LUMBAR (BACK)

Lumbar means pertaining to the abdominal segment of the torso.  There are five vertebrae (bones) in the lumbar region of the back (L-1 – L-5).  These are the largest and strongest of the spinal column.  In between each lumbar vertebrae a nerve root exits to form the sciatic nerve.  The sciatic nerve runs through the back of each leg and into the feet. 

LUMBAR SPRAIN occurs when ligaments (tissue that holds bones together) are torn from their attachments.  Muscle strains and lumbar sprains are the most common cause of low back pain.  A muscle strain occurs when the muscle fibers are abnormally stretched or torn.  These are difficult to distinguish, as both will have similar symptoms.  These symptoms can be pain around the lower back and upper buttocks, low back muscle spasms, and pain associated with activities but relieved with rest.  Most patients develop a lumbar sprain or muscle strain because they are doing an activity that places their back at risk.  This may be a sudden forceful movement, lifting a heavy object or twisting the back in an unusual manner. 

HERNIATED DISC /BULGING DISC / DISC PROLAPSE (SLIPPED DISC) can be usedinterchangeably.  This is less common in the cervical spine and more often occurs in the lumbar region.  About 90% will occur at (lumbar) L-4 and L-5 or (sacral region) S-1.  A herniated disc may occur suddenly in an event such as a fall or accident, or may occur gradually with repetitive straining of the lumbar region.  It occurs when the center of the disc leaks out of the disc and puts pressure on the nerves which emerge from the spine.  If the injury is in the cervical region, the patient will present with pain in the neck and shoulder which may radiate down the arm.  The pain is exacerbated by neck movements.  If the injury is located in the lumbar the patient may have weakness in extending the big toe.  They may also complain of numbness and/or pain on top of the foot.  If the injury occurs in the sacral region, the patient will have weakness when attempting to stand on their toes and numbness and/or pain on the outside or sole of the foot.  A MRI scan is helpful in the diagnosis.  The x-rays, physical exam, and patient’s symptoms are information that plays a part in the treatment plan. 

• More info on Herniated Discs

SCIATICA is inflammation of the sciatic nerve.  The most common cause of sciatica is a herniated disc.  This compresses the nerves and patients experience pain, weakness, and numbness.  Common symptoms include shooting pains from the buttocks down the leg or a burning sensation in the thigh.  There are different treatment options for sciatica.