What Are the Symptoms of L4-L5 Nerve Damage?

Lumbar nerve damage is a common cause of chronic lower back pain. Left untreated, it can present the risk of permanent complications. 

In this article, we’ll explore the symptoms of L4-L5 nerve damage and when to seek professional care for lower back pain. 

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How Do I Know If I Have Nerve Damage?

You may have nerve damage if you experience numbness, tingling, burning, muscle weakness, or pain that radiates to the extremities. These are telltale symptoms of nerve damage (also known as neuropathic pain).

Other signs of nerve damage include:

  • Frequently dropping objects
  • Sensitivity to touch
  • Difficulty balancing or walking
  • A prickling or “pins and needles” sensation in the feet
  • Sharp or jabbing pain in the back or lower extremities

In more severe cases, nerve damage can cause:

  • Loss of bladder or bowel control: If the nerves that manage bladder or bowel emptying become damaged, you may experience incontinence. 
  • Sexual dysfunction: Neurological disorders like peripheral neuropathy can trigger sexual dysfunction by compromising sensation in the genitals. 
  • Compromised coordination and mobility: Individuals with severe nerve damage may struggle to walk, balance, hold objects, and complete other daily tasks. 
  • Paralysis: Left untreated, nerve damage poses the risk of temporary or permanent paralysis. This is the inability to make voluntary motions. 

How Do I Know If I Have L4-L5 Nerve Damage?

The L4-L5 spinal segment is the lowest segment of the lumbar spine. It innervates the front portion of the thigh, inner portions of the lower leg, outer sides of the lower leg, upper foot, and area between the first and second toes. 

So, with L4-L5 nerve damage, you may experience symptoms in the lower back, legs, and feet. 

How Can I Test Myself for L4 L5 Nerve Damage?

You can test yourself for L4-L5 nerve damage at home with a few simple positions. While these tests may indicate if your pain is related to nerve damage, only a qualified physician can accurately diagnose your condition. 

Start by sitting in a chair with your hands clasped behind your back and rounding your spine in a slumped position. Then, one by one, complete the following movements:

  • Bend your neck down while lifting one leg up, with your toes flexed toward the ceiling, noting if this causes pain. Then, gently lift your head, noting if this lessens your pain.
    • If the initial position causes pain, you may be experiencing nerve pain. 
    • If lifting your head lessens your pain, you’re likely experiencing nerve pain, as lifting your head moves the spinal nerves without impacting your leg muscles. 
  • In the slumped position, extend your legs in front of you. Start with each leg individually, then extend both simultaneously. If you experience pain that radiates from the lower back to the leg(s), you may have spinal nerve irritation.
  • In the slumped position, raise your right knee to your chest, noting pain or difficulty completing the movement. Repeat with the left knee. Pain or an inability to raise the knee may indicate spinal nerve irritation.   

What Is the Most Common Nerve Damage?

The most common cause of nerve damage is degenerative spinal changes. This includes spinal degeneration related to osteoarthritis, spinal stenosis, herniated discs, and spondylolisthesis.

  • Osteoarthritis is also known as wear-and-tear arthritis. It can break down the cartilage within the spine’s facet joints, creating friction, inflammation, and, in some cases, bone spurs. All of these degenerative changes can irritate the spinal nerves, leading to nerve damage symptoms. 
  • Spinal stenosis develops when the spinal canal narrows, often due to degenerative spinal changes like thickened ligaments, bone spurs, and degenerated discs. As the canal narrows, the open space around the spinal nerves decreases, and spinal structures may eventually press on the nerve tissue. This leads to symptoms like radiating pain, numbness, tingling, and weakness. 
  • Herniated discs are spinal discs that become damaged, typically due to repeated impact over time. This impact can tear the disc exterior, causing the jelly-like interior to push outward into the spinal canal. The damaged disc may then press on nearby spinal nerves. 
  • Spondylolisthesis develops when a vertebra slips down over the vertebra beneath it. This can result from degenerative spinal changes or a congenital spinal defect. This misaligned vertebra can irritate nearby spinal nerves, eventually causing nerve damage. 

Do Damaged Nerves Ever Heal?

Damaged nerves can heal eventually with treatment, in many cases. 

Oftentimes, a nerve can heal on its own with conservative therapies like rest, activity modifications, and physical therapy. In other cases, surgery is required to remove pressure from the nerve, allowing it to heal. 

However, in severe cases, nerve damage progresses to an irreversible point. While the nerve may be past the point of regrowth, a surgeon may be able to remove the damaged nerve tissue and reconnect the remaining nerve endings. 

To prevent permanent nerve damage, visit your doctor as soon as you experience signs of a nerve problem. Early intervention prevents nerve damage progression and reduces the likelihood that you’ll need surgery. 

L4 L5 Nerve Damage Treatment

L4-L5 nerve damage treatment options include lifestyle modifications, pain medications, physical therapy, radiofrequency ablation, and spinal decompression surgery. 

Lifestyle Modifications for L4-L5 Nerve Damage

Commonly recommended lifestyle changes for L4-L5 nerve damage include:

  • Remaining active with low-impact exercise, like aerobics, walking, and swimming
  • Refraining from movements or activities that trigger symptoms, like weightlifting and excessive spinal extensions
  • Reaching and maintaining a healthy weight to reduce day-to-day impact on the spine
  • Eating a nutrient-rich diet
  • Limiting prolonged periods of sitting
  • Improving your posture to keep the spine in optimal alignment

Medications for L4-L5 Nerve Damage

Over-the-counter medications, like non-steroidal anti-inflammatory drugs (NSAIDs), can provide temporary relief from L4-L5 nerve damage. If OTC medications don’t offer relief, your physician may suggest prescription formulations. 

Physical Therapy for L4-L5 Nerve Damage

Physical therapy for L4-L5 nerve damage involves strengthening the core and back muscles that support the spine. Your PT will provide a targeted exercise routine that suits your condition and stage of recovery. 

Some physical therapists offer complementary therapies, including electromagnetic stimulation, acupuncture, heat/cold therapy, and massage. 

Radiofrequency Ablation for L4-L5 Nerve Damage

Radiofrequency ablation, or RFA, uses radiofrequency energy to alter nerve tissue. It heats and destroys the targeted nerve, which keeps it from sending pain signals to the brain. This provides relief from L4-L5 nerve pain. 

RFA can effectively relieve chronic L4-L5 nerve pain for some people. It can also reduce your reliance on pain medications and may delay or prevent surgery. The procedure presents a low risk of complications, but may not work for everyone. 

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Surgery for L4-L5 Nerve Damage

Surgery for L4-L5 nerve damage typically involves spinal decompression. Surgical spinal decompression removes the tissue impinging on the spinal nerve. This restores blood flow to the nerve and allows it to heal. 

Surgical spinal decompression procedures include:

  • Laminectomy involves removing some or all of the lamina, the piece of bone that covers the spinal canal. It’s commonly used for spinal stenosis, herniated disc, and spondylolisthesis. 
  • Discectomy involves removing some or all of a damaged spinal disc to alleviate nerve pain from a herniated disc. 
  • Foraminotomy involves enlarging the foramen, the opening through which nerve roots leave the spinal canal. It can create more space around a compressed spinal nerve. 

Spinal decompression procedures are often accompanied by spinal fusion to restabilize the spine. However, innovations like the TOPS System can stabilize the spine without permanently compromising spinal stability. Contact a spinal specialist in your area today to learn more.