The lumbar spine has five lumbar vertebrae which are numbered L1, L2, L3, L4 and L5. These vertebrae make up the lower back portion of the spine and are aligned in a reverse “C” like the cervical spine, creating a normal lumbar lordosis. The five lumbar vertebral bodies are the weight-bearing portion of the spine. The vertebrae are much larger in diameter compared to the thoracic and cervical vertebral bodies. The upper lumbar vertebrae, L1, meets the bottom of the thoracic vertebrae, T12, located below the shoulder blades and the lower vertebrae, L5, sit atop the sacrum, which is a triangular bone forming part of the pelvis.
The lumbar discs sit between the lumbar vertebra and a healthy disc is cushiony, with a lot of water, and has a sponge-like substance. It acts like a shock absorber in the spine, allowing flexibility and providing protection from jarring movements.
The lumbar spine’s lowest two spinal segments, L4-L5 and L5-S1, which include the vertebrae and discs, bear the most weight and are therefore the most prone to degeneration and injury. This is the reason why most disc problems (disc protrusion, discus prolapsed) occurs to the disc between L4 and L5 or to the disc between L5 and the sacrum (S1) and why it’s the area of the lower back most commonly affected by wear and tear/osteoarthritis.
The lumbar spine is built for both power and flexibility – lifting, twisting and bending and the joint between the L5 and S1 is of most importance as it allows for considerable rotation to enable the hips and pelvis to swing when the body runs or walks. Because of the anatomy and the importance of the lower part of the spine, this is an area of the spine which chiropractors treat very frequently and fortunately most of the problems here are mechanical in nature.
Mechanical back problems mean that the pain is coming from restricted or stiff spinal joints with overlying muscle spasm and back pain treatment often involves gentle adjustments to the back, stretching and soft tissue techniques to free up the restricted/stiff joints and relax the surrounding muscles.
There are nerves that branch off from the spinal column at each level of the spine. They pass through small holes in the back of the lower spine. They then connect together to form the sciatic nerve, which travels into the legs down the back of each thigh and into the calves and feet.
Sometimes degenerative disc diseases to the spinal structures or disc herniations can cause irritation to or put pressure on one of the nerve roots in the lower back. This is often referred to as sciatica. Spinal disc herniation pressing on one of the lumbar or sacral nerve roots is the primary cause of sciatica.
Sciatica is a relatively common form of low back and leg pain, but the true meaning of the term is often misunderstood. Sciatica is not really a diagnosis but more a set of symptoms caused by the nerve pressure/irritation and a patient’s pain and specific sciatica symptoms depends on where the injured/irritated nerve originates in the lower back.
Treatment for sciatica or sciatic symptoms depends on underlying cause and the level of pain. A thorough examination will determine this.
Sciatica can be caused by compression of the sciatic nerve roots by a herniated (torn) or protruding disc in the lower back, wear and tear/osteoarthritis, tightness of the piriformis muscle (piriformis syndrome), pregnancy and trauma.
Conditions often associated with the cervical spine that we treat include:
Low back pain, low back pain with pain radiating down the leg, trapped nerve in lower back, disc protrusion, disc herniation, pulled muscle, low back stiffness, sciatica, piriformis syndrome, hamstring problems caused by low back dysfunction, pain around the hip area.