Sciatica occurs when one or more nerve roots from L4 to S3 are irritated or compressed due to conditions such as a herniated disc, stenosis, or degeneration.
The most common cause of sciatica is a disc herniation in the lumbar spine. The most common levels in the spine where disc herniations occur, is between the 4th and 5th lumbar vertebrae (L4-5) or between the 5th vertebra and the sacrum (L5-S1).
A pinched L5 nerve root usually results in radiating pain in the foot. This pain can come in the form of numbness, tingling, weakness and shooting and is commonly felt in the big toe, inside of the foot, top of the foot and ankle. Radiculopathy of the L5 nerve may also cause loss of coordination in the foot and toes.
2. 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.
Symptoms and Signs Stemming from L3-L4. The L3-L4 motion segment may cause muscle pain, discogenic pain, radicular (nerve root) pain, and/or radiculopathy (neurologic deficit) that typically affects the lower back and/or the legs.
There may also be loss of bowel and/or bladder control. The condition must be treated on an urgent basis to preserve leg function and restore bowel and/or bladder function. Nonsurgical treatments are often tried first for symptoms that stem from L5-S1. In rare cases, surgery may be considered.
The L4-L5 motion segment may cause referred pain from the joints and/or muscles or radicular symptoms that travel through nerves. 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.
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.
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.
When you're stressed, irritation and inflammation tend to worsen, and since sciatica involves inflammation around the sciatic nerve, it makes sense your symptoms could worsen when you're feeling anxious. Plus, being stressed often causes an increase in muscle tension, which can exacerbate irritation around the nerve.
So what factors trigger sciatica and make it worse? Anything that puts more pressure on the sciatic nerve can cause sciatica symptoms to flare up. This includes sitting too much, wearing uncomfortable footwear or too tight pants, sleeping in a wrong position, and being inactive.
We think that large, extruded L5-S1 disc herniations may affect the superior hypogastric plexus or pre-sacral nerve which is situated anterior to the last lumbar vertebra, the middle sacral artery, the lumbosacral intervertebral disc.
Physical therapy.
Exercise and physical therapy can be modified to specifically target pain stemming from L4-L5 and the lower back. These therapies help stabilize the back and keep the muscles and joints well-conditioned—providing long-term relief.
Yes, it can and most of them do, with proper treatment. The fact is that with treatment, most herniated discs will heal within a few weeks. In extreme cases, it may take a few months. Even surgery cannot put the jelly-like compound of the disc back inside of it.
Conditions affecting the L5-S1 spinal motion segment are usually treated with nonsurgical methods. If the lower back and/or leg symptoms worsen or do not improve despite these treatments, or in case of certain medical emergencies, such as tumors or cauda equina syndrome, surgery may be recommended.
In those patients with types II and III (noncontained) discography and abnormal magnetic resonance imaging scans, a 75% success rate was seen. There was an overall 80% fusion rate for all patients who underwent anterior lumbar fusion at L5-S1.
L5-S1 Disc Bulge Symptoms
This process is absolutely normal and is a part of aging and happens with everyone. L5-S1 bulging discs are most common as they take the stress and weight of the body. The symptoms experienced in the lower back can be terribly painful.
The L4 and L5 nerves (along with other sacral nerves) contribute to the formation of the large sciatic nerve that runs down from the rear pelvis into the back of the leg and terminates in the foot.
Learn more about L3L4 Symptoms. Pain: You may feel sharp shooting pain on the inside of the lower leg usually from below the knee to the top of the big toe. This refers to the disc that is situated between Lumbar bone 4 and 5.
Most importantly, an L4-L5 disc bulge can lead to prolonged pain and other, more serious conditions like spondylolisthesis if you delay treatment. Spondylolisthesis is a condition in which a vertebra shifts or slips, and can cause significant pain that may require surgery to fix.