The most common levels for a herniated disc are L4-5 and L5-S1. The onset of symptoms is characterized by a sharp, burning, stabbing pain radiating down the posterior or lateral aspect of the leg, to below the knee. Pain is generally superficial and localized, and is often associated with numbness or tingling.
Lumbar spine (lower back): Sciatica/Radiculopathy frequently results from a herniated disc in the lower back. Pressure on one or several nerves that contribute to the sciatic nerve can cause pain, burning, tingling and numbness that radiates from the buttock into the leg and sometimes into the foot.
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.
They are highly prevalent in this area and can lead to symptoms such as leg pain, numbness in legs, feet or toes, acute lower back pain, and other symptoms. Approximately 90% of bulging discs occur at L4-L5 and L5-S1, causing pain in the L5 or S1 nerve that radiates down the sciatic nerve.
In paracentral or lateral herniation, the transversing nerve root is usually affected; a lateral herniation at L4-L5 would cause L5 radiculopathy. Extreme lateral (far lateral) herniations typically result in the exiting nerve root being affected; extreme lateral herniation at L4-L5 would cause L4 radiculopathy.
The best way to tell if you have a herniated disk is to see your doctor. They'll likely do a physical exam to find the source of your pain. This usually is the only test you'll need to confirm a diagnosis. Your doctor will check your back for sore or painful spots.
L5 radiculopathy is usually associated with numbness down the side of the leg and into the top of the foot. S1 radiculopathy typically results in numbness down the back of the leg into the outside or bottom of the foot. Weakness is another symptom of nerve root compression.
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.
Pain that radiates below the knee is a red flag for a herniated disc or nerve root compression below the L3 nerve root. This is based on the dermatomal distribution of the nerve roots and the fact that the pain associated with inflammation radiates along the entire pathway of the nerve.
In fact, the hallmark of a herniated disc is radicular pain—pain that runs down into the arm or leg. You may also feel numbness or weakness in these areas.
“Pain may be the first indicator that you have a bulging disc at L4/5. You may have pain in your lower back, near the top of your pelvis. This pain may increase when you press on the muscle next to your spine where the nerve is compressed, or it might suddenly increase with coughing or sneezing,” said Livestrong.
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.
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.
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.
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.
Injuries to spinal cord in the five lumbar vertebra (L-1 through L-5) generally results in some loss of function in the hips and legs, but do not affect the functionality of the upper body.
Herniated discs are often misdiagnosed as piriformis syndrome, a muscular disorder in the buttocks, mild sciatica, degenerative disc disease, and osteoarthritis.
Seek emergency medical attention if you have: Worsening symptoms. Pain, numbness or weakness can increase to the point that they hamper your daily activities. Bladder or bowel dysfunction.
Bulging and Herniated Discs Explained
"A bulging disc is like letting air out of a car tire. The disc sags and looks like it is bulging outward. With a herniated disc, the outer covering of the disc has a hole or tear. This causes the nucleus pulposus (jelly-like center of the disc) to leak into the spinal canal."
L5 nerve impingement (at the L4-L5 level) from a herniated disc can cause symptoms such as weakness in extending the big toe and potentially in the ankle, which leads to difficulty with the heel-to-toe motion in walking. This weakness is called foot drop.
Symptoms of an L4-L5 lumbar disc herniation
When a patient has a lumbar hernia at these levels, one of the common symptoms will be sciatica, the pain that radiates along the path of the sciatic nerve that passes through the lower back, through the hips and buttocks, and leads into one of the legs.