L4-L5 Herniated Disc: Symptoms & Treatment Options – Poway, CA

An L4-L5 herniated disc can start as what feels like a simple lower-back problem and turn into something much more disruptive.

The back may feel stiff or painful, but once a nerve becomes irritated, patients can develop pain into the glute or leg, sciatica, burning, numbness or tingling, and sometimes weakness. Sitting at a desk or driving may become difficult. Sleep can be interrupted. Exercise gets put on hold. Some patients find themselves planning their entire day around what their back or leg will tolerate.

Dr. Cassidy James Boelk, DC has treated patients with lumbar disc injuries and sciatica for more than 22 years. At The Spinal Decompression & Chiropractic Center of San Diego, one of the most common concerns he hears after someone receives an MRI is:

“I have a herniated disc at L4-L5. Does this mean I'm eventually going to need surgery?”

Not necessarily.

Many lumbar disc problems are treated without surgery. The important part is determining what is actually causing the symptoms, whether a nerve is involved, whether there is any neurological loss, and which treatment makes the most sense for that particular patient.

When Back Pain Becomes More Than Just Back Pain

Kaitelyn H. described how much her back problem was affecting her daily life before coming to Dr. Boelk's office.

⭐⭐⭐⭐⭐ Kaitelyn H. — San Diego, CA

“The care I received at Dr. Boelk’s office was so wonderful. I went from having to lay down for several hours a day, to being able to live my life normally, and even began working up my exercise capacity. I always felt cared about, and there was a lot of feedback. The exercise and information Dr. Boelk provides is so critical to maintaining positive results and pain reduction with increased mobility and freedom. All the staff are so caring, and it’s one of the best decisions I made for my back!”

— Kaitelyn H., San Diego, CA

Her comments also touch on something Dr. Boelk believes is important: treatment should not be only about what happens while the patient is lying on a decompression table. Education, appropriate exercise and gradually getting the body moving normally again are important parts of the process.

No-Charge Consultation for Poway Patients

Patients from Poway can schedule a No-Charge, No-Obligation Consultation with Dr. Boelk at his San Diego office.

If you already have an MRI, bring the images and report. Previous X-rays and other imaging can be helpful as well.

Dr. Boelk will want to understand:

• Where the pain starts and where it travels

• Whether symptoms are on one side or both

• Numbness, tingling or burning

• Any weakness in the leg or foot

• What happens when you sit, stand, walk or drive

• Whether pain is interfering with sleep

• How the injury began

• Previous back injuries or surgery

• Treatments already tried

• Which treatments helped and which did not

Dr. Boelk can then compare the history and symptoms with the imaging and determine whether Non-Surgical Spinal Decompression may be appropriate.

Not every patient is a candidate, and there is no obligation to begin treatment.

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

What Happens When the L4-L5 Disc Herniates?

The L4-L5 disc sits between the fourth and fifth lumbar vertebrae. It is one of the lower lumbar discs and is involved in a tremendous amount of normal movement and loading.

When the outer fibers of a disc become damaged, the softer material inside can begin pushing outward. Depending on the degree and shape of the injury, an MRI may describe the disc as bulging, protruded, herniated or extruded.

The MRI may also mention an annular fissure, foraminal narrowing, spinal canal narrowing or nerve-root involvement.

The terminology can sound frightening when a patient reads the report for the first time, but the report is only one piece of the evaluation.

Dr. Boelk wants to see where the disc material is located and whether that location corresponds with what the patient is feeling.

A larger herniation isn't automatically more painful than a smaller one. Location, available space around the nerve, inflammation and other changes in the spine can all influence symptoms.

Common L4-L5 Symptoms

Patients with an L4-L5 disc problem may experience:

• Lower-back pain or stiffness

• Pain on one side of the lower back

• Glute pain

• Sciatica or pain traveling down the leg

• Burning or electrical sensations

• Numbness or tingling

• Symptoms extending toward the lower leg or foot

• Weakness in the leg or foot

• Difficulty sitting for longer periods

• Increased symptoms while driving

• Difficulty finding a comfortable sleeping position

The back doesn't always hurt the most.

Some patients come into the office because the leg pain has become unbearable even though the lower back itself is reasonably tolerable. Others are more concerned about numbness or weakness than pain.

That is possible because the lumbar nerves travel into the lower extremities. Irritating a nerve near the spine can create symptoms farther along that nerve.

Pay Attention to Weakness, Not Just Pain

Patients naturally judge their condition by how badly it hurts.

Dr. Boelk also wants to know what is happening with strength.

A painful leg and a progressively weakening leg are not the same situation.

If you notice that one leg suddenly feels different going up stairs, your foot isn't moving normally, you are stumbling more often, or a movement that was previously easy is becoming difficult, tell the doctor evaluating you.

Progressive neurological weakness may change the treatment recommendations and should not simply be ignored while waiting for the pain to improve.

What Can You Do at Home?

There isn't one perfect exercise for every L4-L5 herniation. The better starting point is often identifying what repeatedly aggravates the symptoms.

Break up prolonged sitting

If sitting causes the pain to build into the glute or leg, change positions before it becomes severe.

Stand up periodically and walk for a few minutes if walking is comfortable. This can be especially useful for people who spend much of the day at a desk.

Look at how you're sitting in the car

Poway patients who commute can spend a considerable amount of time sitting in traffic.

If the seat is very low and your knees are significantly above your hips, the lower back may stay in a flexed position for a long period. Try adjusting the seat so the spine feels supported and you aren't folded forward.

The best position is one that is comfortable and doesn't steadily increase your symptoms.

Be careful with aggressive stretching

A common mistake with sciatica is assuming that the leg hurts because the hamstring needs to be stretched.

An irritated nerve can create a strong feeling of tightness.

If stretching causes pain, numbness or tingling to travel farther down the leg, don't keep forcing the stretch.

Use comfortable movement

If walking feels good, short walks can be a simple way to keep moving during a flare-up.

You don't need to prove anything by walking through increasing leg pain. Start with what is comfortable and pay attention to the response.

Keep track of what changes the symptoms

You don't need an elaborate journal. Just start noticing patterns.

Does sitting make the leg worse? Does walking settle it down? Does bending forward aggravate it? Does the foot become numb after driving? Is sleep getting worse? Is the pain moving farther down the leg?

Those details can be extremely useful when Dr. Boelk evaluates the condition.

Can an L4-L5 Herniated Disc Get Better Without Surgery?

Yes, many lumbar disc herniations are managed without surgery.

Depending on the case, conservative treatment may involve:

• Activity modification

• Medication

• Physical therapy

• Progressive rehabilitation

• Epidural steroid injections

• Non-Surgical Spinal Decompression

These aren't interchangeable treatments, and not everyone needs all of them.

Someone with pain but normal neurological function may be approached differently from a patient whose leg or foot is becoming progressively weaker.

Dr. Boelk is not opposed to spinal surgery when it is necessary. His concern is making sure patients understand whether a reasonable nonsurgical approach exists before assuming surgery is their only choice.

Non-Surgical Spinal Decompression With the DRX9000

Dr. Boelk's office exclusively uses the DRX9000 for lumbar Non-Surgical Spinal Decompression.

The office has four lumbar DRX9000 systems and three cervical DRX9000C systems.

During lumbar treatment, the DRX9000 uses controlled decompression and relaxation cycles. Treatment is not simply based on putting every L4-L5 patient on the same settings.

Dr. Boelk considers the patient's size, disc level, symptoms, MRI findings when available, positioning, treatment angle, starting force, tolerance and response as treatment progresses.

After more than 100,000 decompression treatments, Dr. Boelk places a great deal of importance on the protocol and patient selection—not simply the name of the machine.

Rosa Traveled From Calexico for Treatment

Rosa Algravez had dealt with leg numbness and lower-back pain for four years and had already tried several other approaches.

⭐⭐⭐⭐⭐ Rosa Algravez — Calexico, CA

“Hi my name is Rosa Algravez. I have suffered from leg numbness and low back pain for 4 years. I haven’t been able to do groceries or even take baths without pain. I looked for relief with various doctors with no luck. I have done treatments ranging from chiropractic to acupuncture. My husband found Dr. Boelk in the newspaper and we decided since we had tried everything else that we were going to give this a try. After my first few treatments, I feel as though I have returned to 100%. Life for me is completely different.

My husband and I have returned to enjoying life. We travel 300+ miles everyday from Calexico. I can do things now with little to no limitations. The staff makes you feel welcomed and it’s a very family environment. The payments are easy and I would recommend this to anyone suffering with low back pain. Thank You”

— Rosa Algravez, Age 58, Calexico, CA

Patients have traveled to Dr. Boelk's San Diego office from throughout Southern California and from other states and countries. That isn't necessary for everyone, but it reflects the fact that the practice has spent more than two decades developing a heavy focus on spinal decompression and difficult disc-related conditions.

Why Patients Seek Out Dr. Cassidy James Boelk, DC

Dr. Boelk's background includes:

• Doctor of Chiropractic

• Certified Spinal Decompression Doctor

• Certified Pain-Free Performance Specialist

• More than 22 years of clinical experience

• More than 100,000 spinal decompression treatments performed

• Founder, Non-Surgical Spinal Decompression Training Academy

• Trains other doctors in spinal decompression protocols and techniques

• Founding Member, American Spinal Decompression Society

• Member, International Disc Education Association

• California X-ray radiography credentials

• Seven DRX9000 spinal decompression systems

His experience with spinal injuries also began personally.

Dr. Boelk suffered an L5 compression fracture at age 16 and later experienced disc injuries and sciatica. He has spent years working on rehabilitation, exercise and ways to remain active despite a history of spinal injury.

That background has influenced the way he treats patients today. Getting someone out of pain is important, but the bigger objective is helping the patient return to the things the back problem has taken away.

Sometimes the Right Recommendation Is Surgery

Jeff J. came all the way from Tucson after finding Dr. Boelk's office online.

After the evaluation, he and Dr. Boelk determined that conservative spinal decompression was not the appropriate answer for his back problem.

⭐⭐⭐⭐⭐ Jeff J. — Tucson, AZ

“I found this terrific practice on social media. I followed up and did my own research so I decided to pay them a visit. The place is clean, well organized and run by a very efficient receptionist. I met with the doctor and after a honest and forthright conversation, we both determined that surgery was my only option to correct my back issues. I will return as a customer when the time is right.”

— Jeff J., Tucson, AZ

Dr. Boelk believes knowing who not to treat is an important part of providing spinal decompression.

Conditions that may make lumbar decompression inappropriate or require further evaluation can include:

• Unstable spondylolisthesis

• An unhealed spinal fracture

• Significant osteoporosis

• Abdominal aortic aneurysm

• Pregnancy for lumbar treatment

• Certain malignancies

• Certain surgical hardware at the treatment level

• Progressive neurological weakness

• Cauda equina syndrome

• Other conditions that could make treatment unsafe

If Dr. Boelk doesn't think decompression is appropriate, he tells the patient.

Know When It's More Than a Routine Disc Flare-Up

Most people with back pain or sciatica do not have a medical emergency.

There are some symptoms that should be evaluated promptly:

• New bowel or bladder dysfunction

• Difficulty urinating

• Numbness around the groin or saddle region

• Rapidly progressing leg weakness

• Sudden loss of control of the leg or foot

Don't wait for a routine decompression consultation if those symptoms develop.

L4-L5 Herniated Disc Evaluation for Poway Patients

If you are dealing with an L4-L5 herniated disc and the symptoms are affecting your sleep, work, driving, walking or ability to exercise, it may be time to have the condition properly evaluated.

Bring your MRI images, X-rays and reports if you have them. If you don't have imaging, Dr. Boelk can determine whether additional imaging may be appropriate.

The consultation with Dr. Boelk is No-Charge and No-Obligation.

He will review what is going on, what you have already tried and whether Non-Surgical Spinal Decompression may be an option.

Not every patient is a candidate.

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 to schedule a No-Charge, No-Obligation Consultation.