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.
Read more about the FOUR GRADES OF SLIPPED DISK
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.
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.
TINGLING IN FEET AND LEGS
L4 Lumbar Spine
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.
TINGLING IN FEET AND LEGS ...
MUSCLE WEAKNESS
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.
Read more
ANTI INFLAMMATORY DRUGS ...
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 COAL FACE
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 ...
Read more about LUMBAR FACET SYNDROME ...
HYALINE CARTILAGE ...
IMMOBILISATION ARTHRITIS ...
SPONDYLOLYSTHESIS
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 ...
SPONDYLOLYSTHESIS ...
Lumbar Facet Arthropathy SPONDYLOLYSTHESIS ...
IMPORTANT CONSIDERATIONS ...
POSTERO LATERAL DISK HERNIATION >>
Read more about LATERAL DISC HERNIATION
POSTERO MEDIAL DISK HERNIATION >>
LOWER BACK AND LEG PAIN >>
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