Lumbar L5-S1 disc herniation is a common spinal condition that can cause pain and other symptoms. The lumbar spine is the lower part of the spine, and the L5-S1 disc is located in the lumbar region.
This article will discuss the causes, symptoms, and treatment options for lumbar L5-S1 disc herniation.
The L5-S1 spinal motion segment, also known as the lumbosacral joint, serves as the pivotal region bridging the lumbar spine and sacral spine in the lower back. This specific segment is where the spine's curvature transitions from lumbar lordosis (a forward curve) to sacral kyphosis (a backward curve), playing a vital role in transferring loads from the spine to the pelvis and legs.
Characterized by its unique anatomy, the L5-S1 segment is subjected to a significant amount of mechanical stress and load, more so than the segments positioned above it. This distinctiveness renders the L5-S1 more vulnerable to a range of issues, including traumatic injuries, L5-S1 degenerative disc disease, herniated L5 to S1, and nerve discomfort.
A herniated disc occurs when the nucleus pulposus, the inner gel-like substance of a spinal disc, protrudes through a rupture or weakened area in the annulus fibrosus, its tough exterior. This type of herniation is especially common in the lumbar region, notably at the L4-L5 and L5-S1 spinal motion segments, near the base of the lower back.
The presence of a herniated disc can lead to discomfort and pain, particularly if it impinges on or irritates adjacent structures, such as spinal nerve roots. Interestingly, the severity of symptoms doesn't always align with the herniation's size. Small herniations can provoke intense pain and neurological issues if there's significant nerve root irritation or compression, while larger herniations might not cause any discomfort if they avoid nerve involvement.
The lumbar spine is made up of 5 vertebrae, labeled L1-L5. These vertebrae are responsible for supporting the upper body and allowing for movement in the lower body. The L5-S1 disc is located between the L5 vertebra (in the lower back) and the S1 vertebra (in the pelvis).
The lumbar is classified by being divided into five sections labeled as L1 - L5 vertebrae. Each of these sections can induce specific symptoms that could affect your lower back pain.
L1 — The topmost section of the lumbar spinal column.
L2 — Contains the end of the spinal cord proper. All vertebrae beyond this point only have the spinal nerves, and not the spinal cord.
L3 — The middle vertebra of the lumbar spine
L4 — Second to last section of lumbar spinal column
L5 — The final section of the lumbar spine.
The functions of the lumbar spine include:
The lumbar being sprained or strained are the most common forms of back pain. Back pain can be acute (short-term) or chronic (long-term).
Acute back pain typically lasts for a few days to a few weeks and is caused by overuse or injury of the back muscles. Common causes include strains, sprains, lifting heavy objects, and sudden movements such as bending or twisting.
A lumbar sprain occurs when the ligaments that support the spine are stretched or torn while a lumbar strain occurs when the muscles of the back are overstretched or torn. The sprain or strain causes pain in the muscles of the back, which may cause a burning or aching sensation.
Chronic back pain lasts more than three months and can result from lumbar disc degeneration, arthritis, bulging discs S1 L5, osteoporosis, scoliosis, or other conditions. It can also be affected with age, where the spinal discs are more susceptible to cracks and tears over time.
Chronic back pain can be mild or debilitating, and it may interfere with your work, social life, and quality of life.
Also known as the lumbosacral joint, the L5-S1 spinal motion segment is the transition region between the lumbar and lower back sacral spine. Within this region, the curvature of the spine changes from forward curve (lumbar lordosis) to backward curve (sacral kyphosis).
The L5 to S1 spine carries the most support and has the most movement, making this area more prone to injury. The L5-S1 also helps transfer loads from the spine into the pelvis and legs.
The L5-S1 segment consists of the following structures:
The S1, also referred to as the sacral base, is the upper and wider end of the triangular-shaped sacrum. The S1 consists of a body on the top with wing-shaped bones (alae) on either side.
At the back, the s1 vertebra contains a long bony prominence called the median ridge. This ridge includes bony openings (foramina) on its right and left sides. The L5 and S1 are joined by the lumbosacral facet joints lined with articular cartilage.
The S1 and L5 discs protect the spinal vertebrae and nerves from sudden impact. They also absorb shock from movements of the spine like bending, twisting, and jumping.
Disc herniation occurs when the disc's outer wall, the annulus fibrosus develops traumatic tears (annular tears), allowing the jelly-like nucleus pulposus to push backward out of the tear into the spinal canal or neural foramen.
The part that pushes through the tear is the herniation. In many cases, this hernia can impinge on a nerve, giving rise to inflammation and irritation of the affected nerve.
Disc herniation is caused by several factors which can affect the joints individually or as a combination. The most prevalent of these factors is wear and tear in the spine. As humans age, the cartilage that connects the L5-S1 discs in the spine to the corresponding vertebrae members can become lax and lose elasticity.
Other factors include:
The most common symptom is sciatica, which is pain that radiates down the leg. Other L5-S1 disc herniation symptoms include:
If the L5-S1 herniated disc presses on the spinal cord or nerves, it can cause more severe symptoms such as:
L5-S1 herniated disc is common due to a combination of anatomical, physiological, and lifestyle factors.
Lifestyle and occupational factors which includes prolonged sitting or standing, heavy physical labor, and activities that involve repetitive bending or lifting can exacerbate the risk of herniation at this level. Furthermore, the L5-S1 segment's unique anatomical and biomechanical properties, such as the angle and motion at this joint, increase its vulnerability to degenerative changes and injuries. Conditions like osteoarthritis and spondylolisthesis commonly affect this area due to its high load-bearing function and susceptibility to wear and tear.
If you’re experiencing pain at the L5-S1 location, genetics, age, gender, weight, and nicotine use are among the well-identified risk factors for disc herniation, with genetic predispositions playing a crucial role in susceptibility. Certain genes related to collagen formation, L5 S1 disc degeneration, and inflammatory responses have been linked to an increased risk of herniation. The risk increases with age, particularly among individuals aged 30 to 50 years, and is more common in men than women. Obesity and smoking are also significant risk factors, as they can increase spinal load and reduce nutrient flow to the discs, respectively.
L5-S1 disc issues are categorized into several conditions, each with distinct characteristics and implications for spinal health:
Disc herniation occurs when the annulus fibrosus, the firm outer collagen wall of an intervertebral disc, develops traumatic tears (annular tear), allowing the hydraulic gelatinous core, known as the nucleus pulposus, to push backward out of the tear into the spinal canal or neural foramen. This L5 S1 disc protrusion, referred to as the herniation, can impinge upon nearby nerves, causing inflammation and irritation of the affected nerve. Factors contributing to disc herniation include spinal wear and tear, where the cartilage connecting the discs in the spine to the corresponding vertebrae members becomes lax and loses elasticity. Additionally, herniated discs can also result from sudden impact and trauma from accidents or falls.
A lumbar herniated disc which is also called a bulging disc L5 S1, slipped disc, or L5-S1 disc bulge – is a common but complex condition that affects everyone differently.
The most common cause of lumbar disc herniation is disc degeneration – a natural process that occurs with age – leading to dehydration and weakening of the spinal disc. These changes make the disc weak and reduce its ability to act as a shock absorber, making the outer ring more prone to tearing under pressure and the inner core more likely to progressively herniate over time.
Nerve Root Compression occurs when herniated disc material or bony overgrowths press on the spinal nerve roots. It can lead to L5 S1 nerve compression symptoms such as pain, numbness, tingling, and weakness along the nerve's pathway in the limb. In the L5-S1 region, such compression might affect the sciatic nerve, leading to L5-S1 nerve root compression symptoms like sciatica, characterized by sharp pain radiating down the back of the leg.
If you're experiencing L5-S1 disc herniation, this section explores effective treatment options and recovery timelines.
Disc herniation is a serious condition that can cause pain, numbness, and weakness. If the herniated disc presses on the spinal cord or nerves, it can cause more severe symptoms such as bowel or bladder control loss, paralysis, or difficulty walking.
Most cases of L5-S1 disc herniation can be treated with conservative measures such as rest, ice, and heat. Chiropractic care, physical therapy, and pain medication can also be helpful.
If the patient continues to have L1-L5 pain symptoms, doctors may prescribe medication such as non-steroidal anti-inflammatory drugs (NSAIDs) or steroids. Injection treatments such as nerve root L5 blocks can also help treat the condition.
Physical therapy may also be recommended to strengthen the muscles and ligaments around the spine.
If nonsurgical methods fail to provide relief from the pain, your doctor may recommend surgery. There are different surgery options available for patients who have been diagnosed with herniated discs.
When considering L5-S1 surgery, it is important to note that surgery usually involves reducing the compression on the nerve and eliminating the pain caused by the herniated disc. Patients should be aware that some surgical options carry more risk of complications than others. These complications could include infection or excessive blood loss and often tend to compromise the integrity of the spine and general patient wellbeing.
The surgical treatment selection typically depends on two factors; the associated symptoms and severity of the patient’s injury. These options range from minimally invasive surgical procedures to artificial disc replacements or spinal fusion in extreme cases.
Before a procedure is selected, patients are advised to consult a spine expert to conduct a full MRI scan and review, and allow for a thorough examination and subsequent localized diagnosis.
The most advanced surgery in the world for a herniated disc is the Deuk Laser Disc Repair.
This revolutionary procedure is Deuk Spine Institute’s specialized alternative to dangerous invasive surgeries like spinal fusion or total disc replacement. The laser disc repair does not weaken or compromise the health and integrity of the spine.
Our modernized approach to laser spine surgery has a 99.6% success rate with no complications in any patient over 15 years of performing this procedure and over 2,000 patients treated.
Deuk Laser Disc Repair surgery is a form of endoscopic spine surgery performed in our state-of-the-art surgery center under sedation while the patient relaxes. Through a ¼-inch incision, the injured disc is visualized using an endoscope and live imaging via a high-definition camera attached to the spinal endoscope.
With this method, Dr. Deukmedjian carefully eliminates only the injured disc tissue causing pain and discomfort and leaves the rest of the patient’s own natural disc in place to preserve spinal motion and function. Fusions and artificial discs are not necessary because the patient's repaired natural disc is left in place.
Deuk Laser Disc Repair uses a precision laser to vaporize the herniated tissue and provide the most effective laser spine surgery available. Bone and surrounding tissues are not damaged or removed during this procedure, unlike traditional microdiscectomy, artificial discs and spinal fusions.
Dr. Ara Deukmedjian uses FDA approved tools to access the disc through a natural space in the spine where he does not drill through bone as is done with microdiscectomy. Drilling through bone weakens the spine, which leads to future complications that may require fusion surgery.
Once the herniation and annular tear have been gently vaporized, the body can heal naturally. Irritation around the spine L5 S1 decreases, and neurological symptoms from L5 nerve root or S1 nerve root pressure subside. In time, the S1-L5 disc functions as it did before injury and herniation.
After surgery, patients wake up to immediate relief, with the L5 S1 nerve root compression symptoms gone, and a surgical scar so small the surgeon can cover it with a Band-Aid. Only a few drops of blood are lost and no hospitalization is required. All 2,000 Deuk Laser Disc Repair surgeries done to date have been outpatient with a 1 hour recovery.
A few exercises can help relieve the pain associated with L5-S1 disc herniation. However, it is important to talk to your doctor or physical therapist before starting any exercise program.
Stretching exercises can help improve flexibility and range of motion. Hamstring stretches, hip abductor/adductor stretches, and calf stretches are all helpful.
Aerobic exercises can help increase blood flow to the area and reduce inflammation. Walking, biking and swimming are all good options.
Strengthening exercises can help support the spine and reduce the risk of future injuries. Core strengthening exercises such as crunches and planks are particularly helpful.
Avoid any exercises that cause pain. If an exercise is painful, stop doing it and talk to your doctor or physical therapist. L5/S1 exercises to avoid include hamstring curls, sit-ups, and any other exercises that put a strain on the lower back if you're experiencing sciatica.
Lumbar disc conditions can be diagnosed through X-Ray, Magnetic Resonance Imaging (MRI), Myelogram, Computed Tomography Scan (CT or CAT scan), and Electromyography (EMG).
At Deuk Spine Institute, we specialize in minimally invasive surgical techniques and comprehensive L5-S1 spine treatments to cure back and neck pain. Our world-class physicians are personally invested in the well-being of every patient.
Start your treatment with us today by submitting your MRI online for a free remote review to determine your candidacy for surgery.
If you're dealing with L5-S1 disc herniation, choosing the right healthcare provider is critical. At Deuk Spine Institute, our focus is on healing your L5 S1 pain pattern permanently, not just offering temporary relief.
We recognize the significant impact of a doctor's expertise and care approach on your recovery process. That's why we're dedicated to providing treatments that seek to permanently eliminate your pain.
Start your treatment with us today by submitting your MRI online for a free remote review to determine your candidacy for surgery. During a Deuk Spine MRI review, you will be asked to include both your actual MRI images (DICOM format strongly preferred) and the report.
Once this is done, Deuk Spine Institute and our team of doctors will review it and provide a customized plan on how to eliminate your pain.
