If you have a stabbing pain in your hip, the cause might be a herniated disc in your lower back. However, this symptom is usually associated with other symptoms and it is best to see a specialist for an accurate diagnosis. In the following article, we’ll tell you more about it.
Suppose Ashley has been suffering discomfort in her lower back for some time. However, lately, she has also begun to notice pain in her hip and leg. A specialist will tell you that these are probably not isolated symptoms and that they most likely share the same cause. In the case of an L4-L5 lumbar disc herniation, the lower back pain can radiate to the hip and leg.
When you have a herniated disc in the lumbar spine, the pain is not always located in the affected area. In many cases, the patient begins to notice discomfort in areas that are related to each other. So in addition to lower back pain, they may feel pain in one buttock, or the back of the calf, and they might feel numbness in the sole of their foot.
Symptoms of an L4-L5 lumbar disc herniation
When a patient has a lumbar hernia at these levels, one of the common symptoms will be sciatica, the pain that radiates along the path of the sciatic nerve that passes through the lower back, through the hips and buttocks, and leads into one of the legs. This is one of the possible reasons that someone with this condition would have hip pain.
However, symptoms may vary according to depending on which specific nerve root is affected:
L4 root
When the hernia compresses the nerve root at the L4 level, the patient experiences back pain that radiates to the middle of the thigh and down the inner side of the leg. The quadriceps muscle might be affected which would mean the person will have difficulty extending the knee. This situation can compromise the patellar reflex, the reflex the doctor checks by hitting the knee with that little hammer.
L5 root
In this case, other regions such as the buttock or toe may be affected. That is, on this occasion, the low back pain will go down the buttock until it reaches the thigh, from where it will radiate to the level of the knee, then continue down the front of the leg towards the big toe. When this happens, the patient will have difficulty lifting the foot off the ground and in some cases, will drag it.
L4-L5 disc hernia: diagnosis
When it comes to diagnosing a herniated disc, magnetic resonance imaging is the test most often used by specialists. It allows the doctor to identify the characteristics of the hernia, including whether there is compression at one of the nerve roots, and this will help them make a more accurate decision about the most appropriate treatment for the patient.
It’s true that a computed tomography (CT) scan is also useful to help in the diagnosis of this condition, but it has a disadvantage, and that is that its image is not so clear in this specific case. It is worth mentioning that the doctor’s clinical evaluation of the patient is essential, because in addition to gathering information on the symptoms and the evolution of the discomfort, the doctor will be able to examine the patient physically, which is key to finding out if the pain stems from the pathology seen in the diagnostic images.
At Instituto Clavel, we have yet another diagnostic device, and it is the one we recommend the most: the EOSedge scanner that allows us to obtain a complete image of the patient's skeleton in high quality but with low radiation.
Find out more about how to prevent it and the different treatments
Can an L4-L5 disc hernia be cured?
An L4-L5 disc herniation can be treated conservatively, with the help of minimally invasive treatments, or surgery.
Conservative treatments
At Instituto Clavel, our first choice is always to begin with a conservative treatment plan, since in these cases of herniated disc, 90% of the patients improve after 8 to 12 weeks. The treatment consists of prescribing anti-inflammatories and muscle relaxants with the aim of reducing muscle spasms. This is combined with physical therapy sessions including both active and passive therapies.
Minimally invasive treatments
One of the procedures that we carry out at Instituto Clavel, are epidural infiltrations, which consists of injecting steroidal anti-inflammatory drugs, derived from cortisone; and in some cases they can be mixed with anesthetics. Our main goal will be to relieve low back pain, therefore, we will inject the substance into the area around the membranes that surround the spinal cord.
Surgical treatment
If the pain continues after trying the previously described treatments, the next step will be to consider the possibility of surgery. The Instituto Clavel team is skilled in various resection techniques for herniated discs, including lumbar microdiscectomy, microscopic tubular surgery or endoscopic lumbar surgery.
All of these techniques are minimally invasive surgeries, and post-surgical recovery is usually between 24-72 hours. Once at home, in terms of returning to work, recovery usually takes between 2 and 4 weeks.
Categories: Spine treatments, Spine pathologies, Pain Management