This week I will further discuss Lower back Disc pain of the L2/3 lumbar region which can cause pain to occur into the upper groin and thigh region of the leg. Firstly though I will detail common symptoms associated with both early stage and chronic stage Lower back Disc bulging.
Common Signs & Symptoms of both Acute and chronic stage Disc pain:
Movement of bending forward and twisting when lifting can cause a slight twinge in lower back.
Stiffness in the lower back when getting out of bed in morning time – this stiffness can last between 10-30 minutes.
After sitting for a prolonged period, the patient experiences difficulty in attempting to stand straight.
Difficulty & pain in lower spine when getting into & out of car.
Coughing & sneezing can provoke lower back pain.
Pain when standing that improves when walking
Sleeping on your side at night may be the only painfree position
Forward bending & twisting movements aggravate lower back pain
Prolonged arching of the lower back in a backward position & sidebending to a particular side can bring lower back pain.
L2/L3 vertebra causing Groin and Upper thigh Pain
Nerve impingement at the L2 level vertebrae due to advanced disc bulging between the L2 and L3 vertebrae can be the cause of pain referring into the front of the thigh and groin region. This is because the nerves that innervate the Rectus Femoris & Psoas muscles (muscles at the front of thigh) and adductor muscles (groin region) partially originate from the L2 vertebrae. To confirm that this pain is caused by disc herniation between L2 & L3 vertebrae and not by arthritic changes in the Hip Joint, the patient is asked to push their knee upwards against resistance whilst in a seated position. If the Patient is only able to provide some resistance in this test then nerve root compression in the Lumbar spine at L1, L2 & L3 vertebrae can be suspected. A feeling of Leg weakness coupled with lower back pain whilst climbing a stairs is a possible symptom of L2/L3 disc herniation.
Treatment & Management
If the disc between L2 and L3 vertebrae is pressing on the surrounding nerve roots, graded mobilizations and postural exercises can be used to help relieve symptoms. In some cases nerve gliding techniques & traction techniques can be beneficial. MRI examination is very useful in that it helps detail the stage of the disc protrusion and whether a Patient should be referred to a Neurosurgeon.
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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Injury Solutions Clinic
Physiotherapy & Injury Rehabilitation Clinic in Tipperary