Is any pain in the lower back related to the lumbar disc? On the other hand, do the symptoms of the lumbar disc appear only in the position of the spine? In this case, how can we diagnose complex and sometimes unrelated pains with the origin of the lumbar disc? Surely, these and similar questions arise for many of you who are facing pain in the spine for any reason. But it is necessary to know that every pain in the lower back is not a symptom of a lumbar disc rupture, or that some seemingly unrelated symptoms have roots in a herniated disc. In this article, from Mahan Physiotherapy Group, we intend to carefully examine the symptoms of lumbar disc rupture and distinguish the pains and problems caused by it from other pains.
What is meant by lumbar disc?
Lumbar disc is a type of cartilaginous bed among the vertebrae of the spine, which consists of two parts, the outer cartilaginous area and the inner soft tissue area. These very simple cartilaginous plates are a kind of shock absorbers between the vertebrae of the spine, which in addition to preventing the bones from rubbing against each other, cause flexibility of the back and range of motion. What we know as a lumbar disc is actually any type of injury such as protrusion or tearing of this cartilaginous area among the vertebrae of the spine.
Improper lifting of heavy objects, sudden movements under high tension, smoking, aging, etc. are all causes of lumbar disc protrusion or rupture. Anyway, the rupture of the disc on the one hand causes the bone area of the spine to wear, and on the other hand, it causes fluid inside the disc and nerve irritation, especially the sciatic nerve. In this case, he may even witness pains or symptoms completely different from the lower back, such as leg pain and tingling, intestinal problems, urinary incontinence, muscle weakness, etc. That’s why examining lumbar disc symptoms is a completely specialized matter and should be done under the supervision of an orthopedist and with the discretion of a specialist physiotherapist. But what are these symptoms?
Take a look at the symptoms of lumbar disc rupture
Pain is the most important symptom of lumbar disc herniation. A pain that may appear in different areas of the lower body and is sometimes dull and confusing. At the same time, it is even possible to face moving pains that seem to move in different parts of the lower body from the hips to the ankles. Also, the type of pain is different according to the severity of the cartilage tissue damage of the lumbar disc. For example, weak injuries lead to short, tingling pains. But the pains caused by a serious lumbar disc injury are heavy and hard and will even cause movement problems. Any kind of nerve stimulation due to disc rupture leads to chronic and severe pain or numbness and weakness. But the type of these pains or their positions are different. Such as:
- Numbness and tingling in the legs
- Any feeling of muscle weakness in one or both legs
- The feeling of severe muscle cramps in the legs, especially the areas behind the knees, which even leads to movement disorders.
- Pains in the lower back due to pressure and stimulation of the sciatic nerve.
- In severe cases, pressure on the spinal nerve and even paralysis from the waist down
- Chronic back pain that does not get better after 4 to 8 weeks.
- Disorders of the digestive system, especially the intestines, or urinary incontinence
In the rest of this article, we will discuss each of these symptoms. But before examining these symptoms, it is necessary to mention a little about the relationship between lumbar disc and sciatica; Because a large part of lumbar disc symptoms have nerve roots under the influence of sciatica stimulation.
What is the relationship between lumbar disc and sciatic nerve?
Sciatica is the largest nerve in the body, which is branched in two parallel strands from the lower parts of the spinal cord in the spine, and each of them is sent to one of the legs. This nerve is responsible for the nerve stimulation and distribution of nerve fibers of all lower body organs, from bowel control, urinary tract to legs and pelvic areas.
When a disc rupture occurs, as a result of this rupture, the mucous fluid inside the disc spills out and irritates the nerve around the spine. Inflammation of the sciatic nerve is one of the serious complications of lumbar disc rupture, which will cause various nerve pains in different parts of the body.
In this way, when the legs tingle or the muscles become weak and even lose their power of movement, it may actually be due to the inflammation of the sciatic nerve under the influence of the rupture of the lumbar disc. Of course, not all pains or any kind of weakness and tingling in the legs are symptoms of lumbar disc. It is possible to diagnose this issue through photography and detailed medical examinations. At the same time, it is necessary to go through the treatment process to relieve the sciatic nerve inflammation under the supervision of a knowledgeable physiotherapist and with a careful examination of the dimensions of the lumbar disc destruction. We describe these lumbar disc symptoms in more detail.
Pain in the legs or arms
Where the disc herniation occurred in the spine, the location of nerve irritation and inflammation is different, and finally, the affected organs are diverse. For example, if the disc herniation occurred in the lower parts of the spine, the symptoms of the lumbar disc can be seen in the form of chronic pain in the buttocks, thighs, legs, and even soles and toes. But if it happened in the vertebrae above the spine and near the neck, you should expect pain in the shoulder and arms. If due to sudden movements, such as sneezing or coughing, the pain in the legs or arms intensifies, in a form that feels like tingling, the possibility that it originates from a ruptured lumbar disc is high.
Muscle weakness in the back, hips and legs
Inflammation of the sciatic nerve may even affect muscle control. In this case, the person suffering from disc herniation feels mild or severe weakness in his muscles. This person may not feel pain; But he is painfully unable to perform normal body movements such as walking, balancing, leg strength, waist movement, etc.
Numbness or tingling sensation
Nerve damage or inflammation due to disc rupture is sometimes so severe that the affected person experiences local numbness in some organs, such as fingers and toes, or a tingling sensation in the lower part of the body. In general, mild tingling is one of the symptoms of lumbar disc. But in general, this complication is caused by a not so severe damage to the disc, which may become progressive. In general, take seriously any kind of tingling sensation that does not go away after a while and get checked by a specialist doctor and do professional physiotherapy treatments.
back ache
The presence of severe pain in the lower back is the most common symptom of lumbar disc herniation. In some cases, disc herniation is seen only in cartilage tissue protrusion. In this case, there is no rupture and the nerve around the spine is not stimulated. Therefore, we do not face nerve pain in areas other than the back. But the back itself has been accompanied by severe pain due to the destruction of the disc. Chronic pains that do not go away easily. At the same time, with appropriate physical therapy and sufficient rest, there is a possibility that these pains will be resolved and the symptoms of lumbar disc protrusion will be improved.
Inability to control urine or gastrointestinal problems
In rare cases, inflammation of the sciatic nerve interferes with the function of internal organs. Digestive problems and lack of urinary control are such symptoms. Of course, it is necessary to check the origin of the symptoms carefully.
Lumbar disc symptoms by spine vertebrae
There is a close relationship between lumbar disc rupture and sciatic nerve inflammation. But this nerve is very large and its branches continue from the upper vertebrae of the spine to the lower vertebrae and the coccyx. The symptoms of lumbar disc and neuroinflammation are different according to the position of disc herniation, which we will examine as follows:
- Disc herniation between L2 and L3 vertebrae
L2 and L3 are the second and third vertebrae of the spine, respectively, and the rupture of the disc between them affects the third lumbar nerve root. People who have ruptured discs in these vertebrae usually complain of severe, shooting pain in the front of the thigh. Knee pain is another symptom of disc rupture between L2 and L3 vertebrae.
- Disc herniation between L3 and L4 vertebrae
This disc is also located between the third and fourth vertebrae of the spine. The roots of the fourth lumbar nerve branch off from the space between these vertebrae, and disc rupture affects the fourth lumbar nerve. People who suffer from a ruptured disc between the L3 and L4 vertebrae have reported pain in the front of the thigh or knee. These pains are relatively stronger and more rooted than the third nerve root. As far as their range continues to the front parts of the leg.
Disc herniation between L4 and L5 vertebrae
Disc damage between the L4 and L5 vertebrae is one of the most common cases of lumbar disc that affects the fifth nerve root in the lumbar region. This nerve inflammation spreads to chronic pain and muscle numbness in the back and outer sides of the thighs and finally the back of the legs. In severe cases of neuroinflammation, it is even possible that the affected person suffers from tingling pain or numbness in the big toe.
Disc herniation between L5 and S1 vertebrae
This disc is located between the last lumbar vertebra and the first pelvic vertebra in the spine. This disc is actually the last intervertebral disc in the spine that may face acute neurological problems. The rupture of this disc can put pressure on the first nerve roots of the pelvic area and you can feel the effect of this inflammation in the form of chronic pains in the back of the thighs, back and outer part of the legs. In some cases, the root of this pain is in the little toe. Pay attention that although the extension of the pain of the first pelvic nerve from the disc between the L5 and S1 vertebrae is somewhat the same as the pain of the fifth lumbar nerve between the L4 and L5 vertebrae; But they differ in the way the pain spreads. The pain of the fifth lumbar nerve stimulates the outer and back of the thigh and leg, but the first pelvic nerve will move in all areas of the back of the thigh and leg due to the rupture of the disc between the L5 and S1 vertebrae.
What is the process of formation and occurrence of back pain and symptoms?
Lumbar disc is not a complication that appears all of a sudden and its pains get better all at once. The process of finding lumbar disc pain is more or less the same according to the place of rupture and its severity. Therefore, if you have pains in the back area or are struggling with nervous weakness, it is necessary to check the progress of the disease and the location of the pains. This process in the symptoms of lumbar disc rupture is as follows:
- The initial symptoms of lumbar disc are very mild. To the extent that people may not notice it for a long time. For example, it is possible that a person has back pain due to sudden movements or excessive pressure on the vertebrae while lifting heavy objects, which will get better after a few days of rest. But in fact, maybe this is the beginning of mild and invisible lumbar disc symptoms.
- Repeated impacts and pressures weaken the disc. Aging and even smoking are effective in accelerating the weakening of discs. Finally, various factors affect the dryness and inflexibility of the disc.
- As long as the disc is in an unfavorable condition, a small impact or an unusual movement of the body is enough for the disc to bulge. Sudden but transient pains are common at this stage. However, we have not yet entered the main stage of the lumbar disc.
- The bulging discs are very sensitive and can rupture due to other stimuli such as impact or injury. The ruptured disc secretions will not ooze out. Therefore, at this stage, the nerve symptoms of the lumbar disc do not appear; But we face other symptoms such as burning in the back.
- If the ruptured disc treatment process is not done on time, it will completely rupture due to exposure to another stimulus. At this stage, the jelly core protrudes inside the disc and nerve stimulation begins in the spinal or sciatica area. Symptoms such as chronic back pain, leg pain, inner thigh pain, arm pain, numbness or tingling in the fingers, etc. are all among the symptoms of advanced lumbar disc. At this stage, special treatments are required.
- The most difficult condition is when the core of the disc completely protrudes and is placed in the extruded disc state. At this stage, we have no choice but surgery.
How do we know that we have a mild back disc?
Lumbar disc treatment in the early stages is almost simple as long as the rupture has not yet occurred and the gelatinous substance of the internal membrane has not leaked out. Mild lumbar discs can be treated easily by going through the appropriate physiotherapy process. But it is important to recognize the symptoms of a mild lumbar disc and apply the correct physiotherapy methods in time to complete the treatment process. In any case, take these symptoms seriously:
- Pain in the lower back that may continue to the sides or the upper parts of the legs.
- Any kind of feeling of swelling and inflammation in the lower back that may have occurred due to disc inflammation.
- Any kind of feeling of slowness in body movements that are difficult to perform. mild lumbar disc, although it is not in a critical condition; But due to low flexibility, it makes the movements of the back difficult and slow.
- Muscle weakness can be a serious symptom of a mild lumbar disc. Herniated discs are usually prone to mild nerve irritation.
- If you experience pain in your back while performing daily tasks, to the extent that lifting light objects is difficult and exhausting for you.
How do we know that we are in a critical condition of the lumbar disc?
Critical conditions appear after the rupture of the disc and the release of the jelly substance inside it, eventually, the bones wear and the inflammation of the spinal nerve or sciatic nerve appears. This stage is absolutely critical, and you should act as soon as possible for improvement and basic treatment methods such as physiotherapy and in some cases surgery. Otherwise, you may even face paralysis of the lower body. The symptoms of critical lumbar disc are as follows:
- Feeling of severe muscle weakness in the legs, sides, back muscles in such a way that it is very difficult for you to do routine tasks.
- A significant decrease in the sensitivity of the organs in such a way that you do not notice any sensation in some areas of the body, such as the waist or ankles.
- If you have no control over the function of the bladder and intestines.
- If you are facing pain and rapidly developing symptoms.
Methods of treatment and relief of lumbar disc pain
Most of the lumbar disc symptoms are caused by nerve irritations, which cause chronic pain and movement restrictions, especially in the lower back and lower limbs. For treatment, it is necessary to improve the lumbar disc symptoms and relieve the pain in the first step. There are several treatment methods for this purpose.
Immobilizing the spine to prevent pain is an effective solution in cases of advanced lumbar disc herniation. Anti-inflammatory drugs to reduce nerve stimulation are other ways to reduce pain. Muscle relaxants are other methods. But the most effective step to reduce lumbar disc symptoms and even the beginning of its treatment is the use of specialized physiotherapy techniques.
Local heating or cooling, specialized massages, electrical stimulations, etc. are among the passive methods in physiotherapy that reduce pain symptoms and prepare the patient for active movements such as stretching and rehabilitation movements. The choice of physiotherapy technique and how to perform massages and movements should be done under the supervision of a physiotherapist and according to the type of lumbar disc. For any type of lumbar disc physiotherapy, you can use the specialized services of the Mahan physiotherapy team.
