L4-L5 Nerve Root Compression

The L4-L5 nerve root is found in the lumbar spine. It leaves the spine at the L4-L5 vertebrae and provides sensation to much of the lower extremities. Unfortunately, while it plays an essential role in many basic movements and functions, the L4-L5 nerve root is also subject to significant impact over the course of a lifetime. 

This impact can lead to L4-L5 nerve root compression symptoms. In this article, we’ll discuss these symptoms, how they affect spinal function, and available treatments for lumbar nerve compression. 

Table of Contents

What Are The Symptoms of L4-L5 Nerve Root Compression?

Common symptoms of L4-L5 nerve root compression include:

  • Burning, sharp, or radiating lower back pain
  • Stiffness in the lower back
  • Numbness, tingling, and weakness in the lower back and extremities
  • Poor coordination of the lower extremities

L4 L5 Nerve Root Controls

The L4 L5 nerve root controls the hips, knees, feet, and toes. 

Essential for the movements of the lower extremities, the L4-L5 nerve root is crucial for many day-to-day activities. However, the L4-L5 spinal segment bears impact from most twisting and bending motions of the torso. This makes it especially vulnerable to wear-and-tear-related damage. 

Degenerative Disc Disease at L4-L5

Degenerative disc disease at L4-L5 can trigger a variety of symptoms affecting the lower back and extremities, including:

  • Pain when you bend or twist the spine
  • Pain when seated
  • Pain that radiates to the lower extremities
  • Neurological symptoms like numbness, tingling, and a pins-and-needles sensation in the lower extremities
  • Weakness in the lower extremities that may cause foot drop (trouble lifting the front of the foot)

Pain from degenerative disc disease at the L4-L5 spinal segment may go away when you lie down or switch positions. This occurs because certain positions can temporarily alleviate the pressure on the damaged disc. The pain may also improve with low-impact movements, like walking. 

Some people experience bouts of severe pain from lumbar degenerative disc disease. These flare-ups can last for days, weeks, or even months. 

How Do You Treat L4 L5 Nerve Root Impingement?

You can treat L4 L5 nerve root impingement with lifestyle modifications, physical therapy, anti-inflammatory medications, spinal injections, and surgery. 

Lifestyle Modifications for L4 L5 Nerve Root Impingement

Commonly recommended lifestyle modifications for lumbar nerve root impingement include: 

  • Activity modifications prevent activities that place more impact on the damaged nerve, like excessive spinal twisting. 
  • Reaching a healthy weight through sustainable weight loss methods alleviates excessive impact on the lumbar spine. 
  • Improving your posture helps keep your spine in proper alignment. 
  • An anti-inflammatory diet including nutrient-dense vegetables, fruits, lean proteins, whole grains, and healthy fats can support the body’s healing process. 
  • Avoiding prolonged bed rest prevents muscle atrophy and helps preserve your range of motion.  

Physical Therapy for L4 L5 Nerve Root Compression

Physical therapy for L4 L5 nerve root compression involves stretches and strengthening exercises. These targeted exercises generally focus on core and back muscle strength, which can reduce the impact on the spinal nerves. 

Your PT may also offer alternative therapies like massage, acupuncture, and electromagnetic stimulation to complement your treatment plan. These methods may reduce inflammation and stimulate the body’s natural healing process. 

Medications for L4 L5 Nerve Root Compression

Certain medications may provide short-term relief from L4-L5 nerve root compression. Examples include non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants.

Talk to your physician about which medications may work for you. Keep in mind that medications typically aren’t a long-term solution for nerve root compression and may cause side effects. 

Spinal Injections for L4 L5 Nerve Root Impingement

Spinal injections for L4 L5 nerve root impingement can include nerve blocks and epidural steroid injections. 

  • A nerve block is an injection administered near a specific nerve (or collection of nerves) for symptom relief. The injection typically contains anti-inflammatory medication and a local anesthetic. Bringing down inflammation in the damaged nerve can improve its ability to heal while lessening pain. 
  • An epidural steroid injection is an injection of steroid medication into the epidural space (the space between the dura mater and the spinal bones). The dura san is the tissue that protects the spinal nerve roots. Steroid medication temporarily reduces inflammation in the area. 

Surgery for L4 L5 Nerve Root Compression

Surgery for L4-L5 nerve root compression usually involves a form of lumbar decompression. Decompression surgery alleviates pressure on the spinal nerve roots by removing tissue in the affected area. 

Lumbar discectomy is often performed for L4 L5 nerve root compression from degenerative disc disease. In this procedure, the surgeon removes some or all of the spinal disc pressing on the nerve root. 

Laminectomy is another common form of spinal decompression surgery for compressed nerve roots. It involves removing part of the lamina, the piece of bone that covers the back of the spinal cord. Removing some of the lamina at the affected spinal level creates more space around the irritated nerve.

How Do You Fix L4 L5 Compression?

L4 L5 compression can be fixed with conservative treatment, like physical therapy, medication, and lifestyle changes in mild to moderate cases. You may need surgery to fix severe L4 L5 compression. 

Early intervention is the best way to ensure that you can fix L4-L5 compression without surgery. Visit your physician for an evaluation if you experience lower back pain that persists longer than two weeks, or if you have other symptoms of spinal nerve compression.  

Regain your mobility with Premia Spine!

David danced at his son’s wedding

Bonnie explains why TOPS surgery was the right decision for her

Wade is back to hiking

Scott speaks about going to surgery

Regain your mobility with Premia Spine! Contact us now

TOPS System for L4 L5 Segment

The TOPS System is a non-fusion implant that can treat the L4-L5 segment. With a superiority-to-fusion claim from the FDA, the TOPS System treats lumbar spinal stenosis and spondylolisthesis without the need for fusion.
If you’re suffering from moderate to severe L4-L5 spinal stenosis with or without spondylolisthesis, the TOPS System may alleviate your symptoms without compromising your range of motion. To learn more about this FDA-approved implant and if it could work for you, contact a spinal specialist in your area today.