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L4 Lumbar Spine
L4 Lumbar Spine disc protrusion may cause a serious list to port (or starboard!) called an antalgia, though not necessarily. We at Chiropractic Help call it the sign of Pisa! And of course accompanied by acute lower lumbar back pain. In Holland it's called 'spit'. In the English speaking world, "slipped disk".
The word "antalgia" is really two words joined together:
Ant - away from
Algia - pain
Ant-algia = Leaning away from the pain.
It's a reflex spasm of the back to protect the nerve from being pinched when you have a bulging lumbar disc. It's a serious sign, and neglected often progresses to a sciatica - severe pain down the leg. Always assume it will take at least six weeks for the annulus fibrosus to heal because, if you have a relapse, you can expect that it will quickly progress from a Grade I lumbar disc protrusion, to Grade II, III and even heaven forbid, Grade IV and a high likelihood of lumbar spinal surgery.
The first grade is known as a
LUMBAR DISC PROTRUSION ...
The rule in health care is the same as in money. Look after the pennies, and the pounds will look after themselves. Care properly for your Grade I Lumbar disc protrusion and you won't end up with a Grade II... and ultimately Grade IV.
Go on, take a look, I'll wait until you're done! Hit the "Go back one page" arrow at the top of your page, and I'll be waiting ... for the rest of your L4 lumbar spine tour ... how to avoid lumbar surgery.
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What is confusing is that antalgias come into two forms: one away from the pain, and one towards the pain - but we call them both antalgias.
Away from: Postero-lateral bulge.
Towards: Postero-medial bulge.
They must both be taken seriously, but what is interesting is that the postero-medial kind responds very quickly to Chiropractic adjustments - but it still takes six weeks to heal. If you ignore this fact, relapse is common frequently progressing to pain and tingling in feet and legs.
Should the bulging disk irritate the nerve, usually the L5 nerve, you will start to feel tingling following a specific pattern. Then the skin becomes hypersensitive, and if you still do nothing the skin, particular on the lower leg stretching over towards the top of the foot and the big toe, will become numb.
Within each spinal nerve, there are in fact two nerves. One bringing information from the limbs for example, and the other innervating the muscles.
The L5 nerve root, the one usually affected by a bulging L4-L5 disc, classically supplies a muscle called the Extensor Hallucis Longus. If it's weak, you will have difficulty raising your great toe off the ground.
Can you do this?
LOWER BACK SURGERY
Because the pain often resides quite quickly with Chiropractic help with a medial slipped disk, patients sometimes stop the rehab, thinking the condition was no big deal and your chiropractor has golden hands!, start sitting and bending too quickly, and whoops, a relaps. In my experience, the medial disk is much easier to manage, but in reality, research proves that a greater percentage of medial disks end up in lumbar spinal surgery.
Medicine's approach is to treat a herniated lumbar disk first with anti inflammatory drugs and then, if that doesn't help, with lower back surgery.
However, at Chiropractic Help, we don't see this as an inflammatory condition, unless it's been neglected for weeks or months. Rather, like a broken arm, the displaced nucleus pulposis should first be reduced (varietious manual techniques are used), and then the joint rehabilitated. A corset to immobilise the joint for a period, when doing unavoidable activities like bending and sitting, may be useful, but should not be used for long periods.
We are also not in principle against good lower back surgery, and every chiropractor has to refer patients to good surgeons periodically. However, Failed Back Surgery is a daily phenomenon in our clinics, so we are convinced that a course of Chiropractic care should be mandatory before surgery.
FROM THE COALFACE
Mr van der D, aged 68 had an attack of "spit" seven years ago. He didn't respond well to drugs or physiotherapy, and it was decided that he should have a lumbar decompression operation. This is the X-rays taken BEFORE the operation.
The L4 lumbar spine op didn't help, so six weeks later he had a second more drastic operation. Look carefully at the L4-L5 disc space. These X-rays were taken immediately after the second op.
Notice the severe loss of the disc space where the nucleus pulposis was extracted in the lumbar decompression of this L4 lumbar spine. He has a flat tyre, and quite soon it's going to be bone-on-bone.
The operation relieved his back pain and leg pain, for a time, but set him up for a certain lumbar stenosis: severe narrowing of the foramen where the nerves emerge. Now he has had severe unrelenting pain down the leg for three months ...
Read more about CHIROPRACTIC HELP Lumbar Stenosis …
He's responded well to the first two treatments, but to be quite honest, the future remains uncertain. At least six to eight weeks of treatment, rehab, and a life time of Chiropractic care.
Before you go for a lumbar spinal surgery after a L4 Lumbar spine protrusion, try everything first. When and if all else fails, including a solid attempt at Chiropracic Help, then and only then submit to your surgery. Done by an expert, say your prayers, it can be a wonder. But it can also be a disaster. Just the anaesthetic ...
ANAESTHETIC ALZHEIMERS …
L4 LUMBAR SPINE CASEFILE
Never treat Case files as gospel, but cases like this one often they reveal a gem of truth worth considering...
L4 LUMBAR SPINE CASEFILE ...
LUMBAR FACET SYNDROME
Between every pair of lumbar vertebrae are three joints:
One disk joint
Two facet joints.
See those facets, right and left? They are the source of much lower lumbar back pain. If they remain chronically fixated then the hyaline cartilage is starved of nutrients and oxygen causing what is known as
IMMOBILISATION ARTHRITIS ...
In the figure above, notice the line called 'pars'. This is the site where a fracture can occur, usually in childhood when the cartilage has not yet turned to bone. This can allow L4 to slide forwards on L5 ... but sometimes it occurs because of severe degenerative changes in the facet joints causing Lumbar Facet Arthropathy SPONDYLOLYSTHESIS ...
I receive many questions about Chiropractic. It might be help with a spinal condition, but it might also be from a person who can't walk after a hip operation, or some such thing.
I will do that by answering your questions personally, but it will be converted to a Web Page so others can benefit from your questions. Omit your name if you like...
However, do understand that, in the main, I'm going to be directing you (should it be pertinent) to a Chiropractor in your neck of the woods. I'll respond to all reasonable inquiries, but please be specific, and give some details.
There is no charge for this service, however if you find my answer useful, you might like to consider purchasing my latest book, Stones in my Clog. Gems, both funny and healthful, from the life and work of a Chiropractor. It's only $2.99. (http://www.bernard-preston.com/Stones-in-my-Clog.html)
Pose Me A Question! Pretty please, in decent grammar and spelling.
I will never give or sell your e-mail address to anyone.
Do understand that lower back pain is extremely complex, so I can only give general guidelines. There's no substitute for a careful thorough chiropractic examination.
What Other Visitors Have Said
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Back pain and leg numbness
Middle and lower back pain, numbness in legs and tingling in hands. Strange feeling like something is leaking down my back and left leg. More images http:...
