Introduction
This page aims to provide you with information on conditions that affect the Lumbar Spine. The Lumbar Spine is located at the lower back, is made up of 5 vertebrae (L1 – L5) which are separated by ‘discs’ known as the intervertebral discs . A number of conditions can affect the Lumbar Spine, several of which are explored in the relevant sections below:-
Overview
Lower Back Pain is very common, with around 8/10 people experiencing it at some point in their lives. Usually Lower Back Pain improves within a few days or weeks and is not caused by anything serious and thus is often referred to as ‘Non-Specific Back Pain’.
However, in certain circumstances it may be caused by specific conditions, some of which are outlined in the other sections of this page. Where you have concerns or severe and persistent pain it is important to seek medical advice so that the correct diagnosis and treatment can be given (Please note the Cauda Equina Syndrome (CES) section)
Videos
This film Useful information for patients with lower back pain was produced by the OASIS Spinal Team and the Musgrove Spinal Team and provides general information on lower back pain.
This film Mechanical lower back pain was put together by the Somerset MSK Physio Team. It explains the condition and common symptoms, together with ideas on how to manage it.
External Links
Patient.Info
The following link contains an overview of lower back pain, it’s diagnosis and treatment:-
https://patient.info/bones-joints-muscles/back-and-spine-pain/lower-back-pain
The Chartered Society of Physiotherapy (CSP)
The following link contains information from the CSP about the causes of back pain, its treatment and useful exercises:-
Overview
This page aims to provide you with useful information about Lumbar Radiculopathy, a type of which is often referred to as Sciatica.
Radiculopathy is a clinical condition which involves one or more nerves resulting in impaired function (a neuropathy). The site of injury in radiculopathy is at the level of the spinal nerve root. The result is pain (known as radicular pain), weakness in limbs, numbness/paresthesia, and difficulty in controlling specific muscles.
In radiculopathy, the problem occurs at or near the site of the origin of the nerve root as it exits from the spinal cord, but the pain and accompanying symptoms usually radiate to the part of the body that is supplied by that specific nerve. For example, an impingement in the lumbar region can be manifested with symptoms in the foot.
The most common symptoms of radiculopathy are pain, numbness, and tingling in the arms or legs. It is common for patients to also have localised neck or back pain as well. Lumbar radiculopathy that causes pain that radiates down a lower extremity is commonly referred to as sciatica.
Sciatica is where the sciatic nerve, which runs from your lower back to your feet, is irritated or compressed.
Approximately 8 out of 10 people will find that their symptoms subside within around 10-12 weeks of onset. In a small minority of cases some symptoms may persist for up to 18 months. Symptoms of numbness or weakness may last longer than those of pain. The symptoms can be very unpleasant, although it is important to remember that the pain you experience does not mean that ongoing harm is being done
However, please note in rare circumstances Sciatica can be associated with a serious spine condition (See CES) and will require immediate medical attention. If this happens you may experience:
• Sciatica in both legs
• Loss of feeling or pins and needles between your legs, around your genitals or back passage
• Changes to bladder and bowel function, such as loss of sensation, loss of control or an inability to empty your bladder
• Sexual problems such as loss of vaginal sensation or the inability to achieve an erection or ejaculate
• Weakness in the legs affecting walking
If you have any combination of the above symptoms, please seek immediate medical advice.
Videos
Content being developed
External Links
NHS.UK
This page provider further information regarding Sciatica and its symptoms and treatment.
Overview
This page aims to provide you with information regarding Cauda Equina Syndrome (CES). CES is a rare but serious condition in which the nerves of the lower back suddenly become significantly compressed.
CES can have the following symptoms:-
• Loss of feeling/pins and needles between your inner thighs and genitals.
• Numbness in or around your back passage or buttocks.
• Altered feeling when using toilet paper to wipe yourself.
• Increasing difficulty when you try to urinate.
• Increasing difficulty when you try to stop or control your flow of urine.
• Loss of sensation when you pass urine.
• Leaking urine or recent need to use pads.
• Not knowing when your bladder is either fully or empty.
• Inability to stop a bowel movement or leaking.
• Loss of sensation when you pass a bowel motion.
• Change in ability to achieve an erection or ejaculate.
• Loss of sensation in genitals during sexual intercourse
(HSIB – 2020 – adapted from Greenhalgh et al, 2016)
Whilst rare, any combination of the above symptoms could indicate CES – Please seek immediate medical advice.
Videos
External Links
Patient.Info
The following link contains further information regarding CES, it’s diagnosis and treatment.
https://patient.info/bones-joints-muscles/back-and-spine-pain/cauda-equina-syndrome
Cauda Equina UK
The following link is to the charitable organisation Cauda Equina UK (part of the Spinal Injuries Association)
Overview
Spinal Stenosis is a common condition, often related to the ageing of the spine, in which the spinal nerves become compressed as they pass through the spinal canal, for example due to enlargement of the facet joints or spinal ligaments .
Whilst the condition can occur throughout the spine, it is most common in the lumbar and cervical sections.
In Lumbar Spinal Stenosis, for some people, the compression of the spinal nerves can result in a constant sciatica (see Lumbar Radiculopathy/Sciatica). In others, they may be pain free when sitting down but, as soon as they try to stand or walk they develop gradually worsening pain and aching in the legs which requires them to sit down frequently (claudication).
Some people have one or two episodes then the pain resolves whilst other people find that modifying activities provides enough relief for them to carry on with fairly normal activities. However, some people have worsening pain and are very limited by their symptoms and may be suitable for an operation
Videos
This film is about spinal decompression surgery, an operation where a portion of some of the spinal structure is removed to create more space for the nerves to pass through or exit the spine at that level.
This film is about spinal fusion, an operation where two or more spinal segments are joined together to prevent movement at these levels.
In this film spinal decompression post operative care one of our advanced nurse practitioners talks through three important recovery care stages: wound care, painkillers and posture.
In this film pre-operative exercise and balance, our physiotherapist Patrick talks through some key pre-operative exercises. Please complete as prescribed by your physiotherapist.
External Links
Patient.Info
The following link contains an overview of Spinal Stenosis, it’s diagnosis and treatment:-
https://patient.info/bones-joints-muscles/back-and-spine-pain/spinal-stenosis
NHS.UK
The following link contatians further information regarding Lumbar Decompression Surgery:-
https://www.nhs.uk/conditions/lumbar-decompression-surgery/