Herniated Disc L5
A herniated Disc L5 occurs when a herniated disc causes the L4-L5 nerve root or the L5-S1 nerve root to be compressed, causing a L5 nerve or S1 nerve impingement.
Herniated discs occur to a combination of a loss of the ability of the interior of the discs to retain water, and a weakening or wearing out of the outer wall of the disc. Degenerative disc disease has been used to describe a combination of one of these two factors occurring in the intervertebral discs of the spine.
As the degenerative changes to the disc occur, the walls of the disc may weaken to the point that it begins to bulge outwards at one point. Because the walls of the annulus fibrosus (wall of the disc) are the weakest along the back of the disc, the disc is likely bulge at this section. When this happens, the condition is known as a bulging disc. In the event that the wall of the disc were to tear completely, the condition would be known as a herniated disc.
Both bulging discs and herniated discs may affect cause pain by pressing into the spinal ligaments, or the nerve roots exiting the spine. In the event of a bulging disc, the wall of the disc may be moved far enough to come press upon the nerve root or spinal ligaments. Both of these anatomic structures have pain receptors that respond to compression and irritation, and may transmit pain signals to the brain. In the event of a herniated disc, the wall of the disc becomes torn completely, and its contents may spread out and also press into the nerve roots and ligaments.
The walls of the discs are most vulnerable to wear and tear at the bottom of the spine where the discs and sacroiliac joints must absorb the most weight and force. Our unique physiology of walking upright is necessitates the bottom of our spine absorbing the majority of energy caused by us standing upright. Because of this, about 90% of disc herniations occur in the bottom lumbar segments. A Herniated Disc L5 may refer to a herniation of the intervertebral disc at between the 4th and 5th lumbar vertebra, or between the disc between the 5th lumbar vertebrae and the sacrum. Both of these herniation may affect their closest nerves if they press into them and compress them. This is the reason that a herniated disc are also referred to as a pinched nerve. If the herniation between the 4th and 5th lumbar segments compresses the L5 nerve, the result is a L5 nerve impingement. If the disc herniation is between the 5th lumbar vertebra and the 1 segment of the sacrum, then the result is called a S1 nerve impingement.
Both of these nerve impingements may cause pain and related symptoms (numbness, tingling) along the leg and into the feet. L5 nerve impingement may affect the ankle and big toe and make flexion difficult. Foot drop is a term that describes the event where the person is unable to flex their foot and/or big toe. S1 nerve impingement is more likely to cause the patient to have difficulty with extension of their ankle and toes, where the patient used them to push off when walking. Burning, numbness, and pain due to impingement at this level of the nerve is more likely to be felt in the sole or outside of the foot.