Introduction
The spinal column consists of the: The lumbar spine (short: lumbar spine) again consists of five vertebrae lying on top of each other, which are made of bone and form a horizontal underside. The intervertebral disc rests on this underside, which on the one hand reduces the friction of the movements that the spinal column has to perform and on the other hand absorbs the forces acting on the spinal column (shock absorbers of the body). – Cervical spine
- Thoracic spine and
- Lumbar spine.
The intervertebral discs are partially elastic and consist of two parts, the fibrous ring (annulus fibrosus) and a gelatinous core (nucleus pulposus). The intervertebral disc lies exactly between two vertebral bodies and is quite well fixed. If chronic, unphysiological strain is placed on the spinal column, the pressure on the intervertebral disc can become so great that the ring tears and the liquid core escapes.
In this case, the disc tissue (prolapse, med. also called prolapse) can either leak backwards (dorsal) or forwards (ventral). As a result, the intervertebral disc has lost its swelling pressure and the shock-absorbing properties let go.
The pressing out of the intervertebral disc between both vertebral bodies or the nucleus pulposus from the annulus fibrosus is called a herniated disc. As a result, the vertebral bodies are no longer at a safe distance from each other and come closer together. You can also find a lot of general information on our main page: Slipped discIf the slipped disc is very old or very pronounced (so-called mass herniation), it is possible that the vertebral bodies between the intervertebral disc are approaching each other to such an extent that the ends of the bones come into contact and rub against each other under particularly heavy load.
Usually it is the trailing edges or the leading edges that meet. The result is chronic back pain. The middle part of the vertebral body rarely comes into contact with its neighbouring vertebral body.
Basically, this only happens when the intervertebral disc has completely squeezed out of the narrowness between the vertebral bodies and the entire vertebral body lies on lower vertebral bodies. The bone contact between the individual vertebral bodies and the friction ultimately causes pain. Mostly during movements of the spine (e.g. when walking, bending or sitting), but in extreme cases also at rest.
Symptoms of a slipped disc of the lumbar spine
More detailed information can be found here: Pain in the back or is there a herniated disc even without pain? In many cases a herniated disc causes compression of the nerve roots leaving the spinal cord in the area of the lumbar spine. This causes severe back pain, which occurs very suddenly and “shoots into the back”, so to speak.
Triggers for such an attack of pain are, for example, activities in which one lifts something up or bends over in front. The affected person immediately adopts a relieving posture, as any further movement makes the pain worse. Even a sneeze or cough is enough to intensify the severe back pain.
To protect the spine, the muscles in the back and especially in the lumbar region harden reflexively. It feels stiff, which is also called muscle hard tension or muscle blockage. A herniated disc in the lumbar spine area is sometimes announced (often with initially milder symptoms).
Severe pain in the back that lasts longer than a week and may even radiate into the legs can be warning symptoms of an impending herniated disc and should definitely be examined by a doctor (herniated disc symptoms in the leg). The so-called sciatic nerve runs in the area of the lumbar spine. If this important nerve is constricted by the herniated disc, it often causes back pain that radiates into the buttocks or leg, which is generally referred to as “lumbago“.
In addition, there may be neurological deficits. These include, for example, tingling in the leg (“formication”), a furry feeling or numbness due to the herniated disc in the area from hip to foot. While tingling is more likely to indicate minor damage to the nerve, numbness is already a sign of complete loss of the sensory component of the affected nerve.
These symptoms must be taken seriously, as paralysis of the leg muscles may even occur. Another symptom of a slipped disc in the lumbar spine can be a changed gait pattern. Depending on whether the prolapse is located between the fourth and fifth lumbar vertebrae or between the fifth lumbar vertebra and the coccyx, the affected person can no longer stand on the tip of the foot or on the heel.
In the worst and very rare case, nerves can be constricted by a herniated disc to such an extent that a cross-sectional syndrome develops, in which, for example, neither pain nor touch is felt, and paralysis of the legs occurs. This condition is an acute emergency and must be treated surgically immediately. You can see the schematic image of an MRI of the lumbar spine.
- Blue: Intervertebral disc
- Red: Slipped disc (mass prolapse L4/5)
- Green: Spinal cord
- Yellow: Vertebral body with spinous process
A characteristic symptom of a herniated disc of the lumbar spine (lumbar spine) is pain. Depending on the exact location of the herniation, however, the pain can be of varying intensity and in different places. Typical is a suddenly beginning, very strong and “shooting” pain in the lower back.
If there is a herniated disc in the lumbar spine, pain often radiates into the leg and foot. Especially if the pain radiates into one or both legs, a herniated disc is likely to be the cause. Pain in a herniated disc in the lumbar spine is caused by compression of the nerve cord that runs through the spine.
Due to the compression of the nerves in the lower back, the pain is often felt in the legs or feet. The pain can be treated conservatively through exercises and the intake of pain-relieving medication. Surgery for a herniated disc in the lumbar spine also relieves the nerves and pain relief can be achieved. Which therapy is appropriate in each individual case should be discussed with the treating doctor after a detailed diagnosis.
