Pain of the lower spine:
Throughout our lives, we make countless numbers of movements with our spine that have a harmful effect on the intervertebral structures. This harmful effect is associated with the way in which the intervertebral disc responds to flexing movements of the spine, moving in the opposite direction to the vertebrae. It increases the pressure inside the disc as the vertebrae move closer to each another on one side. The most frequent movement that we have to make is bending our trunk forward. As we bend forward, the disc moves backwards, compressing the root structures. This is a direct cause of pain, which may be localized in different parts, depending on the degree of disc translocation inside the annulus fibrous, and consequently on the degree of compression of the nerve root. Pain is not confined to the spine since it may radiate to the buttocks or thigh or even to the foot. Some people may also experience local dysaphia. The location of these pains depends on the spinal section that is under compression. If dislocation takes place in the disc between the 4th and 5th lumbar vertebrae (L4 – L5), it will cause compression of the 5th lumbar root (L5). Other spinal regions are affected in a similar way.
Neurological changes caused by compression of a given root:
| Dislocation level | Pain area | Dysaphia | Muscular paresis |
| L3 – L4; pressure on the 4th lumbar root | Lower parts of the spine, anterior surface of the thigh and lower leg | Anterior and medial surface of the thigh and knee | Weakened quadriceps muscle of the thigh |
| L4 – L5; pressure on the 5th lumbar root | The area over the sacroiliac joint, lateral surface of the thigh and lower leg | Lateral surface of the thigh and the big toe and medical surface of the 2nd toe | Weakening of flexor muscles of the foot – difficulty in walking on the heels, possible foot drop |
| L5 – S1; pressure on the 1st sacral root | The area over the sacroiliac joint, postero-lateral surface of the thigh and lower leg, heel | Posterior surface of the lower leg, lateral surface of the foot | Weakening of flexor muscles of the sole – difficulty in walking on the toes |
The mechanism that triggers disc dislocation is very simple, but its symptoms produce a varied clinical picture. That is why a decision on an appropriate form of treatment should be preceded by a careful evaluation of pain characteristics.
Doctors warn that nearly 90% of the human population experience spinal pain at least once in their lifetime. Prophylaxis is essential to prevent these conditions and their recurrence. Unfortunately, the fast pace of modern life makes it easy to forget about these basic health matters. The most frequent cause of spinal pain is an event which had a direct effect on our spine. During the day we usually bend our trunk forward with our legs straight. This is a dangerous movement, because it may place great pressure on the lumbar section of the spine, exerting a huge force on the nucleus pulposus and leading to its dislocation, and consequently to pain complaints. Therefore we should pay attention to the way in which we bend, lift objects, stand up or sit down. These activities are repeated frequently during the day and may lead to ailments, if done incorrectly. For this reason it is worth learning the proper techniques for performing these activities.
Here are some simple tips on how to minimize the risk of pain:
1. Never lean forward with your legs straight
2. Always remember to maintain a proper spinal posture
3. Avoid straightening up or bending abruptly, especially when combined with a lateral twist of the trunk
4. Do not lift weights exceeding 15 kg
5. Weights should be lifted with a smooth movement, by straightening the knees
6. Stand with your feet apart
7. Take care when sitting down or getting up from a chair or bed, avoid sudden movements
8. Get up from the bed from a lateral position, leaning on your hands. Maintain a proper spinal posture as you lower bent legs to the floor
Following these simple rules will relieve pressure on the spine and enable us to avoid these unwanted pain episodes.
Sources: 1. Orthopaedics and Rehabilitation of Wiktor Dega; edited by W. Marciniak; A. Szulc; author: Doctor of Medicine A. Nowakowski; title: Sacralgia
2. Orthopaedics and Rehabilitation of Wiktor Dega; edited by W. Marciniak; A. Szulc; author: Dr. T. Stengert; title: McKenzie’s Method in the Diagnosis and Treatment of Sacralgia of Mechanical Origin
