L4 L5 Bulging Disc

The L4 L5 level is one of the most common places in the spine to have a bulging disc.
The amount of people that come to me thinking that their “back is ruined” because they have a bulging disc in the l4 l5 lumbar spine.
And they think they are the only ones in the world that have this condition, it made me want to write an article about it

As you know the l4 and l5 stand for the 4th and 5th vertebrae down in the lumbar spine

The reason this is the most common area of disc bulge is that it is at the base of the spine. The 4th and 5th vertebrae are the last unfixed bones before the spine turns into the sacrum and becomes fixed.
So naturally these are the last 2 true vertebrae

Now if you haven’t read my other article about what exactly is a bulge discs, I urge you to click here and read it before continuing.
It will give you a great understanding about what discs are, their role and why they get injured.
But today I am just going to talk about the l4 l5 disc

So, as mentioned earlier the l4 l5 disc is the disc that separates the 4th and 5th lumbar spines. When this disc bulges out it can have an effect on a lot of the different nerves and tissues around the spine.
This can cause a lot of pain.
Not only in the local area of the l4 l5 vertebra (the lower back) but also referring down the buttocks, into the legs, groins, and feet.

A picture of the most common areaa of referred pain for the l4 l5 is below:
But before you look at that you should know, that just because you have pain in that area it doesn’t mean that your disc bulge is so severe that it is squeezing against the nerve and is pinching it!

Bulged Discs DO NOT EQUAL Pinched Nerve

Research has shown that most of the time, someone who has bulging discs in the spine experience no pain.
However, the way a bulged disc can cause pain is when the bulge stretches the outer wall (or layer) of itself.
Now just like any muscle or ligament, if your overstretch it, it will hurt
For example ,if you take you finger and bend it back towards your wrist and hold it there, you will no doubt start to experience some level of discomfort. Now imagine holding that finger bent back like that, stretching out all the tissues of the joint all day! Imagine the pain it could cause!

This is similar to how a disc can cause pain.
The way we live each day, our postures, our workloads , our furniture and environments, we are constantly causing the disc to be bulged and therefore stretched just like our finger.

Anyway,

Like I said, pain going down the legs, even if it shooting, sharp, burning, pins and needles, this doesn’t necessarily mean that your disc is too blame.

What can happen is when the disc gets stretched (like it does when it bulges constantly) the tiny ligaments and tissues over the disc get stretched.
Now the body’s natural mechanism when a ligament or tissue is overstretched is to have an inflammatory response, sending vital blood and healing agents down to the joint to start repairing it.

However there is one problem with this.

In the spine where the joint space is very small already, the fluid can quickly fill up the entire joint and cause an increased amount of pressure throughout the joint.
This pressure unfortunately can cause more pain (and a constant ache) that makes us want to restrict how much we move our spine, and with every move we still feel that sharp shooting pain.

This is where it becomes an issue…

As the nerves that pass through this joint space all of a sudden they are under a lot more pressure due to inflammation around the joint

and this is why we get referred pain going down the legs

NOT because a bulged disc is pinching the nerve up against the spine.

Now the best way to treat this is to get rid of this inflammation. I have found that 3 simple techniques all used together work very effectively.

1. Get a massage

Massage lengthens the muscles around the spine stopping the constant compression of the disc in the first place, therefore reducing the bulge temporarily.
This is why massage is great for short-term relief, but as soon as the body gets back into its old habits the muscles tighten up again and compress the disc again.

2. Take some over the counter anti-inflammatory

There is an issue of inflammation, and a consistent course of NSAID’s will assist.

3. Use heat pack and an ice pack

10mins heat
10mins ice
10mins heat

This is what professional sports-stars do after the game to promote flowing of fluid and reduce inflammation.

If its good enough for billion dollar footballers, its good enough for you.

4. Start moving

Just like if you stretched a ligament in your ankle, its bad to let the swelling around the joint pool there.

The best way to get rid of this is to move the joint.

But don’t move it too much!

If you over stretch and injured ankle it will hurt a lot and just cause more inflammation.

This is the same with the back, move it as much as you can without any pain. Let pain be your guide and as soon as you feel sharp shooting pain stop, and go back to just gentle movements.