‘Explaining Lower Back Disc Pain & Shooting Leg Pain’
July 19, 2016
People with lower back problems constantly scratch their heads when listening to their Physio using medical jargon to explain a Slipped Disc. This week I will simplify these terms when explaining how disc herniation can cause shooting pain into different areas of the leg.
A Lumbar disc herniation of the lower spine occurs when a disc protrusion worsens and ultimately presses on the surrounding nerve root causing shooting leg pain. The Lumbar spine comprises of 5 vertebrae blocks numbered L1 to L5 with a disc between each vertebrae block. Each vertebrae block holds the nerve root of the nerves that innervate the muscles of the lower body. The nerve roots exit each of the Lumbar vertebrae and extend downwards like a wire where it branches off to supply movement control and sensation to each muscle. The most common sites of Disc injuries are situated between L4 and L5 and between L5 and S1. (SI referring the head of the sacrum bone directly beneath L5 within the spine) In relation to L1-L3, referral pain down the leg due to disc herniation is less common.
I will now outline the different symptoms that can occur due to disc herniation at the L5/S1, L4/L5 and L3/L4 levels of the Lumbar spine:
Nerve root compression at L5/S1 vertebrae:
Advanced bulging of the disc between L5 & S1 with sciatic nerve root compression can cause shooting pain into the buttock and down into the hamstring region and into the outside ankle region, sole of the foot and toes.Muscle wastage can be noted in the calf muscles with weakness felt in the hamstring and foot.
Nerve root compression at L4/L5 vertebrae
Nerve Impingement due to advanced disc bulging between the vertebrae blocks of L4 & L5 leads to shooting pain into the buttock and outside thigh area, travelling down into the inside foot area and big toe.The patient experiences a weakness when attempting to bend the foot towards his shin bone.In addition pins & needles and numbness can be felt on the inside of the calf and ankle joint.
Nerve root compression L3/L4 vertebrae
A herniated disc between the L3 &L4 vertebrae block can press on the surrounding nerve root at this level and cause pain into the buttock, front of the thigh and knee.Prolonged compression of the nerve leads to quadriceps muscle wastage.Weakness can be noted in the patient’s ability to straighten their knee such as when climbing stairs.
Next week I will discuss further the subject of lower back disc pain.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
Contact Number: 0504 26672
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