L4 Lumbar Spine
(Keywords: L4 Lumbar Spine, chiropractic help, lumbar surgery, lumbar facet arthropathy spondylolysthesis, slipped disc rules )
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.
Searching for something specific? Say, " slipped disc rules ". Just type it in here...
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.
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 ...
SLIPPED DISC RULES
Small slipped discs are not uncommon and you will recover quickly with chiropractic help, but if you have a severe attack of lower back pain, are standing like Pisa, and especially if you have radiating pain down the leg, then we strongly recommend these slipped disc rules if you want to escape lumbar surgery.
Some of them are controversial. For example, research shows that bed rest alone has little or no value, in fact may make you worse. My unresearched opinion is that, combined with chiropractic help, and active exercises done every half an hour, and getting up every hour for a short walk, that bed rest is very beneficial.
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 ...
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 ...
Have A Question about your lower back?
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
Click below to see contributions from other visitors ...
tingling in arms and feet and legs and back 
tingling in arms and feet and legs and back
I am a dwaff and i am 47 I've had a mri and emg and came back ok. I've got l4/5 and l3/4 and l5/s1 what …
i am having problem of l5-S1 EXTRUSION AND L4-5 BULGE HAVING PAIN IN LOWER BACK WHILE SEATING
HAVING PAIN WHILE SEATING FRO LONG IN THE LOWER BACK ALSO HAVING PAIN WHILE BENDING FORWARD NUMBNESS IN THE LEFT HIP.
Many lower back conditions cause …
pain from left lower back trouble and lifting foot off floorafter standing or walking a short time
I have pain and stiffness from my neck and shoulders down the left side from my lower back down to my ankle and foot. If i walk for a short time I have …
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://radiology-ima …
sensitive skin on left side of back Not rated yet
I had a herniated disc L5 5 years ago. Have been ok now for 3 years with the odd bout of pain. At the minute I am experiencing sensitive skin and burning …
Back pain left side about 1/2 in from spine at about t12 Not rated yet
I have had decompression at L2-5 in 2010. a few weeks ago I fell down a few steps. 2 days later i started getting new pains on the left side that I can …
Loss of control in the right leg only while running Not rated yet
I suffer from, for lack of a better phrase, loss of control of the right leg, but only while running. There is no pain, no cramping, no spasms, and no …
Severe right lower back pain. History of L4-L5 stenosis. Not rated yet
I have had this for a couple of years now. I've tried epidural injections and anti-inflammatories but they don't help. A few days ago I bent over to pick …
Pins and needles in right foot. Pain in lower back, feels asif its pulling stiff. Pain which feels like its directly on the spine, Not rated yet
Hi! I am a mother of four, 33yrs old. During birth to my second child in 1998 he moved down against my spine(I believe). After giving birth I could not …
sharp pain in right butt cheek and right hip Not rated yet
have had 4 ESI and be adjusted mant times. Also been on traction table. All help a little but still doesnt fix it. Pain comes every 7 to 10 days and can't …
complete loss of feeling in femaral artery area on right side from pubic area to groin area Not rated yet
x ray today showed degeneration of L4 and L5
ana blood test back in two days looking for RA
Osteoarthritis already confirmed had joint in thumb …
complete loss of feeling in femoral artery area on right side from pubic area to groin area Not rated yet
x ray today showed degeneration of L4 and L5
ana blood test back in two days looking for RA
Osteoarthritis already confirmed had joint in thumb …
Toes, feet numb Not rated yet
My condition has lasted for over a year. Both my feet are numb all of the time, all toes in particular big toes feel like they are jammed all of the time. …
burning pain down lower leg Not rated yet
BURNING PAIN IN LOWER LEG
Hi for the last 6 years I have had bad pain in my left lower leg and walking and standing for more than a min hurt very …
Important tip:
It's my considered opinion that most patients who end up in surgery,
- themselves think the condition too serious for a chiropractor
- their doctor (or spouse) think the condition too serious
- expect to be fixed with a few clicks of the back
- won't take rest and do the exercises faithfully
- don't think the condition serious enough to slow down or stop, or follow the slipped disc rules mentioned above.
POSTERO LATERAL DISK HERNIATION ...
POSTERO MEDIAL DISK HERNIATION ...
LOWER BACK AND LEG PAIN ...
Return to LOWER BACK PAIN home page …
Go from L4 Lumbar Spine to CHIROPRACTIC HELP home page …
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Bernie's May 2013 blog:
Whilst shopping in Maastricht, I was accosted... read on for some light fun. The importance of being ernest ... not by Oscar Wilde!
SMOKING KILLS
- 1 in 5 deaths - half a million Americans per year
- Risk factors are additive: STROKE RISK FACTORS PAINKILLERS ...
Just one cigarette per day ...
"Even brief exposure to tobacco smoke causes immediate harm to the body."
Surgeon General
"Lying to ourselves is more deeply ingrained than lying to others."
Fyodor Dostoevsky
$193 billion per year
Health care costs + lost productivity
"Occasional smoking or just second-hand smoke damages DNA causing cancer."
"Most smokers are already well aware of their increased risk of acquiring lung cancer. Fewer people know about the patients I see every day, those with cancer of the lips, mouth, nose, throat, sinuses or larynx (where the voice box is located).
These cancers account for about 6 percent of all cancer diagnosed annually in the U.S. Ninety percent of these cancer victims can blame their illness directly on tobacco use."
Paul Donald, M.D.
Over 1,000 Americans per day die directly from smoking.
EMPHYSEMA
- worse than cancer
LIVING DEATH
"Tobacco smoke damages every organ in your body - not just your lungs"
Surgeon General
CAUSES OF OSTEOPOROSIS
OBESITY
Obesity + smoking = disaster
CHIROPRACTIC
Chiropractic manipulation + smoking?
Will Tweety have a stroke?
LOW BACK and LEG PAIN
Falls
Bending and twisting
SITTING
SHORT LEG?
Low back and leg pain
LUMBAR FACET SYNDROME
SLIPPED DISC
SACRO-ILIAC JOINT
SPONDYLOLYSTHESIS
EXAMINATION
