Believe it or not, bulging disc L4/L5 isn’t very common. There are other conditions of the same type that affect even more people. However, bulging disc L4/L5 can cause a lot of pain, issues with your lifestyle, and become massive trouble. Luckily, there are treatments for this condition. Before we move to the procedures that can help you, it is important to understand the problem completely.
Human spine: Overview
In order to understand bulging disc L4/L5 completely, you need to know something about the human spine. It is an impressive and extremely complex part of our body. Our spine is made from the vertebra. Every single person has 24 of them. Some will even say that a vertebra looks funny or strange. In essence, these are bones, stacked from the bottom section of your back and reach the upper neck.
The cervical vertebrae are located in your neck and there are 7 of them. They are the top vertebrae of the spine. These are known as C1, C2, and all the way up to C7. C7 is located at the base of a neck. Next, we have the thoracic vertebra. These are known as T1-T12 and they make a middle section of the spine.
The lowest part of the spine is made from lumbar vertebrae known as L1-L5. The lowest one is L5. Bulging disc L4/L5 affects this section of the spine, so it was crucial to explain how the human spine looks and how it is made.
Sacrum is located below the vertebrae L5. It is another weird looking bone that connects the pelvis. In other words, it is located between the left and right sides of pelvis. Sacrum is obviously one bone that has sets of nerves passing through. There are 4 of them, known S1, S2, S3, and S4.
A spinal disc is located between the vertebrae. It is made from cartilage (very strong) and it is filled with fluid. These are called according to the vertebrae above and below the disc. For instance, if a disc is located between L4 and L5 vertebrae, we will define it as disc L4/L5. The discs are extremely important. They help us move, walk, and stand. Without them, we wouldn’t be able to move!
Bulging disc L4/L5: What is it actually?
Discs in our spine suffer wear and tear. This is perfectly normal and it happens to every single person. Obviously, there is no way to prevent this unless you don’t move at all. Sadly, in some situations, a disc may become more damaged or torn on one side than on others. This is called a disc bulge.
When a disc bulges, the outer layer of it, made from strong fibers will get damaged. They will split. This allows the inner section to bulge close to the nerve roots. Sadly, there is an even worse scenario in which the outer layer will get so damaged that it will cause disc herniation. It is an even more severe and more problematic condition!
By now, you should know that the nerves are close to the vertebrae and discs. Once the disc bulge occurs, it may come in contact with the aforementioned nerves. It is when a person will get the first symptoms. If the budged disc touches sciatic nerve, sciatica symptoms occur. These symptoms are extremely common in the case of bulging disc l4/l5 due to the fact the 2 vertebrae are close to the sciatic nerve. Once this happens, you will get sciatica.
Causes for bulging disc L4/L5
Bulging disc l4/l5 isn’t extremely common but there is still plenty of data revealing why this happens to a person. Don’t forget that these are potential reasons. You may have one, two, or multiple causes for your particular condition. Anyway, the most common symptoms are explained below.
1. Sitting too long and smoking
Sitting for the entire day, every single day, and smoking may sound like an ideal life for gamers and web fanatics. It is also an ideal recipe for getting bulging disc l4/l5. This happens due to the fact when we sit, L4 and L5 vertebrae are under a lot of stress, higher stress than we walk. Add the fact a person can sit 10 hours a day and you can imagine why the disc will get damaged over time.
2. Heavy lifting/constant strain
A certain injury to the targeted location or constantly lifting heavy items can cause bulging disc l4/l5 as well. Although this doesn’t happen often and injuries that affect this region only are rare, it can be a cause for your condition. Heavy lifting is especially dangerous if you don’t use proper techniques and you try to lift items that are above your capabilities.
3. Weak back muscles
Weak muscles at the lower back can contribute and speed up the condition. Basically, these will promote the decay of the disc and cause various other complications. Back pain in general is common for people with weak muscles of this kind. We must add that weak muscles cannot keep the spine straight and in the healthiest position. You do need to exercise (using specific exercises) that will target these muscles and make them stronger. As such, the risk from bulging disc l4/l5 or other conditions is eliminated.
4. Bad posture
Don’t think that bad posture while sitting is the only cause. You can have bad posture while sleeping, walking, or just standing. One solution you can use is to use posture correctors. They work well and they are very helpful to almost all users. Recently, we were able to see many companies where employees spend the entire day in front of a computer wearing posture correctors. Even if you spend a lot of time at home in front of your computer, a posture corrector will be more than just recommended.
Obesity adds weight to your spine, obviously. You do know that the spine is the central part of a body that will carry most of that weight? Now you can deduce that obesity will cause bulging disc l4/l5 or at least speed up the process. If you want to stay protected, losing weight is the best or better said mandatory thing to do. Change your diet and add physical activity to the lifestyle you are having. The results will be impressive, although you will need some time to get them.
6. Certain sports
Sports such as MMA or similar can cause or contribute to bulging disc l4/l5 development. This is basically the same reason as an injury. Plenty of strain on the disc and the vertebra can damage the disc and cause you the condition we are discussing right now. In general, this can happen with most action sports that involve contact and possible injuries.
7. Improper shoes
One of the rare causes is related to improper shoes. This affects runners only, so keep that in mind. If you don’t wear proper, orthopedic shoes but you do run every single day for miles, you are at a higher risk of developing bulging disc l4/l5. Explanation is complicated but improper shoes cannot give you the posture your body needs under physical stress. The disc can get damaged which will promote the condition.
8. Certain activities
All activities that will place a massive level of strain and stress on your spine can cause bulging disc l4/l5. This doesn’t mean you should avoid all activities, but rather minimize the ones that are dangerous and affect your vertebrae and discs too much. Make sure to pay close attention to the lower back muscles. If you are planning to perform this type of activity with weak muscles in the back, you are at an even higher risk of developing bulging disc l4/l5.
How bulging Disc L4/L5 is diagnosed?
Here we have one important thing to discuss. How bulging disc l4/l5 is diagnosed? Ideally, your doctor will ask you certain questions that will provide the insight. Those questions are related to the pain location, other issues you are having, injuries or activities you had and etc. Below we will discuss the symptoms of bulging disc l4/l5. In a nutshell, a doctor will ask you questions that should reveal at least one or multiple symptoms. This is the first part of diagnosis.
The second part of diagnosing bulging disc l4/l5 is to use X-ray. It is the first technique most doctors will use and it can show the bulging disc. However, X-ray cannot be effective in 100% cases so often, a doctor will use MRI and/or CT to get better images of the targeted area. The affected disc is clearly visible and usually easy to diagnose.
If you believe that you suffer from bulging disc l4/l5, make sure to get at least X-ray. Getting a proper diagnosis without scanning is almost impossible unless you have all the symptoms mentioned below. There are many, other conditions that have same or similar symptoms so you do need an X-ray, MRI or CT just to be certain.
Most people avoid going to a doctor until they get more complicated and more severe symptoms. This is a mistake. Sooner you diagnose bulging disc l4/l5, sooner you can start recovery and a treatment that will help you get your life back. Life with bulging disc l4/l5 is difficult and for some impossible.
Symptoms of bulging disc l4/l5
Bulging disc l4/l5 is an issue that looks scary and extremely problematic for most people who notice the symptoms for the first time. Even worse is the fact there are plenty of symptoms that may occur. We have divided these into common and less common symptoms. You may have multiple ones or just one at the moment.
Common symptoms of bulging disc l4/l5
1. Pain in the back
Bulging disc L4/L5 usually causes back pain. This is a sharp pain in the lower back and it can feel like a muscle spasm. It can also be tender to touch. In a nutshell, this is the most common symptom that occurs in most patients but not in all! It may sound strange. After all, the bulging disc should cause back pain. However, not all patients have it. You can feel a strong, minor, or aching pain but always in the lower part of the back.
2. Leg pain
The condition can cause leg pain. It will happen on the side of the leg and can reach your foot. Keep in mind that this is the main difference between bulging disc L4/L5 and L5/S1. The nerves that go close to the L4 vertebra control the outside of the leg. Usually, this happens in the spiral pattern and in some cases, it can hurt in the top of the foot. It always begins in the back and moves across the entire leg. In some way, this is a similar symptom to sciatica which will be covered below.
Bulging disc L4/L5 usually causes a pain sensation that is present in the back of the leg. It is called sciatica due to the fact it occurs when a bulging disc touches the sciatic nerve. It is obviously common symptom that can be a nightmare. Some patients have reported that the pain is so intense that it feels like being stabbed with a knife! Others explain it as being stabbed by someone with a hot poker.
Suggested article: Sciatica – Symptoms, Causes, Treatment (Everything You Need To Know)
4. Leg weakness
Leg weakness can happen in one or both legs. More often it will occur in one leg only. It is the most severe symptom here and it means you must visit a doctor right now. This happens when the bulging disc compresses the nerve and prevents it from operating properly. There is no need to add that you are going to need treatment immediately. If you notice weakness in both legs, the situation is even worse.
5. Numbness or pins and needles
A patient can feel numbness or sensations in the foot. This happens because the bulging disc will prevent the nerves from operating properly. As such, some of the signals will pass completely while others won’t. In a nutshell, the sensation you are going to feel won’t be normal. Patients describe this symptom as funny, but it is far from that. For some, this issue can be more annoying and more problematic then the pain itself.
Less common symptoms of bulging disc l4/l5
1. Spasms and shaking of the legs
Most people believe that this is the same as sciatica. As a matter of fact, it is a completely different symptom that is rare but does happen. It means that your muscles in the leg will go into spasm. You should try muscle relaxants in order to get relief.
2. Bowel and bladder issues
It is another, rare, and very serious symptom. It means that the bulging disc will affect the nerves that control your bowel and bladder. You won’t be able to feel when the bladder or bowels are full, you may not be able to go to the toilet or you may end up with ‘’accidents’’. Regardless of which sub-symptom you have, visiting a doctor is a must. We recommend you to visit the first time you feel any of these issues.
3. Private area numbness
It means that the lower nerves are seriously compressed and as such you need treatment. If the issue is left untreated, the condition may stay permanent which is a huge problem for all people.
Bulging disc L4/L5 treatments
Bulging disc treatments can be divided into several categories. A good thing is that they start with basic and non-invasive procedures and are usually successful. If you are lucky, you won’t need a complicated treatment but you will feel better. Anyway, here are all known treatments for bulging disc l4/l5 issues, you can find today.
1. Rest and lifestyle change
The simplest and very effective treatment. You will need to rest at least 2 days first. After that, start with simple physical activity, don’t rush, and take your time. Regular walks are the best type of activity to use at this time. Lifestyle changes are mandatory as well. You need to consume more anti-inflammatory foods. The best examples are tomatoes, nuts, spinach, kale, and also fruits such as oranges, blueberries, cherries and etc. try to find foods with anti-inflammatory properties that suit you the most. At the same time, avoid food that is known to cause inflammation.
Other changes you will want to make is to drink plenty of water. Consume 3-4 liters per day. This is essential for the condition due to the fact dehydration will have a negative effect and can worsen your symptoms.
Sleep is essential for recovery. Your bulging disc will recover when you sleep. Sadly, sciatica can make sleep almost impossible. Try to find a position in which you can fall asleep and stay asleep for at least 8-10 hours. During the day, take a 30-minute nap. These are known to provide impressive benefits.
Suggested article: The Best Sleeping Positions For Sciatica – And The Worst One
Not all exercises are recommended. You need to aim for a special treatment that is adapted for bulging disc l4/l5. The goal of the exercises is to make your muscles and joints in the spine stronger and therefore help recovery and prevent future issues. Making abdominal muscles stronger is important and quite useful.
You may want to consider physical therapy provided by your healthcare provider or experts in order to get the best exercises and the best results. Don’t forget that this takes time so don’t expect recovery overnight. One, an important advantage of physical activity is the ability to prevent future complications of bulging disc l4/l5. However, you will need to exercise on a regular basis.
Medications are used as well and they are very helpful in managing pain. If you are planning to start with this treatment, begin with NSAIDs or non-steroidal anti-inflammatory drugs. They are basic over the counter drugs which are proven to help people suffering from bulging L4/L5 conditions. Best examples are naproxen and ibuprofen. Corticosteroids, opioids and tramadol are the next line of treatment. They are used when NSAIDs do not work.
Sadly, medications are not a cure for this condition. They can help you decrease or completely eliminate pain while your body recovers. You can use these alongside other treatments from the list.
Epidural steroid injection is the next treatment. It is a special type of injection injected around the affected nerve. It is used when a patient is still in pain after 6 weeks and after using all treatments, we have covered above. A single injection will give you temporary pain relief. It is effective in 50% cases.
In order to get complete pain relief, a patient will need multiple epidural steroid injections. A single one can provide pain relief that can last between a few weeks and even a few years. Experts recommend using the injections alongside other treatments in order to create a more successful treatment overall.
Surgical treatments of bulging disc L4/L5
Due to the fact these treatments are more complicated and there are a few of them, we decided to explain them in a separate section. These are also bulging disc L4/L5 treatments and they will be used when nothing from the above works. It happens rarely and most patients won’t need these procedures.
Microdiscectomy is the most common type of surgery for patients suffering from bulging disc l4/l5. A doctor will use a small incision above the affected vertebrae and he will use a microscope. You can get a clear idea of how small the incision is. A doctor will remove the tissue that is pressing the nerve. In some cases, the same procedure may be used for multiple discs. After it, a patient will need recovery and a doctor will likely recommend 30-minute walks every single day. This procedure is helpful to 85% patients and full recovery time is 6 weeks.
Suggested article: Sciatica Pain After Microdiscectomy
2. Minimally invasive microendoscopic discectomy
Minimally invasive microendoscopic discectomy is a bit more complex surgery that is being used more and more often these days. A small incision is still made at the back of a patient. A doctor will use small tubes (dilators) in order to make the tunnel to the vertebra larger. A part of the bone is removed in the procedure. Ruptured disc is removed as well. This surgery is less-invasive and requires a shorter recovery.
Laminectomy can be used in some cases. A surgeon will remove a small portion of the backside of the vertebrae called the lamina. As such, more space is given to cauda equina. This is one of several, similar procedures used today. They are not complex and they are generally very successful.
4. Disc replacement
This is the rarest procedure of this kind and it is rarely used for this condition. However, in some cases, it may be the only cure. Basically, a surgeon will remove the affected disc and replace it with artificial treatment. A good thing is that the condition is eliminated completely and it cannot occur again. A downside is the complexity of the operation and long recovery time.
Additional things to know when it comes to surgeries is that a surgeon may use multiple procedures at the same time. For instance, he or she may use foraminotomy and laminectomy. This surgery is called laminoforaminotomy and it is far from common. As every other form of surgery, these ones do carry some risk! Nerve damage, allergic reaction, bleeding, and infection are possible. Your doctor will advise you to start with the simpler treatments explained above and only if they are unsuccessful, surgery will be performed.
Recovery timeline from Day 1 to Day 90 for bulging disc L4/L5
If you are just diagnosed with bulging disc l4/l5 condition, you will need plenty of time to recover. In most cases, this time frame is 90 days long. Below, we will explain how the recovery looks and what you can expect in detail.
This is a very bad part of the recovery. You will be in constant pain and there are no simple things you can do to make pain go away immediately. Try taking medications for pain. They are usually very helpful. Physical activity in moderation is highly recommended. But, rest is mandatory.
Use this time to find the cause for the condition. It may be when you did something or caused by something completely else. Talk to your doctor and try to find the cause and see available options. Make sure to consider sleep and your diet. As we have explained earlier, making changes to sleep pattern and diet are effective treatments for bulging disc l4/l5.
Now you should feel a bit better. It may look like the worst has passed. The most important thing to do during this time frame is to drink water, plenty of it. If your body lacks fluids, disc recovery will be either postponed or even impossible. The simplest solution is to drink plenty of water, much more than in general.
A mandatory thing to add is gentle movement. Try to be careful when you stand, move, or even walk. Regular walks are highly recommended.
During this period, you will feel much better. This means that now is the time to start stretching your legs, to perform more complicated exercises, and to develop a workout routine that works the best for you. Exercising and walking as much as you can are highly recommended tips.
Now you can also consider the cause of your issue and try to find a treatment. Weak lower back, poor lifestyle, or a wrong technique while exercising/working are all causes. Find the cause and you will be able to prevent it and make sure the condition doesn’t come back in your life.
In this period, you should feel much better but not great. You will still have a day or two loaded with pain. It is crucial to keep things slow and to avoid hard exercises, lifting, or anything that makes symptoms worse. Continue working on the exercises and techniques that can help you with the condition. For example, if you have weak muscles around the spine, you will need to make them stronger.
If you are still feeling bad and in pain, you will need help from an expert. It simply means that your body needs a more advanced treatment and you need medications, injections, or possibly surgery. A good thing is a fact this rarely happens.
Can TENS machines help for bulging disc L4/L5?
During the time frame you are in pain, there is an interesting method you can use to trigger natural pain killers already available in your body. This is possible thanks to transcutaneous electrical nerve stimulator or better-known TENS machines. They work like magic and they are very helpful to most patients suffering from bulging disc l4/l5.
TENS is ideally used during some form of physical activity. You should wear it while walking for 30 minutes every single day. The result will be instant. TENS machine will send electrical impulses to the affected area and trigger endorphins alongside other chemicals that act as pain killers. On the other hand, there are no complications or side effects of these machines. But, if you have pacemaker, metallic implants, or spinal cord simulator, you must not use TENS machines. In addition, some people are allergic to nickel or adhesives TENS machine use. Talk to your doctor before you start using one.
Overall, these machines are safe to use and very versatile. A person can use these for arthritis, muscle pain, fibromyalgia, neck, and back pain. As you may know, there are a lot of models out there. Be free to start with the simplest machine and if it works well, all you need to do is to continue using it. Investing in a more powerful and advanced machine is ideal if you can afford it and you want more advanced features.
Suggested article: How To Use A TENS Machine For Sciatica Pain Relief
Bulging disc l4/l5 may sound like a huge problem. In most cases, it isn’t. It is something that causes pain and can be solved with simple lifestyle changes. Don’t think that just because it is in your spine that it is very dangerous. A huge part of patients solves and eliminates the condition using non-invasive and simple lifestyle changes. Now you know all there is about this condition so you can recognize it on time and find a treatment that will work the best for you.
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