Lumbar spine
Lumbar spine pathologies are conditions that appear in the lower back but may cause pain in the pelvis, hips and legs.
Degeneration of discs, or degenerative changes in the joints of the lumbar spine can cause localized back pain, nerve pain in the leg or spinal deformities.
Back pain often radiates to the hips and can reach the back of the thighs, even when the nerves are not involved. The experience of back pain varies between one-time episodes, pain that appears for episodes or constant pain.
Arthritis of the lumbar spine causes thickening of ligaments and formation of bone spurs (osteophytes) around the joints and discs of the spine. The discs dry out, lose height and in some cases become unstable. These changes can cause nerve pinching or spinal deformity. If a nerve is affected, then radiating pain may appear in the leg, sometimes accompanied by weakness, numbness or tingling.
Deformity can lead to a stooped or sideways posture, and in some cases back pain, difficulty and fatigue when trying to walk.
care
Symptoms of degenerative changes in the spine usually develop over time.
Early treatment for back pain is based on changing your activity to avoid pain triggers, anti-inflammatory drugs, physical therapy, and alternative therapies.
Often the pain will subside within a few weeks but may return and become episodic, in which case it is important to try and continue to be active. Nerve pain can also be treated in a similar way and cortisone injections into the spine are another option, but the relief from the injections is usually only temporary.
Lumbar spine surgery is recommended for unrelenting nerve pain in one or both legs. Sometimes, surgery is used to correct a spinal deformity. Surgical treatments used to relieve nerve pressure vary and the choice will depend on your symptoms and diagnosis based on the physical exam and imaging tests.
Degenerative changes in the lumbar spine
A herniated disc occurs when the hard outer rim of the disc (annulus) is torn, a situation that allows the soft, central part (nucleus) to push out and make contact with the nerve located near the disc.
Symptoms include pain in the buttock and pain radiating down the leg and sometimes the foot, known as sciatica. In addition, weakness, numbness or tingling of the leg or foot can also appear. The onset is usually sudden and usually follows a slight twisting movement followed by pain, which can be severe.
care
In most people the symptoms go away after a few weeks which include rest and reduced activity, physical therapy and medication. Spinal cortisone injections are also an option, although they are not always helpful.
Surgical treatment can be a solution to incessant pain in the leg (sciatica) or severe weakness of the leg. The most common procedure is a microdiscectomy through a small incision in the back.
Lumbar disc herniation and sciatica
symptoms
Spinal claudication is heaviness, numbness or pain in the buttock and legs that comes while walking or standing for a long time and is relieved by sitting.
Usually, walking is limited to about 100 meters due to leg pain, which is relieved by sitting for a few minutes and then walking the same distance again.
Claudication is caused by degenerative changes of the lumbar spine with narrowing of the central spinal canal so that the spinal nerves are compressed.
Spinal movements associated with standing and walking further compress the nerves and cause the symptoms to appear, while sitting or bending forward opens the canal, reducing pressure on the nerves and relieving leg pain.
care
Spinal claudication develops slowly and over time.
Early treatment may include losing weight and maintaining physical activity, sometimes the use of anti-inflammatory drugs may also help. Spinal cortisone injections are another option but usually provide only temporary relief.
Surgery is usually recommended when symptoms persist and interfere with daily activities. The proposed surgeries may vary from simple surgeries to release the canal to more complex surgeries including fixation of the spine, depending on the physical examination and the findings in the imaging tests.