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

If you have been told you have an L4-L5 herniated disc, there is a good chance you already know this is about much more than having a sore lower back.

Maybe sitting has become miserable. You get out of the car and have to stand there for a few seconds before you can straighten up. The pain may start in your lower back or buttock and travel down your leg. Your shin, ankle, or foot may tingle or feel numb. You might wake up at night trying to find one position that doesn't hurt.

And then there is the worry that comes with reading an MRI report filled with words like herniation, protrusion, stenosis, nerve compression, degenerative changes, or foraminal narrowing.

Dr. Cassidy James Boelk, DC has spent more than 22 years working with patients with disc injuries, sciatica, and difficult lower-back conditions. One of the most important things he wants patients to understand is this:

An L4-L5 disc herniation on an MRI does not automatically mean surgery.

It also does not automatically mean spinal decompression.

The first step is figuring out whether the L4-L5 finding actually explains what the patient is experiencing and then determining which treatment options make sense.

Amanda's Pain Became So Severe She Needed a Cane

Amanda's story will sound familiar to some people dealing with a serious lumbar disc problem. She spent months going between doctors and urgent care because the pain had become unbearable. Eventually an MRI identified an extruded disc pressing on her L5 nerve.

⭐⭐⭐⭐⭐ Amanda — San Diego, CA

“Last year, I spent three months constantly going back and forth between doctor’s appointments and urgent care. The pain was unbearable—I was taking medication regularly just to get through the day. Getting out of bed was excruciating, and walking or standing felt like torture. Every step filled me with dread.

In December, my doctor finally ordered an MRI. That’s when I learned I had an extruded disc pressing on my L5 nerve, which affects the leg and foot. My doctor scheduled two follow-up appointments: one for pain management (spinal injections), and another to evaluate me for surgery.

Then I discovered spinal decompression therapy. I was thrilled to find a non-invasive alternative. I never ended up needing either of those appointments.

Now, I’m walking regularly, standing up straight—something I couldn’t do before. When I first sought help, I was so hunched over that I had to use a cane just to move forward. Because of the pain, I hadn’t exercised in months. But now, I’m doing a program called 75 hard which requires not one but 2 45-minute workouts per day, and I've even gotten back to lifting weights!

I’m so thankful I found this place. It’s conveniently located near my work, which makes it easy to fit sessions into my lunch break. Dr. Boelk and the staff are incredibly friendly and polite—it’s always a pleasure to come in.

The environment is so relaxing that I look forward to each visit. I truly thank God for leading me to this alternative. It’s made such a difference in my life.”

— Amanda, San Diego, CA

Amanda's results are her own and cannot predict how another patient will respond. But her story illustrates something Dr. Boelk sees regularly: a problem in the lumbar spine can completely change how someone walks, sleeps, works, exercises, and lives.

Have an L4-L5 MRI? Dr. Boelk Will Review It With You

Patients can schedule a No-Charge, No-Obligation Consultation with Dr. Cassidy James Boelk, DC at The Spinal Decompression & Chiropractic Center of San Diego.

If you already have an MRI, bring the actual images if possible—not only the written report. Bring previous X-rays and reports as well.

Dr. Boelk wants to understand what is happening to you, including:

• Where the pain starts

• Where it travels

• Whether there is numbness, tingling, or burning

• Whether your foot or leg feels weak

• How long you can sit

• Whether driving aggravates the symptoms

• Whether walking helps or hurts

• Whether the pain wakes you up

• How the problem started

• What you have already tried

• What helped, what didn't, and what made you worse

• Whether you have had previous spinal surgery

If you don't have an MRI, that is okay. Dr. Boelk can determine whether additional evaluation or imaging may be appropriate.

There is no obligation to start treatment, and not every patient is a candidate for Non-Surgical Spinal Decompression.

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

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

Why Can an L4-L5 Disc Hurt All the Way Into Your Leg or Foot?

This confuses a lot of patients.

“If the problem is in my back, why does my foot hurt?”

The L4-L5 disc sits between the fourth and fifth lumbar vertebrae. When that disc herniates, the disc material itself is only part of the problem. Its location relative to the nearby spinal nerves can be extremely important.

If a nerve becomes irritated or compressed, symptoms can be felt farther along the path of that nerve.

That can mean pain in the buttock or leg rather than just the back. It can also produce burning, tingling, altered sensation, or numbness farther down the leg.

Some patients tell Dr. Boelk:

“My back actually feels better. It's my leg that I can't deal with.”

That can absolutely happen with a lumbar disc injury.

What Does an L4-L5 Herniated Disc Feel Like?

There isn't one universal pattern.

Patients may experience some combination of:

• Lower-back pain or stiffness

• Pain concentrated on one side

• Buttock or hip-region pain

• Pain traveling down one leg

• Sciatica

• Burning or electrical sensations

• Numbness or tingling

• Symptoms extending toward the shin, ankle, or foot

• Leg or foot weakness

• Difficulty standing fully upright during a flare-up

• Pain after prolonged sitting

• Difficulty driving

• Interrupted sleep

One person may have severe back pain and minimal leg symptoms. Another may have almost no back pain but significant numbness and weakness farther down the leg.

That difference matters.

Five Things You Can Do Right Now

If you are dealing with an L4-L5 flare-up, there are some simple things you can pay attention to before you ever walk into Dr. Boelk's office.

These aren't a substitute for a proper diagnosis, but they may help you stop repeatedly aggravating an already irritated area.

1. Stop sitting for hours without moving

If sitting aggravates your symptoms, don't wait until the leg is screaming at you before changing position.

Break up longer sitting periods. Stand up. Walk around briefly if walking is comfortable.

For some disc patients, several short periods of movement are much better tolerated than spending hours in one position.

2. Look at your driving position

Pay attention the next time you get into your car.

Are you sitting extremely low with your knees significantly higher than your hips? Is your lower back rounded? Are you reaching for the steering wheel?

That position may aggravate some lumbar disc problems when maintained for long periods.

Try adjusting the seat so you are supported and comfortable rather than folded into the car.

3. Don't automatically stretch a “tight” leg harder

This is a big one.

Sciatica can make the hamstring, calf, or entire back of the leg feel extremely tight.

That doesn't necessarily mean the muscle simply needs more stretching.

An irritated sciatic nerve can produce a pulling or tight sensation. If aggressive hamstring stretching causes pain to shoot farther down your leg or increases tingling or numbness, repeatedly forcing that stretch may be making things worse.

4. Pay attention to where the symptoms are going

Don't monitor only your back pain.

Notice what is happening farther down the leg.

Is the tingling spreading? Is numbness becoming more constant? Is pain traveling farther toward the foot? Is the leg beginning to feel weak?

Those changes are worth reporting to the doctor evaluating you.

5. Keep moving within reason

Complete bed rest is generally not the answer for routine back and disc problems.

If comfortable walking is tolerated, short walks and reasonable movement may be preferable to lying down all day.

But don't turn that into “push through anything.”

If an activity repeatedly causes neurological symptoms to intensify or travel farther down the leg, back off and get the condition properly evaluated.

Why Your MRI May Look Terrible but You Feel Okay—or the Opposite

Patients sometimes walk into the office frightened by their MRI report.

They have highlighted every mention of a bulge, degeneration, stenosis, or narrowing.

Then Dr. Boelk looks at the images and listens to the patient's symptoms.

Those two things need to be put together.

A dramatic-looking MRI does not automatically mean someone needs surgery. Likewise, a disc problem that sounds relatively small in the written report can still be extremely painful if it is positioned where it irritates a nerve.

Dr. Boelk is interested in questions such as:

Where is the herniation? Which nerve may be involved? Where does the patient's pain travel? Is there numbness? Is there weakness? Do those findings make sense together?

Treating an MRI without treating the person attached to it is not enough.

What Are the Treatment Options for L4-L5?

There is no single best treatment for every L4-L5 herniation.

Some patients improve with time, appropriate movement, and activity modification.

Other options may include medication, physical therapy and rehabilitation, or epidural steroid injections.

Selected patients may be candidates for Non-Surgical Spinal Decompression.

And yes, there are patients who need a surgical opinion.

The correct recommendation depends on the patient's symptoms, neurological findings, imaging, spinal stability, previous treatment, overall health, previous surgery, and whether the condition is improving or deteriorating.

Non-Surgical Spinal Decompression and the DRX9000

The Spinal Decompression & Chiropractic Center of San Diego exclusively uses the DRX9000 for lumbar Non-Surgical Spinal Decompression.

Treatment involves controlled decompression and relaxation cycles directed toward the lumbar spine.

But there isn't an “L4-L5 button.”

Dr. Boelk considers the individual patient and may modify factors such as treatment angle, positioning, starting force, treatment cycles, body size, symptom pattern, tolerance, and response.

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

The technology is important, but Dr. Boelk believes the machine is only as useful as the evaluation and protocol behind it.

Knowing who not to treat is just as important as knowing how to use the equipment.

Some Patients Travel a Long Way for an Opinion

Lynn traveled from Alaska after experiencing pain radiating into her legs, difficulty sleeping, and problems walking.

⭐⭐⭐⭐⭐ Lynn C. — Alaska

“My name is Lynn. I am from Alaska, and I just want to say it was totally worth taking a trip to go to the Spinal Decompression & Chiropractic Center of San Diego. I was having pain radiating down my legs, I couldn’t sleep, I could barely walk.

After treatment I am back to shoveling snow, teaching school, taking walks. So, I just want to thank Dr. Boelk and the clinic, you guys are wonderful, and you have created such a wonderful, friendly, kind and truly caring atmosphere. I highly encourage anybody that might be considering spinal decompression therapy, it really makes a difference.”

— Lynn C., Alaska

Patients have traveled to the San Diego office from outside the immediate area, but geography is not what determines whether treatment makes sense.

Candidacy does.

Dr. Boelk Will Also Tell You When He Doesn't Think He Can Help

This is important.

The purpose of an evaluation should not be to find a reason to put every patient into the same treatment program.

Jeff J. traveled from Tucson after finding the practice online. After meeting with Dr. Boelk, they came to a very different conclusion.

⭐⭐⭐⭐⭐ 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

That is part of responsible spinal decompression care.

Dr. Boelk screens patients carefully. Conditions that may make lumbar decompression inappropriate or require additional evaluation can include an unstable spondylolisthesis, 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, and other conditions that could make treatment unsafe.

Sometimes another conservative approach makes more sense.

Sometimes more imaging is needed.

Sometimes the right answer is a surgical consultation.

When Should an L4-L5 Herniation Be Taken More Seriously?

Pain can be severe without necessarily being dangerous.

Progressive neurological loss is different.

Seek prompt medical attention for symptoms such as:

• New bowel or bladder dysfunction

• New difficulty beginning urination

• Numbness around the groin, inner thighs, or saddle region

• Rapidly progressing weakness

• Sudden difficulty controlling the leg or foot

• Other significant and rapidly worsening neurological changes

Those symptoms should not wait for a routine spinal decompression appointment.

And even without those emergency symptoms, increasing weakness deserves attention. If the foot suddenly isn't working the way it normally does, don't simply assume you need another week of stretching.

What About Sleeping With L4-L5 Disc Pain?

Sleep can become one of the hardest parts of a disc flare-up.

There isn't one sleeping position that works for everyone, but there are a couple of simple positions worth trying.

If you sleep on your side, try placing a pillow between the knees so the pelvis and legs are comfortably supported.

If you sleep on your back, a pillow or support under the knees may make the lower back more comfortable.

Avoid forcing yourself to stay in a supposedly “perfect” position if it clearly increases the leg symptoms.

Also pay attention to how you get out of bed. Rapidly twisting the lower back while trying to sit straight up can be uncomfortable during an acute flare-up. Rolling toward the side and using the arms to assist while bringing the legs off the bed may be easier for some patients.

If pain is repeatedly waking you throughout the night despite changing positions, that is useful clinical information. Tell the doctor evaluating you.

Why Patients Seek Out Dr. Cassidy James Boelk, DC

Dr. Boelk's practice has a heavy clinical focus on disc injuries, sciatica, degenerative spinal conditions, and Non-Surgical Spinal Decompression.

His 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 of the Non-Surgical Spinal Decompression Training Academy

• Trains other doctors in spinal decompression protocols and techniques

• Founding Member of the American Spinal Decompression Society

• Member of the International Disc Education Association

• California X-Ray Radiation Supervisor & Operator

• Seven DRX9000 spinal decompression systems

• Exclusively uses DRX9000 technology for Non-Surgical Spinal Decompression

Dr. Boelk's interest in spinal injuries is personal as well as professional.

He suffered an L5 compression fracture at age 16 and later dealt with disc injuries and sciatica himself. He has spent thousands of hours over the years working through rehabilitation, exercise, spinal mechanics, and returning to an active lifestyle.

So when a patient says:

“I don't just want my MRI to look better. I want my life back.”

Dr. Boelk understands what they mean.

Don't Make “Pain-Free” Your Only Finish Line

When the pain is terrible, getting out of pain understandably feels like the only thing that matters.

But think a little farther ahead.

What do you actually want back?

Maybe you want to sleep through the night.

Put your shoes on without struggling.

Drive to work without your leg going numb.

Walk around the neighborhood.

Pick up your kids or grandkids.

Get back into the gym.

Surf.

Golf.

Run.

Travel.

Simply stop thinking about your back every 10 minutes.

As symptoms allow, rehabilitation becomes important because the eventual objective is not to spend your life avoiding movement.

It is to gradually rebuild the ability to live normally again.

Still Struggling With an L4-L5 Herniated Disc?

If you have been trying to manage this yourself and the pain keeps returning—or you have already gone through treatment and are still struggling—the next step may simply be getting a better understanding of what is 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.

Dr. Boelk can review your history and available imaging, discuss where your symptoms are traveling, what you have already tried, and whether Non-Surgical Spinal Decompression may be an option.

Not every patient is accepted for decompression.

If Dr. Boelk does not believe it is appropriate, he will 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 to schedule a No-Charge, No-Obligation Consultation.