What is an L5 syndrome?
The L5 syndrome describes a pain syndrome that is caused by nerve irritation of the fifth lumbar vertebra. Within the spinal column runs the spinal cord, from which nerves emerge along the entire length of the spinal column to supply the individual areas of the body with sensitive and motorized energy. If nerves become trapped, pain and other problems can result.
This is therefore a root compression syndrome. L5 is a very frequently affected segment, which is located in the lower part of the lumbar spine at the transition to the coccyx and supplies the area from the rear thigh to the big toe. The compression of the nerve root can lead to pain, paralysis and/or sensory disturbances in the area supplied by the affected nerves. Depending on the cause of nerve irritation, many different accompanying symptoms, abnormalities and therapies can result from L5 syndrome.
Treatment of L5 syndrome
Treatment can vary greatly and must be made dependent on the cause of the L5 syndrome. The treatment of a herniated disc is too often surgical, although physiotherapeutic and conservative therapies are equally successful. Although surgery can sometimes achieve success much faster, in the long run the results are equal to those of conservative treatment, which has fewer risks.
In some cases, however, surgery may become necessary during the course of treatment. In the case of a herniated disc, this is the case with acute damage to the nerve roots. In the case of tumors or spinal canal stenosis, surgery is often the only possible causal treatment.
This also applies to sudden incontinence caused by the damage. Supporting all causes of the L5 syndrome, sufficient pain therapy should be carried out to enable movement and prevent relieving postures. This can be done with light painkillers from the NSAID group, for example ibuprofen or diclofenac.
For severe pain, opioids such as morphine can also be used. Pain-relieving medication is prescribed to prevent pain-related relieving posture. Depending on the intensity of the pain, drugs such as diclofenac, ibuprofen or indomethacin may be effective.
For particularly severe pain, pain-relieving opioid drugs are prescribed. These include fentanyl, buprenorphine, hydromorphone, oxycodone and tilidine. Some painkillers have an increased risk of developing a dependency.
Medication intake should be discussed with the treating physician or family doctor and adjusted if necessary. Targeted exercises of the back muscles can help to alleviate the symptoms of a herniated disc with L5 syndrome. One should start with low stress and gradually increase.
Exercises such as arm support with arm and leg lifting, planks, abdominal exercises such as sit-ups and male dogs can have a positive effect on posture. The periradicular therapy is a pain treatment. As the Latin name suggests, it is a small operation directly at the nerve root, whereby certain drugs can be applied directly to the trigger of the pain using CT control.
Usually a mixture of pain-relieving and anti-inflammatory drugs is injected to allow the tissue to heal. This often includes an anesthetic and cortisone, which additionally stops an inflammatory reaction. PRT can be an important treatment for severe and especially chronic pain, but should not be a permanent solution.
The pain is hereby suppressed for a few days before a new treatment becomes necessary. This can give the body the time to resolve the herniated disc itself. For long-term complaints, however, physiotherapeutic measures should be in the foreground.
Surgery is necessary in case of L5 syndrome, when the spinal canal is constricted, for example by degenerative bone protrusions. Herniated discs are rarely operated on. However, if the affected person suffers from a herniated disc with pronounced motor deficits, i.e. paralysis of the leg, surgery is usually performed immediately.
All articles in this series:
