L4-L5 Herniated Disc: Symptoms & Treatment Options – Kearny Mesa, San Diego

An L4-L5 herniated disc can show up in ways that don't always make sense at first.

Your lower back may hurt, but sometimes that's not even the worst part. You may have pain deep in one buttock, burning down the leg, tingling into the foot, or a patch of numbness that wasn't there before. Sitting in the car can be worse than walking. You may feel pretty decent for the first hour of the morning and terrible by the afternoon.

Some patients describe the leg as feeling “tight” no matter how much they stretch it.

Others say something more concerning:

“My leg just doesn't feel as strong as it used to.”

Dr. Cassidy James Boelk, DC sees these types of patients every week at The Spinal Decompression & Chiropractic Center of San Diego in Kearny Mesa.

He has worked with herniated discs, bulging discs and sciatica for more than 22 years, and one of the first things he explains to patients is that an MRI finding by itself doesn't decide the treatment.

An L4-L5 herniation does not automatically mean surgery.

It also doesn't mean everyone should have spinal decompression.

First, Dr. Boelk needs to figure out whether the disc seen on the MRI actually fits the symptoms the patient is describing.

When a Disc Problem Starts Taking Over Your Life

Calder Pearce had been dealing with lower-back problems for more than five years. He had already seen six other doctors because he was trying to find an option other than surgery.

By the time he came to Dr. Boelk's office, he couldn't bend normally and was walking with a limp.

⭐⭐⭐⭐⭐ Calder Pearce — San Diego, CA

“Dr. Boelk and his team are the best in the business! I have had lower back problems for over 5 years and been to 6 other doctors seeking options other than surgery. I came in early January not able to bend and walking with a limp. By February I was able to bend again with minimal pain and by March I am now able to bend without any pain and am able to walk normally.

I am EXTREMELY happy I did not have surgery and found Dr. Boelk. Trust him and the process and he will get you feeling better. He also said from the beginning that if at any stage in the process he felt like progress wasn't happening he would let me know which was not the case with other specialist I have seen in the past so I appreciate that.”

— Calder Pearce, San Diego, CA

Calder's results are his results. Nobody should read a testimonial and assume the same thing will happen to them.

But the last part of what he said is important.

If a patient isn't progressing the way Dr. Boelk expects, that matters. Treatment shouldn't just continue indefinitely because somebody bought a package.

If You Already Have an MRI, Bring It In

The office is located right in Kearny Mesa at 5095 Murphy Canyon Road, and patients can schedule a No-Charge, No-Obligation Consultation with Dr. Boelk.

Bring the MRI images if you have them. X-rays and previous reports are helpful too.

Dr. Boelk will want to know where the pain goes, whether the leg or foot is numb or tingling, what happens when you sit or drive, whether you are sleeping, whether you are noticing weakness, and what you have already tried.

Sometimes the MRI explains the symptoms beautifully.

Sometimes it doesn't.

And sometimes a patient comes in convinced the problem is L4-L5 because that's what the report says, but there are other findings that need to be considered.

There is no obligation to start treatment. Not everyone is a candidate for Non-Surgical Spinal Decompression.

Phone: 619-298-0800

“Why Does My Leg Hurt if the Disc Is in My Back?”

This is one of the most common questions patients ask.

It makes sense. If you injure your knee, your knee hurts. So if you injure a disc in your lower back, shouldn't the pain stay in your lower back?

Not necessarily.

The nerves leaving the lower spine continue into the legs. If disc material is irritating or compressing one of those nerves, the patient can feel symptoms somewhere along that nerve pathway.

That's why someone can have an L4-L5 disc problem and come into the office talking mostly about the leg.

They may describe pain, burning, tingling, numbness, or weakness.

And two patients with what sounds like the same MRI diagnosis can feel completely different.

One patient has mostly back pain.

Another has buttock and leg pain.

Another says the pain isn't terrible anymore, but part of the foot is numb.

Another is much more concerned because the leg feels weak.

Those aren't details to brush aside. They help determine what may actually be happening.

A Few Things You Can Try at Home

Patients frequently ask Dr. Boelk what they should be doing between appointments or while deciding whether they need an evaluation.

There isn't one set of exercises that is right for every herniated disc, so be careful about randomly copying someone's “best disc exercise” from the internet.

There are, however, a few basic things worth paying attention to.

Don't sit for three hours if sitting clearly makes you worse.

It sounds obvious, but people do it all the time. They work through the pain until the leg is throbbing or numb and then spend the rest of the day trying to calm it down.

If your symptoms allow it, get up periodically and move around.

Take a look at your car seat.

If your seat is extremely low, your knees are significantly higher than your hips, and your lower back is rounded while you drive, try changing the setup.

You don't need to sit rigidly upright like you're standing at attention. Just find a supported position that doesn't fold you into the seat.

Be careful with aggressive hamstring stretching.

This is probably one of the more common mistakes Dr. Boelk sees.

The back of the leg feels tight, so the patient keeps stretching harder and harder.

But an irritated sciatic nerve can feel “tight.”

If stretching causes the pain or tingling to shoot farther down the leg, stop assuming that more stretching is the answer.

Walk if walking feels good.

You don't necessarily need to lie in bed because you have a disc herniation. Short, comfortable walks can be helpful for many people.

But again, listen to what the leg is telling you.

A little muscular soreness is one thing. Increasing numbness, weakness, or pain traveling farther down the leg is something else.

Don't Get Too Hung Up on the Millimeters in Your MRI Report

Patients come in worried about whether their herniation is 3 mm, 5 mm, or 7 mm.

Size is useful information.

It isn't the whole story.

A smaller disc problem sitting right where a nerve has very little room can cause tremendous symptoms. Another person may have an MRI with multiple bulges and degenerative changes and still function fairly well.

Dr. Boelk looks at where the disc material is, how much space is available around the nerve, what else is happening at that spinal level, and whether those findings fit the patient's symptoms.

The written MRI report is useful, but when possible Dr. Boelk prefers to look at the actual images too.

What Can You Do Before Considering Surgery?

Plenty, depending on the situation.

Some L4-L5 herniations improve with time and sensible activity modification.

Physical therapy and rehabilitation may help restore movement and strength. Medication can sometimes make an acute episode more manageable. Epidural injections may be recommended in certain cases to help control inflammation and nerve pain.

And some patients may be candidates for Non-Surgical Spinal Decompression.

The key word is may.

A treatment that makes sense for a 35-year-old with a disc protrusion and leg pain may make no sense for another patient with instability, severe osteoporosis, progressive weakness, or certain previous spinal surgeries.

What Dr. Boelk Does Differently With Spinal Decompression

The Kearny Mesa office exclusively uses the DRX9000 for lumbar Non-Surgical Spinal Decompression.

There are four lumbar DRX9000 systems in the office and three cervical DRX9000C systems.

But patients sometimes put too much emphasis on the machine.

The DRX9000 is a tool.

It still takes someone to decide whether to use it, how to use it, and when not to use it.

Dr. Boelk looks at the disc level, symptoms, MRI findings when available, body size, positioning, treatment angle, starting force, tolerance, and how the patient responds.

The settings can be changed as the patient progresses.

That is very different from assuming everyone with an L4-L5 herniation gets the exact same treatment.

People Actually Travel Here for This Care

Dee M. lives in Peoria, Arizona. Her testimonial is short, but it says a lot about why patients with long-standing lower-back problems seek out a practice that focuses heavily on spinal decompression.

⭐⭐⭐⭐⭐ Dee M. — Peoria, AZ

“Dr Boelk is highly knowledgeable and has made a difference in my life.

I have a degenerative bone issue in my lower back. Spinal decompression is the only way that gives me relief all the way to my feet. I highly recommend
the Spinal Decompression center.”

— Dee M., Peoria, AZ

Dr. Boelk has also treated patients who have traveled from Alaska, Nevada, the Imperial Valley, and even outside the United States.

That doesn't mean someone should travel across the country simply because an MRI says L4-L5.

It means patients sometimes seek out doctors whose practices spend a significant amount of time dealing with the specific problem they have.

Why Patients Seek Out Dr. Cassidy James Boelk, DC

Dr. Boelk has been working with Non-Surgical Spinal Decompression for more than 22 years and has performed more than 100,000 spinal decompression treatments.

He is a Certified Spinal Decompression Doctor and Certified Pain-Free Performance Specialist, and he founded the Non-Surgical Spinal Decompression Training Academy, where he trains other doctors in spinal decompression protocols and techniques.

He is also a Founding Member of the American Spinal Decompression Society and a member of the International Disc Education Association.

His interest in this area started long before he opened the Kearny Mesa office.

Dr. Boelk suffered an L5 compression fracture when he was 16 and later dealt with disc injuries and sciatica himself.

So when someone says:

“I don't care what the MRI is called. I just want to be able to sit, sleep and exercise normally again.”

He understands that.

Because ultimately that's what most patients care about too.

Sometimes Dr. Boelk Says No

This part probably doesn't get talked about enough with spinal decompression.

Not everyone should have it.

Toni W. traveled from Lake Elsinore to see Dr. Boelk. She had extensive hardware from previous back surgery.

After evaluating her situation, Dr. Boelk did not recommend his decompression program.

Here is what she said afterward:

⭐⭐⭐⭐⭐ Toni W. — Lake Elsinore, CA

“Very nice Dr. and Honest ! I would definitely recommend anyone who hasn't had metal put in there back in a surgery to go to him and give his program a shot. I believe it would definitely help. Just not in my personal case. As I have a lot of hardware in my back. But I'm glad I took the time to meet with him. It was very informative all around.”

— Toni W., Lake Elsinore, CA

That testimonial is important because a consultation isn't supposed to end with everybody becoming a patient.

Dr. Boelk screens for conditions that can make lumbar decompression inappropriate, including certain surgical hardware at the treatment level, unstable spondylolisthesis, unhealed fractures, significant osteoporosis, abdominal aortic aneurysm, pregnancy for lumbar treatment, certain malignancies, cauda equina syndrome, and other conditions that may make treatment unsafe.

Progressive neurological weakness is also something he takes seriously.

Sometimes another doctor needs to be involved.

Sometimes additional imaging is necessary.

And sometimes surgery really is the appropriate option.

One Thing Dr. Boelk Doesn't Want You to Ignore

Pain gets people's attention.

Weakness should too.

If your back hurts terribly but your strength and neurological function are stable, there may be time to consider different conservative options.

If the leg is becoming progressively weaker, that's different.

And there are certain symptoms that should be evaluated urgently rather than waiting for a routine office visit:

• New loss of bowel or bladder control

• Difficulty starting urination

• Numbness around the groin or saddle area

• Rapidly progressing leg weakness

• Sudden loss of control of the leg or foot

If that is happening, seek prompt medical attention.

What Does Getting Better Actually Mean?

Dr. Boelk doesn't think the finish line should simply be:

“My pain went from an 8 to a 2.”

That's important, obviously.

But can you sleep?

Can you put your shoes on?

Can you drive?

Can you sit through dinner?

Can you walk normally?

Can you pick up your child?

Can you work?

Can you get back into the gym?

Can you surf, golf, run, hike, travel, or do whatever it is that makes you feel like yourself?

Once symptoms begin settling, rehabilitation and gradually rebuilding function become increasingly important.

The spine eventually has to live in the real world again.

If You're Dealing With an L4-L5 Herniated Disc in Kearny Mesa

You don't have to decide today whether you need spinal decompression, an injection, physical therapy, or surgery.

Start by figuring out what is actually going on.

Patients can schedule a No-Charge, No-Obligation Consultation with Dr. Cassidy James Boelk, DC.

Bring your MRI images, X-rays, and reports if you have them. If you don't have imaging, that's okay too.

Dr. Boelk can go through your symptoms, what you've already tried, your available imaging, and whether Non-Surgical Spinal Decompression may make sense.

If he doesn't believe you're a candidate, he'll tell you.

The Spinal Decompression & Chiropractic Center of San Diego
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123

Phone: 619-298-0800
www.SanDiegoBackCare.com

Live 24/7 Answering Service • Hablamos Español

Call 619-298-0800 for a No-Charge, No-Obligation Consultation.