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    L4 L5 Disc Herniation Explained

    by User_01 Sortino Marketing

    A herniated disc is one of the most common spinal conditions to affect adults. It occurs when one of the discs located in between the vertebrae becomes damaged. Typically, the jelly-like disc interior pushes through a crack in the tough disc interior and presses on nearby nerves.

    The lumbar spine is more flexible and bears more impact than any other area of the spine. So, disc herniation in the L4-L5 spinal level is particularly common. This article will explore L4-L5 disc herniation and how it can be effectively treated. 

    Table of Contents

    What Are the Symptoms of L4-L5 Disc Herniation?

    The symptoms of L4-L5 disc herniation are lower back pain, sciatica, back muscle spasms, numbness, weakness, and/or tingling that radiates into the lower extremities. 

    Lower Back Pain from L4-L5 Disc Herniation

    L4-L5 disc herniation typically causes lower back pain. This pain may be continuous or intermittent, occurring only when a movement or position flares up the affected nerves. 

    Pain from an L4-L5 disc herniation may feel sharp and severe, especially when you’re physically active. For some people, this pain improves when they’re seated or lying down. 

    Sciatica from L4-L5 Disc Herniation

    Sciatica occurs when the sciatic nerve is pinched or compressed. The sciatic nerve extends from the lower back through the buttocks and down the backs of the legs. So, sciatica symptoms affect the lower back and lower extremities. 

    L4-L5 disc herniation is a fairly common cause of sciatica. This is because a herniated disc at this level of the spine can press on the sciatic nerve, causing the following symptoms:

    • Pain (often described as a burning or electric shock-like sensation) that radiates from the lower back down one leg
    • Increased pain when sneezing, coughing, bending, or raising your legs while lying down
    • Numbness, usually in parts of the lower back and leg
    • Tingling (formally known as paresthesia) or a “pins and needles” sensation down the path of the sciatic nerve

    Symptoms of more severe forms of sciatica include:

    • Weakness in the muscles of the lower back or legs
    • Urinary or bowel incontinence (an inability to control bowel or bladder movements)
      • If you experience incontinence, it’s important to seek emergency medical care to prevent permanent nerve damage

    Back Muscle Spasms from L4-L5 Disc Herniation

    Some people experience painful lower back spasms with L4-L5 disc herniation. This occurs when the body tries to immobilize the muscles around the herniated disc as a natural protective measure. Unfortunately, this can trigger muscle spasms that are, in some cases, debilitating. 

    What Nerve Is Affected by L4-L5 Herniation?

    The L5 nerve root is usually affected by L4-L5 disc herniation. 

    L5 nerve roots leave the spine through the intervertebral foramen, the small, bony passageways on either side of the spinal canal. The L5 vertebra is the fifth (and lowest) lumbar spine vertebrae. 

    Is L4-L5 Herniated Disc Serious?

    L4-L5 herniated disc can become serious if it’s left untreated. 

    Untreated, an L4-L5 herniated disc can gradually worsen, causing increased lower back pain and neurological symptoms. This may lead to chronic back pain over time, which is associated with a range of health risks, including a decreased quality of life and an increased risk of mental health conditions like depression and anxiety. 

    If a herniated disc causes a pinched nerve, the nerve inflammation is likely to become more over time. This can eventually lead to lasting nerve damage, creating the risk of severe health conditions like:

    • Muscle atrophy 
    • Incontinence (loss of bowel or bladder control)
    • Paralysis in one or both legs

    With early intervention, herniated discs can often be successfully treated with non-surgical therapies. This is because the earlier the disc is treated, the more effectively your physician and PT can prevent further damage to the spinal tissues. 

    Early Signs of L4-L5 Herniated Disc

    Understanding the early signs of L4-L5 herniated disc can help you receive treatment for the condition in its initial stages before it becomes severe. Early signs of L4-L5 herniated disc include:

    • Lower back pain, especially while walking, sitting, or sleeping for prolonged periods
    • Lower back pain that shoots into one of the legs
    • Worsened pain when you cough or sneeze
    • Numbness and/or tingling on one side of the body

    How Is L4-L5 Herniated Disc Treated?

    L4-L5 herniated disc is treated with rest, anti-inflammatory medications, epidural steroid injections, physical therapy, and (in severe cases) surgery.

    • Rest

    A short period of rest can help lessen inflammation for an L4-L5 herniated disc. However, avoid prolonged periods of bed rest, which can worsen back pain and neurological symptoms. It’s important to remain active with a herniated disc to prevent stiffness, lost range of motion, and muscle atrophy. 

    • Anti-inflammatory medications

    Though they’re not a permanent solution for a herniated disc, anti-inflammatory medications can provide short-term relief for lower back pain and other symptoms. 

    • Epidural steroid injections

    Epidural steroid injections involve injecting steroid medication into the epidural space to significantly reduce inflammation and pain. Patients are advised to undergo no more than four injections per year to prevent tissue atrophy. 

    • Physical therapy

    A physical therapist can help alleviate herniated disc symptoms by providing exercises that strengthen the core and back muscles, as well as passive treatments (like massage and heat/cold therapy) for pain management. 

    • Surgery for a herniated disc

    L4-L5 disc herniation typically only requires surgery if conservative methods have failed to provide relief after several months and the patient’s symptoms are disruptive to their daily activities. A herniated disc may also require surgery if it triggers serious neurological symptoms and poses the risk of permanent nerve damage. 

    Regain your mobility with Premia Spine! Contact us now

    The typical surgical approach for a herniated disc is spinal decompression with fusion. Spinal decompression removes the tissue that’s impinging on the nerve, while fusion stabilizes the spine by permanently fusing the affected vertebrae. 

    Unfortunately, spinal fusion can limit the patient’s spinal motion while creating the risk of adjacent segment degeneration. Fusion alternatives like the revolutionary TOPS System can resolve symptoms of spinal stenosis from an L4-L5 herniated disc without compromising your mobility. 

    If you’re experiencing symptoms of L4-L5 disc herniation, contact a spinal specialist in your area for a formal diagnosis and treatment plan. 

    Strong Painkillers for Lower Back Pain

    by User_01 Sortino Marketing

    Most of us have a bottle of Advil or Tylenol in our medicine cabinets to ease minor aches and pains. But, when lower back pain becomes an everyday issue, what’s the next step? Medications are one of the primary treatments for lower back pain, and while they can help with daily discomfort, they come with various risks. 

    In this article, we’ll explore painkillers for lower back pain and how to best use them on your journey to pain relief. When they’re used safely and sparingly, painkillers can have a positive impact on your back pain treatment plan.  

    Table of Contents

    Why Is Back Pain So Hard to Treat?

    Back pain is so hard to treat because the spine is one of the most complex structures in the body. With a complicated system of nerves, tendons, ligaments, and vertebrae, back pain can indicate a vast range of injuries and conditions. This can make it challenging to pinpoint the exact cause of a patient’s back pain, let alone eliminate it. 

    Additionally, different types of back pain can present with very similar symptoms. For example, the symptoms of spinal disc damage can be virtually identical to those of spinal soft tissue damage. This makes it challenging for physicians to know which area of the spine to address. 

    It’s also worth noting that back pain can be hard to treat simply because it’s such a prevalent medical issue today. Hundreds of millions of people across the globe experience back pain, but the effectiveness of certain treatments can vary significantly from person to person. So, although back pain is extremely common, patients generally need an individualized treatment approach. 

    When Are Painkillers Used to Treat Back Pain?

    Painkillers are typically used to treat back pain along with physical therapy and lifestyle adjustments. This combination is often the first treatment approach used for back pain that doesn’t resolve on its own.  

    Before prescribing painkillers, most physicians will recommend over-the-counter (OTC) medications. OTC medications are available at drugstores without a prescription because they’re considered safe to take without monitoring from a physician. These drugs typically contain lower dosages and a lower risk of side effects when compared to prescription painkillers.

    What Is a Safe Painkiller for Back Pain?

    Over-the-counter NSAIDs are widely considered to be safe painkillers for back pain.

    NSAIDs stands for nonsteroidal anti-inflammatory drugs. These medications work by blocking an enzyme, cyclooxygenase, to reduce prostaglandin production. This, in turn, reduces inflammation and pain. 

    A variety of NSAIDs are available over the counter, including aspirin, ibuprofen, ketoprofen, and naproxen. Ibuprofen and naproxen are among the most widely recommended for treating back pain. Ibuprofen provides rapid pain relief, while naproxen offers long-term pain relief (all day or all night, depending on when you take the pill). 

    Risks and Side Effects of Over-the-Counter NSAIDs

    Though over-the-counter NSAIDs are considered a safe choice of painkiller for many back pain patients, it comes with a few risks and side effects. 

    Risks

    First off, patients should know that NSAIDs aren’t a long-term solution to lower back pain. These medications typically aren’t intended to be taken for more than 10 days, unless your physician advises you to do so. The longer you take NSAIDs, the more likely you are to experience side effects and health risks. 

    Additionally, NSAIDs increase the risk of severe stomach and bowel side effects, such as bleeding and ulcers. In patients who have a history of stomach ulcers or bleeding, are taking blood thinners, consume three (or more) alcoholic drinks per day, are taking multiple NSAIDs, or are older in age, this risk is even higher.

    Non-aspirin NSAIDs also increase patients’ risks of stroke or heart attack. For this reason, it’s advised to avoid non-aspirin NSAIDs before and after heart bypass surgery.     

    Side Effects

    Like virtually any medication, over-the-counter NSAIDs can lead to side effects. While some of these side effects are minor and can be easily tolerated, others can be disruptive to your daily routine. In some cases, side effects indicate an underlying health problem, which is why you should always discuss your side effects with your physician.  

    The most common side effects of NSAIDs include:

    • Bloating
    • Gas
    • Stomach pain and discomfort
    • Heartburn
    • Nausea
    • Constipation
    • Diarrhea
    • Dizziness or lightheadedness
    • Mild headache

    Is Paracetamol or Ibuprofen Better for Lower Back Pain?

    The choice of whether paracetamol or ibuprofen is better for lower back pain will depend on the patient’s symptoms, preferences, and medical history. These medications each offer unique benefits and drawbacks, so there’s no clear-cut answer to this question. 

    Paracetamol (also known as acetaminophen) is an analgesic and antipyretic drug that’s widely used to treat pain and fever. Unlike ibuprofen, paracetamol isn’t an anti-inflammatory medication, so it will only help with pain in the back – not swelling. 

    With that said paracetamol can be safely taken by pregnant women, unlike ibuprofen. It’s also gentler on the stomach. However, like ibuprofen, paracetamol can damage the liver if it’s taken improperly. 

    Ultimately, the decision of whether to take paracetamol or ibuprofen is a personal one. Some people find that one works better than the other for relieving their symptoms. Your physician can help determine which of these medications better suits your needs.    

    When Painkillers Don’t Work for Back Pain

    When painkillers don’t work for back pain, you’ll need to consider other treatment options. If you’re not already seeing a physical therapist for your back pain, ask your doctor for a referral. Physical therapy is considered one of the safest and most effective treatments for chronic lower back pain. 

    Aside from physical therapy, your doctor may recommend medications other than painkillers to manage your symptoms. One example is skeletal muscle relaxants, which can help with muscle spasms in the back.  

    Other lower back pain treatments include:

    • Cortisone injections
    • Chiropractic treatment
    • Acupuncture
    • Lifestyle changes
    • Surgery

    Why Do I Still Feel Pain After Taking Painkillers?

    You may still feel pain after taking painkillers because the medication doesn’t resolve your pain, but simply blocks the sensation of pain. So, after the effects of the painkillers wear off, you may still feel lower back pain. This is why painkillers are rarely recommended as a long-term treatment.

    What if My Back Pain Doesn’t Go Away With Ibuprofen?

    If your back pain doesn’t go away with ibuprofen, schedule an appointment with your physician. Rather than trying another over-the-counter painkiller, which could put your stomach and liver at risk, talking to your doctor will help get to the root of your back pain. A qualified physician can present alternative treatment options for your symptoms. 

    Regain your mobility with Premia Spine! Contact us now

    Sometimes, patients with back pain that doesn’t go away with ibuprofen will eventually need surgery. Thankfully, with innovations in medical technology, patients who need spinal surgery have more options than ever. The TOPS System, for example, eliminates the need for spinal fusion during decompression surgery, allowing patients to retain their mobility while overcoming lower back pain.   

    The Importance of Prompt Doctor Appointments for Lower Back Pain

    Prompt doctor appointments for lower back pain are important because it prevents further damage that could exacerbate your symptoms. A doctor can pinpoint lifestyle activities that may be worsening your condition and advise you to stop them. This will facilitate faster symptom relief. 

    Additionally, the sooner you start your treatment plan, the sooner you’ll experience relief from lower back pain. This will help you avoid major disruptions to your work, sleep, and personal life.