Symptoms of a slipped disc in the lumbar spine

The lumbar spine experiences the greatest stress and is affected by 90% of all herniated discs. Often the disc between the fourth and fifth lumbar vertebrae or the disc between the fifth lumbar vertebra and the coccyx is affected. Those affected usually feel acute pain, which is sometimes so severe that the patient adopts a relieving and incorrect posture.

If a nerve root is irritated or compressed by the intervertebral disc, the pain radiates into the entire supply area of the nerve. As a result, the affected persons feel pain, numbness, tingling and other sensory disturbances all the way into the leg. These are particularly severe when the herniated disc affects the sciatic nerve.

Doctors then speak of ischialgia, which manifests itself as stabbing and electrifying pain from the buttocks via the back of the thigh to the foot. However, neurological disorders in the form of reduced strength or even paralysis of the legs and feet are also possible. The most common symptoms reported by patients are paralysis of the big toe lifter, foot lifter or knee extensor.

A slipped disc in the lumbar spine can also become a medical emergency if it causes the so-called cauda equina syndrome (horse tail syndrome).This means that the bundle of nerve roots that originate between the first lumbar spine joint and the sacrum are compressed by the herniated disc. The bruising leads to paralysis of the legs and lack of control over bowel movement and bladder emptying. If these symptoms occur, the herniated disc must be treated surgically within the next 72 hours.

Classical symptoms Often accompanying symptoms

Severe back pain
Radiation in buttock/thigh/or lower leg
Emotional disorders
Numbness/tingling
Force reduction

Paralysis of the big toe
Aggravated heel and forefoot
Tensions

However, a definite diagnosis can only be made using magnetic resonance imaging. The imaging procedure shows the intervertebral discs and allows an assessment of the spinal canal and nerve channels.

If the doctor suspects a herniated disc in the lumbar spine, he will perform the Lasègue test, among other things.
The patient lies on his back. Now the doctor carefully lifts the stretched leg so that the stretched leg is passively bent by 90° in the hip joint. As soon as the patient reports pain, the test is stopped.

If this is already the case with a flexion of about 40-60°, the Lasègue test is positive.
An important test is also the so-called Schober sign. The doctor stands behind the patient and places a skin mark on the spinous process of the 1st coccygeal vertebra. The doctor does the same 10 cm further up.
The patient is asked to bend forward as far as possible. Now the distance between the two points is measured. In healthy persons the distance is now 5 cm.

Then the patient is asked to stand up again and bend backwards. The distance in healthy persons is then 1-2 cm.
To check the mobility of the lower spine, hips and pelvis, the doctor can also measure the finger-to-floor distance. The patient stands shoulder-wide and should now bend forward with knees straightened.
The test should be stopped in case of pain. When maximum prevention is achieved, the doctor measures the distance between the floor and the middle finger. Normal findings are between 0-10 cm.

>If the herniated disc affects the lumbar spine, the following exercise is suitable: Further exercises are described in the article Exercises for a herniated disc in the lumbar spine.

The affected person lies down on a firm surface and puts his head down. The arms are placed to the side of the body, the legs are angled at 45° and the feet are set up. The affected person should now lift his buttocks from the surface as far as possible without pain.
In the best case, knees, pelvis and shoulders form a diagonal line. The first task is to hold this position for 10 seconds. Then the buttocks should be put down again.

If the patient can perform this exercise 5 times painlessly one after the other, the exercise is increased. This means that the patient now lifts the buttocks and then imagines a horizontal line at the position of his pelvis. On this imaginary line he should first move the pelvis to the left.

At the end point of his movement, the pelvis is held for 5 seconds. Then the pelvis is moved to the right and held for 5 seconds. The radius of movement does not have to be large.

If the patient succeeds in doing this 5 times on each side, a further increase is added. The patient lifts his buttocks again, but at the same time he should now lift one leg off the floor and stretch it out. Repeat 3 times on each side.