What is Lumbago and How is it Associated With Sciatica

Human Spine/Vertebral Column

Spine/Vertebral Column

What is Lumbago
For those of you who are not familiar with the term lumbago, it’s an acute mid and low back pain radiating down the posterolateral(back of thigh, not in the center, kind of to the side) aspect of the thigh and leg.

Causes of Lumbago
Often, it’s caused by a posterolateral protrusion of a lumbar IV(Intervertebral) disc at the L5/S1 level that affects the S1 component of the sciatic nerve. The clinical presentation may not always be exactly the same, but the onset of acute pain in the lower back is usually a common symptom.

Due to the fact that muscle spasm is associated with low back pain, the lumbar region of the vertebral column usually becomes rigid, causing movement to be painful. With treatment however, the lumbago type of back pain usually begins to disappear after a few days; but if left untreated, it may gradually develop into sciatica.

Image (149)What is Sciatica
This more popular and bothersome pain, is the pain one experiences in the lower back and hip that radiates down the back of the thigh into the leg. This can be caused by several different reasons, such as the following:

1. A herniated lumbar IV disc that compresses and compromises the L5 or SI nerve root.

2.Damage done to a IV disc, as a result of violent rotation or flexing of the vertebral column, can compromise nerve root causing irritating pain.

3.As we aged, our nuclei pulposi become shrunken and thinner because of dehydration and degeneration. (It’s believed that this slight loss in height of the IV disc accounts for one of the main reasons we experience a slight loss in height during old age). When an IV disc undergoes a decrease in height, this results in the narrowing of the foramina, which may cause compression of the spinal nerve roots.

4.Naturally, as the IV foramina(opening where nerve exits) in the lumbar region gets progressively smaller, the size of the lumbar nerves gets larger, this situation clearly explains the reason it’s so common for sciatica to occur.

For people who unfortunately develop osteoarthritis, new bone deposited during this condition further narrows the foramina, compressing the nerve even more, causing shooting pains down the lower limbs.

What Determines the Quality of Pain

Any movement or exercise that stretches the sciatic nerve, such as flexing the thigh with the leg extended, may either produce, worsen, or even relieves the pain caused by disc herniation.

Exercises for Sciatica

Based on findings, there are 3 types of exercises that appear to help relieve sciatica
1. Low impact aerobic
2.Hamstring stretching
3.Dynamic lumbar stabilization exercise

Notes:

1. It’s important to note that when an IV disc protrudes, it may compress the nerve roots numbered one below the disc; for example, L5 nerve is compressed by L4/L5 IV disc herniation and SI nerve by L5/SI intervertebral disc(IV disc) herniation.(P.S.picture/illustration above).

2. Five sets of paired nerve roots joined together to form the sciatic nerve — the largest nerve in the body. These nerve roots joined together within the pelvis and continue down each leg.

The sciatic nerve gives off many branches which further form smaller nerves providing sensation and controlling muscles in your legs and feet. In other words, the sciatic nerve innervates all the muscles of the posterior thigh (hamstrings) and all muscles below the level of the knee, including those of the leg and foot. Whereas S1 refers to the first set of sciatic nerve, S2 is the second, and so on.

3.The sciatic nerve is really two nerves combined — the tibial nerve (large), and a smaller common fibular nerve.

4. The nucleus pulposus usually protrudes or bulges out at the posterolateral aspect of the IV disc where the annulus fibrosis is relatively thin and poorly supported by either the posterior or anterior longitudinal ligaments.

Imagepolposus (150)

Clinically Oriented Anatomy 4th Ed

5. Nucleus polposus(singular) refers to the nucleus that is located in the center of each intervertebral disc. It serves as a cushion and shock absorber. When any weight is applied to the vertebral column, such as when standing or more so during lifting, it usually flattens.

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