of your lower leg, the upper part of your foot and the space between your first and second toe.
Both prescription and over-the-counter (OTC) medications are used to help relieve pain from L4-L5. Typically, non-steroidal anti-inflammatory drugs (NSAIDs) are usually tried first. For more severe pain, opioids, tramadol, and/or corticosteroids may be used. Physical therapy.
Daily walks are an excellent way to exercise with a herniated disc, without putting additional strain on your spine and causing painful symptoms to flare up.
How Long to Recover from L4-L5 Fusion? It takes between six months and one year to fully recover from L4-L5 fusion. You may need four to six weeks to return to basic activities around the house after the procedure, and one to two months to return to work.
The best sleeping position for lower back pain is on your side with a partial bend in the knees. View Source . Keeping the knees bent helps balance the body and reduces pressure on the lumbar spine. Many people find it helpful to put a small pillow between their knees to make this position more comfortable.
Damage to L4 and L5, including spondylolisthesis, can lead to hip pain. This is because the misaligned vertebrae can press on nerves that extend through the hips. When these nerves become irritated, inflamed, or damaged, the patient may experience significant hip and leg pain.
Types of exercise to avoid
Weight lifting exercises that involve this movement can be, for example, bent over rows using dumbbells, deadlifts, squats or lunges. If you're not receiving any treatment for your back pain, it's important to stop doing these exercises until you've sought help.
Most commonly, it involves the L4 slipping over the L5 vertebra. It most frequently affects people age 50 and older. Symptoms may include pain in the low back, thighs and/or legs, muscle spasms, weakness and/or tight hamstring muscles.
L3 or L4 symptoms include pain in lower back and /or pain that radiates to the quadriceps in the front of the thigh. L5 symptoms include pain in lower back and/or pain in the outside of lower leg, down to toes, which may include numbness, weakness and tingling.
Injuries below this level (at the L3, L4, and L5 vertebrae) affect the hips and legs and may cause numbness extending to the feet (sciatica). It may also harm the tip of the spinal cord known as the cauda equina, which is a bundle of spinal nerves and nerve roots that innervate the lower lumbar spine to the sacrum.
As a clinical finding, gluteal pain is related to low lumbar disc hernia. The L4/5 level is the main level responsible for gluteal pain in lumbar disc hernia.
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. It's also one of the most obvious signs that the back pain you're feeling could be the result of a disc problem.
In the most severe cases, a herniated disk can compress nerves that control the bowel and bladder, causing urinary incontinence and loss of bowel control. Scientists do not fully understand why disks herniate.
With a herniated disc, the capsule cracks or breaks, and the nucleus squeezes out. This can irritate the spinal cord or nearby nerves, causing weakness and numbness in the arms or legs. A severely herniated disc can cause paralysis.
The L5 nerve travels from the lumbar spine down the outer hamstring muscle. Issues with this nerve can affect the knee in two ways – directly, as irritation of this nerve causes pain in the hamstring, and indirectly as your knees will compensate for the pain by changing the way they move, which may cause damage.
If you're experiencing back pain when sitting, your impulse may be to lie down and then try to slowly progress back to sitting, says Dr. Atlas. But this is the wrong approach. You should lie down to relieve the pain, but the goal should be not to return to sitting, but rather to regain your ability to stand and move.
It is proper to sit up straight without slouching. When you slump, you put extra pressure on the discs in the spine and can aggravate your herniated disc. Additionally, you want to ensure your knees are level with your hips. Your hips should be slightly above your knees if you sit at a desk.
Back pain red flags – Night Pain
Back pain that worsens at night or while you're sleeping might indicate something more severe like an infection or cancer. This is especially true if you also have other symptoms in addition to your back discomfort when you sleep or relax.
This syndrome is a medical emergency and typically causes severe pain, weakness, numbness, and/or tingling in the groin, genital region, and/or both legs. There may also be loss of bowel and/or bladder control.
“It was an extremely large herniation of the L4–L5 disc, the one most commonly injured,” explains Dr. Anderer. The success rate for disc surgery is about 90 percent, but even so, he considers it only if symptoms persist for more than 6 weeks.