A shooting, stabbing pain that travels from your back or buttocks, into the thighs, legs and foot is called sciatica or radiculopathy. It can be associated with weakness or numbness in your foot and leg.
The most frequent cause of the condition is a ruptured disk (also called a herniated disc or bulging disc) in the lower spine. In this report, we will examine disk problems of the lower back, also known as lumbar disc disease.
Anatomy of the Lumbar Spine
The lumbar spine is made up of the last five vertebrae of the backbone. The vertebrae are the bones of your spine. Their role is to give protection and support to the body and particularly the spinal cord.
The facet joints enable the vertebrae to be connected. They provide connections between each vertebra.
An intervertebral disc sits between each vertebra. The annulus fibrosus is the outer ring and will be the disc’s strongest aspect. It is responsible for connecting the vertebrae. The nucleus pulposus is the soft part of the disc. This material is accountable for its shock absorption properties and it has about the consistency of crab meat.
The nerve roots of the spine carry signals involving the lower extremities and the brain that enable us to move our legs (motor function) and perceive sensations such as touch, temperature, and pain (sensory function).
To better understand how each other is affected by the parts of the spine, we must first focus on a spinal segment. A spinal segment is made up of the intervertebral disk between 2 vertebra, and both nerve roots that depart from that spinal degree, one from each side.
The discs have cartilaginous endplates at bottom and the top and are surrounded by the annulus. During degeneration or injury, the fibrous tissue (annulus fibrosus) constraining the soft disc material (nucleus pulposus) can tear. This may result in bulging (protrusion) of this disk or even extrusion of disc material into the spinal canal or neural foramen. This condition becomes what is best known as a prolapsed disc, ruptured disc or herniated disc.
Lumbar Herniated Discs
Among one of the most common problems of the lower spinal column are herniated discs. In this state, a tear in an annulus fibrosus enables the nucleus pulposus to squeeze into the spinal cord canal.
When a nerve root is compressed by the disk material, there can be pain, numbness, and fatigue in the areas supplied by the nerve (often down the rear of a leg). It is not strange for the back itself to painless. Thus, a herniated lumbar disc characteristically produces leg and buttock pain but not back pain. This pain is termed sciatica or radiculopathy.
Numbness will often lead after the function of the nerve root is impaired due to compression. The subject of numbness is determined by the root, and might be in the ankle, the heel, the big toe, the outer leg, or a combination of these. Impairment of motor function of this origin will lead to weakness, and that depends on the special root.
|Disc Level||Root Comp.||Weakness||Reflex Involvement||Sensory Loss||Pain Distribution|
|L3-L4||L4||quadriceps, tibialis anterior||knee jerk||medial knee and shin||anterior thigh|
|L4-L5||L5||extension of big toe||no significant||big toe||back of thigh, lateral calf|
|L5-S1||S1||gastrocnemius (ankle plantar flexion)||Achilles||lateral foot and heel||back of thigh and calf|
In herniated disks, the L5-S1 intervertebral disc is involved 45 to 50 percent of the time, L3-L4 about 5 percent, and L4-L5 about 40 to 45 percent. Disc herniation at the opposite lumbar levels is uncommon.
The nerve root that has been compacted is the one exiting the level below the disk in the majority of cases.
But if the herniation is lateral (on the side of the intervertebral disk, as opposed to a central disk herniation in the center of the disk), then the root compacted will be the one departing over. This is known as a far lateral disc herniation and occurs in about 3 percent to 10 percent of instances.
It’s also important to be aware that while the indications outlined in Table 1 (see above) are helpful in the identification and decision making regarding kind of treatment, not all of the symptoms and signs associated with a root might be present in a person, and multiple origin signs may even be present.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Sciatica
Lower back pain is one of the most commonly reported symptoms among the general population. Sciatica, is well-known group of symptoms, including lower back pain, numbness and tingling sensations, which often describe the source of an individual’s lumbar spine issues. Sciatica can be due to a variety of injuries and/or conditions, such as spinal misalignment, or subluxation, disc herniation and even spinal degeneration.
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Dr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
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