The L4 and L5 are the lowest vertebrae, or spinal bones, in the lumbar spine. The lumbar vertebrae are crucial for the stability of the entire spine, working together with the muscles and ligaments to support your body weight.
Although the L4 and L5 vertebrae are larger than the vertebrae in other areas of the spine, they’re susceptible to injury. This is partially due to their weight-bearing responsibilities, along with the flexibility of the lumbar spine.
If you’re struggling with chronic lower back pain, you may have developed a condition of the L4 and L5 vertebrae. This article will explore the conditions that can affect this region of the spine, such as nerve compression and spondylolisthesis.
Poor posture, lifting heavy objects, repetitive motions, and even a traumatic injury (such as an auto accident injury) can cause L4 and L5 disc problems.
The spinal discs are cushion-like structures located in between the vertebrae. They absorb impact and protect your vertebrae from damage. So, an injury to the L4 and L5 spinal discs can lead to back pain and nerve compression.
One of the most common L4 and L5 disc problems is lumbar disc herniation. Disc herniation occurs when the interior of the disc, called the nucleus, pushes out through a crack in the disc exterior, or annulus.
A herniated L4 or L5 spinal disc usually develops when the disc is forced to undergo excessive pressure or strain. Additionally, the spinal discs become thinner and weaker with age, so older individuals are more likely to experience lumbar disc herniation.
According to research published by StatPearls, the prevalence of lumbar disc herniation is 1% to 3% of patients, with the greatest prevalence among 30 to 50-year-olds.
The sciatic nerve is affected by L4 and L5. It encompasses the L4 nerve, L5 nerve, and various sacral nerves.
As the largest nerve in the human body, the sciatic nerve extends from the lower back through the back of each leg. Conditions affecting the L4 and L5 vertebrae can irritate the sciatic nerve, leading to sciatica symptoms. The most common symptoms of sciatica include radiating lower back pain, numbness, and weakness.
Degeneration of L4 and L5 is the progressive loss of the natural function and structure of the lumbar vertebrae.
Usually, L4 and L5 degeneration results from the natural aging process. Aging causes reduced bone mass, reduced muscle mass, and thinning spinal discs, all of which can contribute to L4 and L5 degeneration.
L4-L5 spinal stenosis is a common condition that develops when the spinal canal narrows. It usually results from age-related degeneration of the lumbar spine, which can cause thickened spinal ligaments, herniated discs, and bone spurs from osteoarthritis. As the spinal canal narrows, the nerves that supply the affected area can become compressed.
L4-L5 nerve compression occurs when the nerves located at the L4-L5 vertebrae are constricted. This leads to inflammation and irritation, which may have a variety of symptoms.
The most prevalent symptoms of L4-L5 nerve compression include:
The symptoms of L4-L5 nerve damage are typically chronic lower back pain, numbness, tingling, and weakness that radiate to the legs and feet.
Spinal nerve damage can be severe. If you experience the symptoms listed above, make sure to schedule an appointment with your physician. But, keep an eye out for the following warning signs of severe lumbar nerve compression, which may require emergency care:
L4 and L5 damage can cause hip pain. This is due to the path of the sciatic nerve, which travels from the lower back through the hips.
When the nerves in the L4-L5 region of the spine become compressed and irritated, the pain can travel from the back to the hips. Symptoms that radiate from the lower back to the hips are common in cases of L4-L5 disc herniation.
Additionally, osteoarthritis and lumbar strains and sprains in the L4-L5 region can cause hip pain. Osteoarthritis is a type of arthritis caused by the gradual breakdown of cartilage in the joints. On the other hand, lumbar sprains and strains are a type of injury relating to the ligaments and muscles in the spine.
L4 L5 damage can cause pain in the buttocks. This is particularly true when L4-L5 conditions irritate the sciatic nerve.
According to a study published in BMC Musculoskeletal Disorders, the L4-L5 spinal level is the primary level responsible for pain in the buttocks with a lumbar herniated disc.
Spondylolisthesis at L4 and L5 is a spinal condition that develops when a vertebra slips out of position, falling onto the vertebra below it. It results from instability, often due to age-related changes to the spinal structures.
The L4-L5 spinal level is the second most common region of the spine to develop spondylolisthesis, topped only by the L5-S1 level. The lumbar spine is more likely to develop this condition than any other spinal region because it’s particularly flexible and undergoes more impact than the thoracic or lumbar spine.
Premia Spine TOPS System helps to effectively cure spinal stenosis of L4-L5.
If you’re struggling with any of the symptoms listed in this article, schedule an appointment with a spine specialist in your area to learn about the treatment options available to you.
Everyone has heard of sciatica, but few people know what it actually is – or isn’t. Sciatica is not a spinal condition or disease, but rather a set of symptoms associated with a variety of spinal conditions. It’s characterized by irritation or compression of the sciatic nerve. Unfortunately, sciatic episodes are painful and can diminish your quality of life.
Below, we’ll explore the topic of sciatica, what causes it, and how it’s treated. With the range of advanced sciatica remedies available today, you can attain relief from this form of nerve pain.
Sciatica pain moves along the sciatic nerve. As the longest nerve in the body, the sciatic nerve extends from the base of the spine through the hips and buttocks and down the legs to the tips of the feet. Considering the length of this nerve, sciatica pain can impact a large portion of the body.
If you’re struggling with undiagnosed nerve pain, you may wonder: What does sciatica feel like?
Symptoms of compression or irritation of the sciatic nerve can include:
In severe cases, sciatica can contribute to the development of cauda equina syndrome. This syndrome involves compression of the cauda equina nerves, which may lead to lost bowel and bladder function. This complication is rare and doesn’t affect most patients with sciatica.
Sciatica feels like a dull ache, subtle tingling, or burning sensation that moves from the lower back down the back of the legs.
Some patients with sciatica also report weakness and numbness in the leg and foot, or trouble moving the leg, foot, and/or toes. With severe sciatica, it can even be difficult to walk or stand up from a seated position.
With that said, the sensation of sciatica can differ from patient to patient. The feeling of this condition varies depending on the extent of the lumbar nerve compression, as well as the patient’s overall health.
For example, for some patients, sciatica causes a dull, constant ache. But, for others, the condition triggers sharp, burning pain that only strikes when they move into a certain position. Some patients even say that sciatica feels like an electric shock.
If you’re not sure if what you’re feeling is sciatica or not, visit a licensed physician for a diagnosis.
Several different spinal conditions can cause sciatica, including:
When one of the intervertebral discs in the spine becomes damaged, the soft disc interior may protrude from the damaged exterior. This is known as a herniated or ruptured disc.
A herniated disc in the lower back (lumbar spine) can press against the spinal nerves or leak fluid into the spinal canal. This may result in pressure on the sciatic nerve.
Traumatic injuries can compress or irritate the sciatic nerve roots, or the sciatic nerve itself. Car accidents and falls are the most common traumatic injuries that can trigger sciatica.
Spondylolisthesis occurs when one of the vertebrae in the spine slips out of position and rests on the vertebra beneath it, most commonly as a result of spinal degeneration in older patients. This condition can cause sciatica if it impinges on any part of the sciatic nerve.
Lumbar spinal stenosis – the narrowing of the spinal canal in the lower back – can compress or irritate the sciatic nerve. This condition can occur as a result of spinal degeneration, osteoarthritis, and bone spurs.
When a patient experiences sciatica symptoms that don’t resolve after a few weeks of conservative therapies, the physician will likely conduct imaging tests to verify that the nerve pain is resulting from sciatica.
Key causes of sciatica including a slipped disc and bone spurs will appear on many types of imaging tests, including a CT scan, MRI scan, and x-ray. Since an x-ray is much faster and more affordable than either a CT or MRI scan, it’s likely to be ordered first.
Sciatica can be categorized by the length of time that the symptoms persist, or by the legs (one or both) that are impacted.
When sciatica is categorized by the duration of the pain, it’s said to be either acute or chronic.
When sciatica is categorized by the legs that are affected, it’s said to be either alternating or bilateral.
Left untreated, sciatica pain may worsen, eventually leading to permanent nerve damage. This could lead to chronic pain in other areas of the body. With this in mind, it’s essential for patients to receive prompt treatment for sciatica pain, even if it appears to be a mild case.
For sciatica treatment, physicians usually begin with several months of conservative treatment before considering surgery.
Conservative, non-surgical treatments for sciatica typically include physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs), and low-impact exercises. Alternative methods such as massage therapy, acupuncture, chiropractic adjustments, and acupressure may also be employed.
In addition to the non-invasive treatments listed above, there are several ways that you can adjust your lifestyle to enhance your sciatica recovery, including:
In severe cases of sciatica involving unrelenting and/or debilitating symptoms, non-invasive treatments and lifestyle adjustments may fail to provide relief. In these cases, surgery for sciatica, such as a discectomy or foraminotomy, may be required.
Spinal decompression surgery relieves the pressure on the sciatic nerve and is often paired with spine fusion surgery to stabilize the spine. During fusion, bone graft material is placed in between the affected vertebrae, causing them to slowly fuse into a single bone.
Unfortunately, spinal fusion eliminates the independent mobility of the fused vertebrae. This limits patients’ mobility after the procedure while requiring an extensive recovery process.
Cases of acute sciatica typically resolve within four to six weeks with rest and at-home remedies. However, chronic sciatica can take much longer to fully resolve, depending on its cause.
If chronic sciatica doesn’t require surgery, it may go away within four to twelve weeks of rest and rehabilitation. For sciatica cases that do require surgery, the recovery process after the operation may last for four to six weeks. But, if spinal fusion is performed, the patient may not fully heal for six months to a year.
Given that spinal fusion greatly prolongs the sciatica recovery process, many patients seek out other options. Thankfully, there’s a spinal fusion alternative that’s proven to improve clinical outcomes, shorten the recovery process, and preserve the patient’s natural range of motion in the individual vertebrae: the TOPS Posterior Arthroplasty procedure.
TOPS is one of the exciting advances bringing new hope to patients with moderate to severe spinal conditions who aren’t responding to conservative treatments. Premia Spine, the creator of the TOPS System, is at the forefront of advanced surgical treatments for spinal disorders.
We encourage anyone with lower back pain and sciatica symptoms to investigate all their treatment options before undergoing spinal fusion. With the range of cutting-edge therapies available today, you can achieve sciatica relief without the limitations and drawbacks associated with fusion.
The facet joint is the vertebrae articular processes conjunction, covered with cartilage and closed by the synovial bag. These elements protect the intervertebral discs from excessive stretching (e.g., when the body bends and turns). Injuries and certain diseases can often cause changes in the intervertebral discs’ integrity, with a significant load on the facet joints. That’s how inflammation (spondyloarthritis) appears, due to which degeneration (spondyloarthritis) occurs.
The facet syndrome in question most often manifests itself in old age, but it can also disturb non-disabled adults. The recurrent nature of the disease often leads to disability or to the emergence of irreversible phenomena in the body that significantly reduce the patient’s quality of life.
Conservative medicine is used in the early stages, but later, when serious changes are observed, surgical intervention is indispensable. In any case, remission will be longer than with drug treatment in combination with pain relievers.
What is Facet Joint Replacement, is it worth doing such an operation, is there an alternative to spinal fusion, how the preparation takes place, and why the results may be disappointing – we’ll discuss it further.
The gradual loss of the spine’s structure and functionality is an aging characteristic and degenerative processes signal. Often such conditions can cause arthritis, tumors, infections.
Over time, the disease progresses; however, the generally accepted picture of symptoms doesn’t always manifest itself and can differ not only in nature but in severity. There is no consensus on diagnosing the disease in the medical literature: it’s rather associated with point manifestations during several years of observation. Note that spinal disc degeneration is often the cause of stenosis, osteoarthritis, scoliosis, and spondylolisthesis.
An illness is often observed in the cervical, and lumbar spine as these areas are most in motion. Its symptoms are continuous pain near the degenerating disc, leading to disability.
Varying load and any activity can provoke pain outbreaks. Often, the symptoms include the occurrence of discomfort in the spine associated with twisting and bending, lifting something heavy. It seems that the spine cannot withstand such loads! The resulting muscle tension is accompanied by spasms, which alternate with temporary relaxation.
The nature of pain is a degenerative disease that is different and can be modified to stitching, acute, hot. However, certain positions (such as sitting, reclining, or a pillow under your knees) can relieve unwellness.
It’s important to note that the degree of disc degeneration doesn’t depend on the severity of pain – people may not experience it at all while suffering from the disease. For this reason, the diagnosis occurs after a complete medical examination, collection of data on the patient’s complaints and medical history.
It’s a surgical procedure to replace the facet joint with stabilizing structures that connect the vertebrae. Historically, conservative treatment has included drug therapy to slow down joint degradation. In addition, blockade (injection of a local anesthetic) and rhizotomy (dissection of the nerve roots of the spinal canal) weren’t successful. The pain didn’t stop, and the risk of complications increased after the operation. Such procedures ended with fusion, which completely immobilized a particular spine area.
However, in the past few years, the development in methodology has shown the world new possibilities with the implantation of structures that give a wide range of movements, including bending and twisting. TOPS™ are implants that belong to the group of minimally invasive ones, respectively, and the healing process will be much faster. The replacement process removes a diseased or dysfunctional joint and its substitution with a prosthetic implant. Thus, the spine’s stability is increased, and the compression of the nerve roots is reduced. The procedure preserves the spine’s standard structure, which allows you to maintain full mobility and flexibility of the vertebral elements.
Data regarding the prognosis of surgical facet joint replacement depend on the preoperative preparation of the patient as well as his physical condition and age. For example, due to degenerative processes, the bones of older people are demineralized, which leads to their fragility. Therefore, the merger procedure may have more negative consequences than promising recovery and relief from pain. Conversely, Premia Spine’s TOPS™ structure can reduce the pressure on the screws. At the same time, they can withstand heavy loads that aren’t available to interspinous and interlaminar devices.
Regardless of the patient’s age, preparation for surgery should include constant mobility, proper nutrition, and massages. It is essential to exclude alcohol from the diet, stop smoking, and utilize drugs – the whole point is that they impair the blood supply, respectively, healing will take place more slowly, and the body’s susceptibility to infections will increase.
Note! In case of demineralization and insufficient secretion of osteoblasts, add mineral and vitamin complexes to the diet but first consult with your doctor.
TOPS™ system delivers superior patient recovery results. Thus, observation of patients for seven years showed that patients recovered successfully in 86% of operations. That’s a significant advantage of the implant compared to the fusion technique, where only 64% could stand on their feet.
Recovery after TOPS™ implantation progresses rather quickly – within 4-6 weeks, the patients can already return to their usual activities and sports. So compared to a fusion, it’ll take about six months, and for laminectomy, this period will be approximately 3-4 months.
While being at home, try to walk and exercise lightly every day. At first, it can be pretty tricky because several rules for sleep and training maintain muscle and spine tone during the early recovery period. You’ll also need to avoid lifting objects heavier than 8 pounds and not driving for 2-4 weeks. Immune nutrition, as well as taking painkillers, will also become a trigger for recovery. In general, you need to follow your doctor’s instructions and not self-medicate.
The answers to questions related to the spine’s health often baffle patients: they don’t understand the dangers of specific surgical interventions. They may neglect their safety in the pre- and postoperative periods. But it’s important to note that sooner or later degenerative processes will occur in every person’s body. Its symptoms can be treated in two ways: conservatively when the likelihood of remission isn’t so high, and operational to maintain a high quality of life for many years. E.g., the procedure of fusion or laminectomy often causes several complications and is ineffective for the patient. They have been replaced by a new generation of TOPS™ implants from Premia Spine, which preserve the entire range of movements and allow you to maintain the structure of the spine in minimally invasive surgery. It’s up to you to decide what to choose, but you’d always consider the forecasts for recovery.