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bulging disc L4/L5

Bulging Disc L4/L5 – Symptoms and Treatment

In my time as a sciatica specialist, I’ve helped countless individuals who are suffering from a bulging disc L4/L5. Although this isn’t the most common disc problem, it’s certainly one that gives people a lot of trouble. Let’s talk about what a bulging disc L4/L5 is, and how to fix it. 

What is a Bulging Disc L4/L5?

When we refer to a bulging disc L4/L5, we are talking about a problem with the spinal disc at the second-lowest level in the spine.

To understand this better, let’s talk a bit about the anatomy of the spine. Once you can picture the area of the body we’re referring to, you’ll be able to understand why you’ve got your symptoms and what to do about it!

 

The Human Spine

The human spine is made up of 24 vertebra (your “back bone”) which are funny shaped bones stacked on top of each other. These vertebrae start in the lowest part of your back and run all the way to the top of your neck.

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The top 7 vertebra in the spine are called the “cervical” vertebrae. These make up your neck. We call them C1, C2, C3 etc… All the way down to C7 at the base of the neck.

Your mid-back is made up of the 12 thoracic vertebra. These are called T1 to T12.

Your lower back is made up of 5 large lumbar vertebra. These are called L1 to L5. L5 is the lowest vertebra in the spine, while L4 is the second lowest vertebra.

Below that is your sacrum. Your sacrum is the funny shaped bone that joins the right and left parts of your pelvis together. Although the sacrum is one individual bone, there are 4 sets of nerves that exit the sacrum. We call these levels S1-S4.

 

The Spinal Discs

Between each vertebrae is a spinal disc – a tough sac made up of strong cartilage, filled with fluid.

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We name these discs based on the vertebrae above and below the disc. For example, if we are talking about the disc between L1 and L2, we would call it disc L1/L2.

So, when we are talking about disc L4/L5, we mean the disc in the spine that sits between L4 (second lowest vertebrae) and L5 (lowest vertebrae).

Although the discs are much stronger than a donut, it might help to imagine the design of the discs like a jam donut – made up of tough outer layers filled with fluid.

The discs are very important. They help the spine move normally. Without them, we couldn’t walk, stand or move our spines.

 

The Nerves and Spinal Cord

Inside the bones in the spine, there is a long hollow passageway. Through this passageway runs the spinal cord – the origin of all the nerves in our body.

From each level in the spine, a tiny portion of the spinal cord splits off and becomes a nerve. This nerve then leaves the spine and runs to a limb or other part of the body. The nerves are vital to human life – they allow us to move, feel, talk and digest food.

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Here, the nerve roots are labelled to illustrate how a disc bulge in close proximity can irritate them.

The longest nerve in the human body is the sciatic nerve. It leaves the spine near the bottom of the back and runs all the way down the back of the leg into the toes. It is around an inch in diameter and allows the legs to work normally.

 

What is a Bulging Disc L4/L5?

Over time, the discs in the spine can suffer normal wear and tear that occurs from repetitive movements throughout our lives. This process happens to everyone.

However, if one part of the disc has weakened more than others, it can lead to something called a disc bulge.

This describes the event where the strong outer fibres of the disc split and the inner part of the disc “bulges” out towards the nerve roots at the back of the spine.

In the image below, a disc bulge can be seen in the MIDDLE picture. (The end picture is a disc herniation – this is a worse version of a disc bulge).

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Here, you can see three disc bulges of different severity. The far right one is a herniated disc, while the middle picture is a disc bulge.

Because of how close the discs are to the nerves that we talked about earlier, a disc bulge can touch one of the spinal nerves, causing an array of symptoms along its course.

If the disc bulge touches the sciatic nerve, the symptoms that follow are called “sciatica”.

Because the L4/L5 disc is extremely close in proximity to the sciatic nerve, a disc bulge at this level often touches the nerve and causes sciatica.

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This is how a bulging disc L4/L5 can cause sciatica. 

 

What are the Symptoms of a Bulging Disc L4/L5?

There are a number of symptoms that can occur following a bulging disc L4/L5. They can be alarming and scary for anyone who first experiences them.

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Luckily, with this article, you’ll understand what’s normal and why you are going through these issues which will hopefully alleviate some of your concern.

 

Common symptoms of a bulging disc L4/L5:

  • Back Pain: Perhaps the most common symptom of a bulging disc L4/L5 is back pain. Now, although this may surprise you, not everyone experiences back pain with a bulging disc, but most people do. I was shocked at first when I would get clients who had a bulging disc yet no back pain whatsoever, but it is certainly possible. Most people who suffer a bulging disc at L4/L5 will experience an aching to sharp pain right across the lower back. It may be tender to touch and feel like the muscles are in spasm.
  • Sciatica: Sciatica is the word we use to describe the sensation of pain the runs down the back of the leg. It is usually shooting and can be severe – sometimes described by my clients as feeling like “being stabbed by a hot poker”.
  • Pain Down the Side of the Leg: Now, this is where a bulging disc L4/L5 differs from a problem with L5/S1. Because the nerves that start at L4 also supply the area on the outside of the leg, a disc bulge at L4/L5 can cause pain down the side of the leg and even onto the TOP of the foot. The pain will likely travel in a “spiral” type pattern, where it starts in the back and runs down the side of the leg into the top of the foot. This pain is similar in sensation to sciatica and can be equally as nasty.
  • Pins and Needles/Numbness: A bulging disc L4/L5 can cause sensory changes in the leg and foot. Usually, the funny sensations will be present in the foot and toes and for some people this symptom can be worse than the pain. This symptom happens because the bulging disc is pressing against the nerve in the spine which stops the nerve from doing its job correctly. This means that some signals don’t get through properly and sensation isn’t felt normally.
  • Weakness in the Legs: Now, this symptom can be alarming and you should definitely head to your doctor if you feel weakness in one or both legs along with any of the other symptoms on this list. Weakness in the legs (particularly thigh weakness with a bulging disc L4/L5) indicates a severe nerve compression. If this sounds like you, it needs addressing as soon as possible.

Less Common symptoms of a Bulging Disc L4/L5:

  • Leg shaking/spasms: Often confused with sciatica, these spasms cause the muscles to tense up and go into spasm. The best way to deal with this symptom is through a short course of muscle relaxants.
  • Problems with the Bladder and Bowel: This is an alarming symptom that needs addressing as quickly as possible by a doctor. This occurs when the nerves that allow the bladder and bowel to do their job are compressed by the bulging disc L4/L5. If you suffer from incontinence (accidents), not being able to “go” or not being able to feel when your bladder/bowel are full, you need to speak to your doctor as soon as you can.
  • Numbness in the Private Areas (or “Saddle” Region): This is another symptom that needs immediate investigation. Again, this indicates the lower nerves are compressed to the point that they can’t function properly. If this isn’t fixed soon, you might end up with a permanent problem.


What to Expect from a Bulging Disc L4/L5

When I worked in professional football, we would usually be able to tell the manager with reasonable accuracy exactly how long a player would be out for, depending on the injury he had.

For example, a mild ankle sprain would almost always be recovered by 3 weeks, while a hamstring injury might take 6 weeks.

However, with a disc injury, it isn’t possible to accurately predict how long someone will suffer for.

Almost always, the healthier you are in general, the faster you will get better.

Age also plays a role – people under 40 tend to recover a bit quicker than those over 40. However, other than that, bulging disc recovery time is difficult to predict.

As a general ball-park figure for you, most people SHOULD feel significantly better after 12 weeks following a bulging disc L4/L5.

However, many don’t. And when you’ve been in pain for a long time, the body undergoes some changes which make recovery slower and more difficult.

That’s why ACTION is key – when you make a commitment to getting better, and do all the right things each day, you can usually accelerate bulging disc recovery significantly.

 

Timeline for Recovery from a Bulging Disc L4/L5

Day 1 – Day 14

  • Expect to be in a LOT of discomfort. Even though staying active as much as possible is key, you’ll need plenty of rest… And that is OK!
  • You’ll need to look at HOW the problem started – were you lifting and shifting with poor technique? You’ll need to address this later in the process.
  • How’s your diet and sleep? The more sleep you get and the “cleaner” you eat (click HERE for info on the RIGHT foods to eat), the faster you’ll get better from here.
  • You may need a short course of pain killers to get through the worst bit.
  • It’s worth getting an assessment from a doctor, especially if you are worried about any of your symptoms.

 

Day 14 – Day 28

  • The pain may have started to ease a bit by now, but you’ll likely have incredible stiffness in the lower back. We need to start addressing that soon!
  • This is the stage where gentle movement is key – in the back, in the leg and getting out for a few walks if you can manage.
  • Make sure to stay hydrated here – when you aren’t fully hydrated, the discs don’t function or recover as well. Drink more water than usual.

 

Day 28 – Day 56

  • Keep going with your exercises, keep walking as much as you can.
  • Start a stretching program for your legs – click here for a simple stretching program you can use for sciatica relief at this stage.
  • Now’s a good time to address the problem that caused the bulging disc at L4/L5 – was it weakness in your back? Was it terrible technique? Was it your lifestyle and the fact that you’ve been generally unhealthy? Start addressing these things now.
  • Click here for a complete program that can help you address all the above and get back to normality!

 

Day 56 – Day 90

  • Now, you should start to be getting back to some normality, although you’ll still be feeling fragile.
  • You’ll need to take things easy – don’t rush back to anything. You should have someone who can help you at work when the pain starts to nag.
  • Don’t worry if you get occasional bad days – it’s normal! Recovery is hardly ever straightforward and few set backs aren’t uncommon.
  • Keep addressing the problem areas. If it’s weakness in your spine, you need to strengthen it. Don’t try and do this without guidance! Find a professional or invest in a proven system that works!

 

Treatment for a Bulging Disc L4/L5

So, when we talk about treatment for a bulging disc L4/L5, we need to split this category into two parts: Lifestyle and Exercise.

 

Treatment for a Bulging Disc L4/L5 Part #1 – Lifestyle

Diet

It’s crucial that you optimise your diet for a recovery from a bulging disc L4/L5.

This involves maximising anti-inflammatory foods: click HERE to learn more about anti-inflammatory foods for a bulging disc.

You’ll also need to minimise pro-inflammatory foods: click HERE to learn about which foods to AVOID when you have a bulging disc.

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General Activity

You need to keep generally active. This means not taking too much time off work.

You should try to walk as much as you can within the realms of comfort. Stop when pain starts, have a break, then get back to it.

One of my clients used to leave his house, walk up the road 100 yards, then come back. That was it for each day. But even those few hundred steps made a huge difference over a number of weeks.

Little and often is key – don’t overdo it. Make sure you stop as soon as your pain starts to worsen. Each day, you’ll be able to build your activity level gradually.

 

Hydration

Drinking plenty of water is absolutely crucial. When you have a disc bulge L4/L5 compressing a nerve, any dehydration in that disc will make the compression worse.

This means that drinking 3-4 litres of water each day is critical to your success and a highly undervalued facet of recovery.

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Sleep

Getting as much sleep as possible is incredibly important when you have a bulging disc L4/L5 (although, sciatica can make sleep more difficult unfortunately).

Sleep is one of the key parts of a recovery from a bulging disc – sleep is when healing occurs. It’s impossible to get better without enough sleep each night.

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One helpful tip to remember is that you can make up for lost hours of sleep as a nap if your pain tends to be worse at night. A 20-minute nap has been shown to be as effective as two hours of extra sleep in the morning in terms of restoration, some research shows.

Click HERE for a brief guide on sleeping better when you have sciatica.

Alternatively, follow this link here to view the 7 Day Sciatica Relief Plan – which includes an in-depth, highly effective guide to maximising sleep when you have sciatica.

 

Minimising Discomfort to Speed Up Recovery

Getting better from a bulging disc L4/L5 is just as much about avoiding making the problem worse as it is about doing extra things.

As a general rule of thumb, if an activity or position is making your pain worse, you need to change it or you run the risk of delaying your disc recovery time. 

 

Products That Can Help

For a bulging disc L4/L5, there are a number of products that can help you go about your day with less pain and more comfort. Here are a few of my top recommended products for herniated disc relief:

 

#1 – TENS Machine for bulging disc L4/L5

TENS machines are useful for providing relief from pain and muscle spasms in the back and legs. They are a safe and effective way of relieving your symptoms without any effort on your part.

Below are 3 of my top recommended TENS machines:

 

TENSCare Perfect TENS Pain Relief Machine

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This TENS machine for sciatica has 8 preset programs so you don’t need to “tune it” yourself – just pick a setting and off you go! There is an option to purchase a ‘Value Pack’ which includes spare pads which I would definitely recommend.

Click HERE to view the TENSCare Perfect TENS Pain Relief Machine on Amazon

 

SHANGPS TENS Machine for Pain Relief

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The SHANGPS design has revolutionized the way TENS machines are used for sciatica – meaning you can now get effective pain relief on the go. With its discrete design, you can easily conceal this under clothing and continue with your day to day tasks without having to stop and sit down to use a TENS machine for sciatica pain relief. Purchase with spare pads for the best value for money.

Click HERE to view the SHANGPS TENS Machine on Amazon

 

TPN 200 Plus TENS Machine

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A super-simple yet sleek design, this TENS machine is perfect for those who want a highly effective model and are confident with using a TENS machine for sciatica pain relief. This unit doesn’t have a fancy display, so you can customize the settings to best suit your needs, tweaking and changing the frequency until you find one that works best for you.

Click HERE to view the TPN 200 Plus TENS Machine on Amazon

 

#2 – Lumbar Roll

A lumbar roll is a specially designed cushion that goes behind your lower back when sitting.

It increases the curve in the lower back, which many people find takes pressure off a bulging disc in the lower back when sitting (which can be the worst position for a lot of people).

Here is a great option for a lumbar roll for the office, car and home:

herniated disc L5/S1,

Click HERE to view the Supportiback® Posture Therapy Lumbar Support Cushion on Amazon

 

#3 – Muscle Rub

A muscle rub or topical anti-inflammatory is a great first-line treatment for a bulging disc L4/L5. Although it won’t affect the actual disc itself, it will ease tension and pain from the muscles in the lower back and legs and can help to relieve symptoms associated with a herniated disc.

Here are the muscle rubs that my clients find most useful (I provide these Tiger Balm rubs to some of my clients as they are so effective in the first few weeks following a disc herniation):

herniated disc L5/S1,

Click HERE to view the Tiger Balm Muscle Rub on Amazon

Home Treatment for a Bulging Disc L4/L5 Part #2 – Exercise

The most important thing to understand when it comes to herniated discs and exercise is that everyone is different; a suitable exercise regime for one person with a bulging disc L4/L5 will be different for another with the same problem.

However, there are some exercises that are commonly useful for many people with herniated discs. Only choose the ones from the following list that are non-painful and don’t make your symptoms worse during and after you finish the exercise.

Always go gently at first and build up slowly.

 

#1 – Cobra Pose

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Instructions:

  • Begin laying face-down on a firm surface like a mat on the floor or a hard mattress
  • Place your hands in line with your shoulders and gently push up, raising your torso off the floor
  • Keep your hips down on the floor
  • Only go as far as is comfortable – no need to get to full extension for a benefit!
  • Gently lower yourself to the starting position and repeat up to a maximum of 10 times.
  • Do a set of these 3-4 times per day

Who this is for:

Usually, people suffering with a bulging disc L4/L5 find this exercise one of the most useful for improving their symptoms. However, regardless of what is causing your sciatica, you should only persist with this exercise if it is comfortable to perform this movement. This exercise is a good place to start if you have trouble bending forward.

Why this sciatica exercise works:

This sciatica exercise works because it involves movement of the lower back which encourages blood to flow to the injured area so healing can occur. Some researchers also believe this exercise causes a disc bulge to “centralise” into the disc where it can’t pinch on a nerve root.

#2 – Knee Rolls

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Instructions:

  • Lie on your back on a mat or a firm mattress
  • Bend your knees up halfway
  • Slowly and gently, allow both knees to roll over to one side only as far as is comfortable
  • Bring your knees back to the start position, then allow them to roll over to the opposite direction
  • Repeat for 30-seconds total, don’t rush the repititions and try to find a rhythm
  • Try to find time to do this exercise every 2-3 hours if you can

Who this is for:

This sciatica exercise is great for relieving any tension in tight muscles in the lower back. It is also a great way to begin to regain any lost rotation in the lower back following a bulging disc L4/L5.

Why this sciatica exercise works:

By gently encouraging a slow, controlled rotation of the lower back, the muscles in your lower back will realise that it is OK to relax a little. This will bring about herniated disc pain relief.

 

 

#3 – McKenzie Side Bends

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Instructions:

  • Start standing next to a wall. Most people prefer to do this exercise with their painful leg being the one FURTHEST AWAY from the wall. However, try both sides and see which one is most comfortable for you – stick with that one.
  • Use your elbow and forearm to support yourself so you are leaning on the wall (1st picture)
  • Slowly and gently, let your hips “glide” towards the wall while keeping your feet in the same position.
  • Only go as far as is comfortable, then return to the start position.
  • Repeat this 10 times, have a break, and do 3 sets total.
  • If this exercise has worked for you, you may feel rapid relief in the painful leg and possibly slightly worsening back pain – rest assured this is a normal phenomenon.

Who this is for:

This exercise works really well for disc problems and is a mainstay for a treatment approach called “McKenzie”. If you have pain in one leg only from a disc bulge or prolapse, try this exercise.  It brings significant sciatica pain relief to many people and can work rapidly.

Why this sciatica exercise works:

The McKenzie approach claims to work by encouraging the disc material called the “nucleus pulposus” to re-centralise into it’s inner middle. Whether or not this actually occurs hasn’t been proven in scientific literature but I have seen this exercise provide relief for many. Be sure to choose the direction that is least painful when performing this sciatica exercise.

 

 

#4 – Standing Extension

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Instructions:

  • Start standing normally.
  • Gently try to lean back. Only go as far as is comfortable.
  • If you feel able to, use your hands to provide support in the lower back allowing you to extend further (3rd picture)
  • Slowly return to the start position
  • Perform up to 10 repetitions, every few hours or so. Cut your set short as soon as you reach the first signs of pain.

Who this is for:

This is a great sciatica exercise for a bulging disc L4/L5 as well. It works especially well for people who have trouble leaning forward and is a more user-friendly/convenient version of #1 on this list. However, I find it to be slightly less effective compared to the Cobra pose as I find people tend to rely more on pelvic rather than spinal movement with this one. You should AVOID this exercise if you suffer from arthritis of the lower back or spinal stenosis.

Why this sciatica exercise works:

This exercise works in a similar way to #1 – it involves movement of the lower back, encouraging blood to flow to the injured area so disc healing can occur. This exercise may help a herniated disc to “centralise” into the inner disc where it can’t pinch on a nerve root.


 

Other Treatment Options for a Bulging Disc L4/L5

Very rarely, surgery is required for a bulging disc. This intervention is reserved for those who have tried everything else and are still suffering.

It’s important to exhaust all non-surgical methods first, as you can’t reverse a surgery and the results from surgery are often underwhelming. Occasionally, surgery can make someone worse which is obviously devastating to hear about.

Another option is an injection, which can give pain relief down the course of the sciatic nerve.  From my experience, these have very underwhelming results for most people. However, they can occasionally be effective.

 

My Final Recommendations for a Bulging Disc L4/L5

If you’re currently suffering with a bulging disc L4/L5, don’t try and go through it alone!

If you want a step-by-step guide to getting better, consider trying The 7 Steps to Overcome Sciatica; my home program that has been proven to help people all over the world looking to recover from a disc bulge in a 100% natural way.

The 7 Steps to overcome sciatica sciatica pain relief

You can view The 7 Steps to Overcome Sciatica by clicking HERE.

 

Conclusion

I hope you’ve found this article helpful. I think it’s useful to understand exactly why you’re suffering the way you are right now from that bulging disc L4/L5, so the symptoms make more sense. I also hope you find some of the exercises in this article useful.

Remember, getting better from a bulging disc is just as much about managing your day in a way that doesn’t make the symptoms worse as it is about doing exercises to fix it.

What did you think of this article? Was it useful? Leave me a comment below and let me know!

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