PROLAPSE IN THE BACK

Lumbar Prolapse

Prolapse of the lumbar spine is a disc injury where the soft contents of one of the intervertebral discs in the lower back have pushed through the outer layer.

This soft mass is called the nucleus pulposus - and can cause nerve pain depending on how far it protrudes from the disc and whether it irritates a nerve root. This means that the pain associated with a prolapse in the lower back may vary.

 

In this article you will get to know your prolapse better - and who knows, maybe you will become friends again? We will at least do our best to help you. Among other things, we will go through:

  • Symptoms of Prolapse of the lower back
  • Cause: Why you get Prolapse in the low back
  • Diagnosis of Prolapse in the Lower Back
  • Treatment of Prolapse in the lower back
  • Surgical Operation of Prolapse
  • Exercises and Training for Back Prolapse
  • Frequently Asked Questions about Prolapse in the lower back

 

Popularly called, the condition is often incorrectly called disc slippage - this is not entirely correct, as the discs are stuck in between the vertebrae and can not be 'slipped out'. But contains, on the other hand, the soft mass, it can slip out.

In the acute phase, this condition can be painful  - and then it may be relevant with an interdisciplinary approach consisting of self-measures, physical treatment and painkillers. Feel free to contact us at Our Facebook page if you have any questions or comments. We remind you that you find exercises and a video further down in the article.

Scroll below to see more videos with great exercise exercises for you with back prolapse.

 



VIDEO: 5 Exercises against Sciatica and Sciatica

As you are probably familiar with (unfortunately), the spinal cord often causes irritation and pinching of the sciatic nerve. This nerve can then cause radiating pain and numbness down the legs, to the legs and down to the feet. In the video below you will see five exercises that can help you reduce sciatic nerve pressure, relieve nerve pain and provide better back movement.


Join our family and subscribe to our YouTube channel for free exercise tips, exercise programs and health knowledge. Welcome!

VIDEO: 5 Strength Exercises Against Back Prolapse

A spinal collapse may be due to a gradual overload over an extended period of time or an acute, high failure overload. Regardless of the cause, it is very important that you regain control of your back pain through customized exercise. In the video below you will see a training program consisting of five custom strength exercises that are suitable for you with back prolapse.

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Does Prolapse Always Pain?

The fact is that prolapse does not always cause pain or symptoms. In fact, many of us go around with prolapse without affecting us at all (1). This depends on whether or not the prolapse presses against the nerves in the back.

However, squeezing nerves in the back can cause local pain in the back, as well as numbness, aching and radiating pain in the leg, leg or foot. It can also cause other symptoms such as poor balance, lack of fine motor skills and muscle wasting (if lack of nerve supply over time).

Symptoms of Lumbar Prolapse

prolapse-in-lumbar
Lower back prolapse can cause a variety of pain and symptoms - depending on the size and pinch of the prolapse. In this section, we will take a closer look at the various symptoms and pains that you may experience.

The classic presentation is often back pain combined with radiation down the legs towards the leg or foot.

  • Poor Balance and Motorism
  • Local Back Pain
  • Numbness and Lack of Feeling in Certain Parts of the Skin (Dermatomas)
  • Referred Pain from Back to Leg or Leg
  • Radiant or Feeling Pain

Prolapse and Balance problems

A low-back disc prolapse can go beyond your balance and aggravate it. This happens due to nerve clamping. The motor nerves can thus not send or receive electrical signals as efficiently as before and the result is slower responsiveness and poorer fine motor.

This also means that the risk of falling increases due to lack of control of the legs and feet. With larger nerve cramps over time, this can also become chronic.

 

Prolapse and Back Pain

A prolapse can occur gradually or in an acute event. What many do not think about is that there is also a reason why they occur - and it is often that one has overloaded the lower back beyond ability.

The result is then tense back muscles, stiff joints and poor back function - which in turn can lead to a disc prolapse in the lower back. The prolapse itself can of course also cause local back pain, but it is often the muscles and joints around that also account for a good portion of the pain.

 

Prolapse and Numbness

By pinching nerves, we can lose sensory sensation and signals. This means that one can lose sensation or become numb in the skin on the affected areas belonging to the affected nerve - such specific areas are better known as dermatomes.

If a nerve is pinched in L5 on the right side - then this could lead to you losing the feeling in the right outer leg.

 

Prolapse and Radiation into the Leg, Leg or Foot

When a nerve gets trapped in the back, this can give pain signals down the leg based on which nerve is pinched. This can be experienced as milder sore pain or as stronger, more electrical, pain signals.

In the example below, we show you how a prolapse in L5 can be experienced.

Example: Root infection against S1 (may occur in prolapse in L5 / S1)

  • Sensory sensation: Impaired or increased sensation may occur in the associated dermatoma that goes completely down to the big toe.
  • Motor skills: The muscles that have their nerve supply from S1 can also be experienced weaker during muscle testing. The list of muscles that can be affected is long, but often the impact is most visible when testing the strength of the muscle that is to bend the big toe backwards (extensor hallucis longus) e.g. by testing against resistance or testing of toe lifts and toe gaits. That muscle also has supply from the nerve L5, but receives most signals from S1.

Why does Prolapse often affect L5 and the lower vertebrae?

The reason why L5 is most frequently affected by prolapse is purely anatomical. L5 is the fifth and lower vertebra - and is thus particularly exposed when we stand and walk. It simply has to do most of the work when it comes to shock absorption.

The lower back is also most at risk when lifting or doing heavy work. Especially working in bent and twisted positions can be unfavorable.



Cause: Why do you get Prolapse in the lower back? Possible Causes?

There are a number of factors that can determine if you are affected by prolapse, both epigenetic and genetic.

Genes and Hereditary Causes: Mom and dad may be directly involved in having a lower back prolapse. This is because curvature in the lower back is something you can inherit. For example, a very straightened spine could cause almost all the strain to fall to the bottom of the lower back and not be distributed over the other joints.

The lumbosacral junction (LSO) is the name of the structure where the lumbar spine meets the pelvis and sacrum - better known as L5-S1. It is no coincidence that it is in this area that we most often suffer from lumbar spine prolapse.

You may also be lucky enough to have inherited a thinner outer wall around the intervertebral disc in the lower back. A weaker wall will naturally have a higher risk of having a disc injury and being affected by prolapse.

epigenetics: Epigenetics are factors around us that affect our lives and our health. An example is poverty - which can mean that you cannot afford to see a clinician for help when the pain occurs. Instead, you bite the pain in yourself and avoid discovering that you have had a prolapse in the lower back.

Other factors include diet, how active you are and whether you smoke. Many people are not aware that smoking leads to poorer blood circulation and thus slower injury healing.



Job / Load: Occupations that contain heavy lifting in unfavorable positions can give a higher risk of injury to the lower back discs. But it can also be a very static office job where you sit all day - and thus put pressure on the lower back throughout the day.

Also read: - The 5 Worst Exercises If You Have Prolapse!

Who gets Prolapse in the lower back?

Due to the fact that the discs are softer at a younger age, it is especially the age group 20 to 40 years that is affected. As we get older, the soft mass will become harder and less mobile - which in turn lowers the risk of disc herniation.

But unfortunately the danger is not over. As you get older, you can get wear and tear and osteoarthritis - which can lead to tight nerve conditions in the back (spinal stenosis)

 

Will a Prolapse Get Rid of Itself? Or should I get help? 

Your body will try to break down the prolapse by sending enzymes and repair material to the area. The enzymes are then instructed to release the part of the disc that has broken through.

But it's not that simple. We must remember that there is a reason why you got the disc injury - and that the answer may lie in bad habits, less healthy diet, smoking, little exercise, static sitting and / or heavy lifting beyond ability.

You can think of it as a mathematical formula. If your math goes in plus, the prolapse will gradually recede and become good again, but if it goes minus or zero then it will either get worse or remain unchanged.

Thus, the person who has been hit by a disc injury must change their lifestyle. They must change the negative factors and implement positive factors - so that the prolapse has better growth conditions.

To achieve this, it can be very beneficial to seek expert help in the form of a modern chiropractor or physiotherapist. These occupational groups have special expertise in assessment, treatment and training due to disc herniation - and can thus help you facilitate optimal healing.

Diagnosis: Diagnosis of Prolapse in the Lower Back

A clinician with expertise in musculoskeletal disorders - such as a chiropractor or physiotherapist - will be able to help you make the diagnosis, as well as tell you which nerve root is pinched.


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The diagnosis of prolapse is primarily based on history taking and a clinical examination. Here, the clinician will collect information about your symptoms and then examine functional as well as neurological tests.

Neurological Symptoms of Prolapse of the Lumbar Spine

Earlier in the article, we talked about what kind of neurological symptoms you might experience from prolapse with nerve root affection in the lower back. These included numbness, reduced strength and radiant pain down the leg.

Among other things, a clinician will be able to examine your functional neurology by testing your strength in the bones, reflexes and sensation in the skin.

Photo examination of Prolapse in the lower back

There are three different diagnostic methods that are suitable for giving us information about lower back prolapse. These are:

CT examination
MRI examination
X-ray

It is no well-kept secret that an MRI scan is the best option to see a disc herniation clearly and distinctly - but CT scanning is an option for those who have devices affected by electromagnetic radiation or metal in the body.

An X-ray can provide information by excluding fracture injuries and showing how much joint wear or calcification there is in the area.



X-ray of Prolapse in the lower back

wear related-spinal stenosis-X-rays

This radiograph shows wear / osteoarthritis-related wear as a cause of nerve compression in the lower back. X-rays cannot visualize soft tissue well enough to indicate the condition of the intervertebral discs.

MR image of Prolapse in the lower back

MRI-spinal stenosis-in-lumbar

In the image above we see an MRI examination of a lumbar spine. The picture shows a prolapse in L3-L4 where the lot of mass clearly points backwards.

CT Image of Prolapse in the lower back

ct-with-contrast spinal stenosis

Here we see a CT image with contrast that shows lumbar spinal stenosis - ie narrow nerve conditions in the back due to calcifications or major prolapse.

Treatment of Prolapse in the Lower Back

Conservative treatment of lower back prolapse involves relieving the pinched nerve and facilitating the quickest possible healing. This is done by improving the biomechanical function of the affected muscles and joints, as well as weeding out bad habits that prevent the prolapse from receding. Thus, the treatment will have four main principles:

Relieve the Affected Nerve
Improve Muscle and Joint Function
Reduce Nerve Pain
Strength Nearby Muscles and Soft Tissue

Treatment methods for Prolapse in the lower back

The most common treatment techniques used for low back prolapse are muscular techniques, nerve mobilization techniques, joint mobilization, traction therapy, laser therapy and intramuscular acupuncture - in combination with home exercises and exercise. The treatment should always be performed by a clinician with public authorization - chiropractor, physiotherapist or manual therapist.

Physiotherapy and Prolapse in the Lower Back

A physical therapist can help you get started with customized exercise, as well as provide symptom relief with muscular techniques and massage. The physical therapist will do an evaluation and then set up a training program to stimulate healing around your injured disc.

Modern Chiropractic and Prolapse

Can a chiropractor help me with a lower back prolapse? Yes. A modern chiropractor works uniquely. This means that they investigate and treat pain and injuries in the muscles, joints, tendons and nerves. Their 6-year education also includes 4 years of neurology that makes them the most competent clinicians to help you optimally treat your prolapse.

A chiropractor utilizes muscle work, custom joints, traction, and effective nerve mobilization techniques to provide better nerve space (2). They also have the right to refer to image examinations should the need arise - and will instruct you in home exercises to strengthen the affected areas.

Doctor and Prolapse

Your GP will be able to advise you on the use of painkillers - which can help you relieve your worst pain.

Your doctor will also be able to help you find a physiotherapist or chiropractor nearby who has significant expertise in the investigation and treatment of prolapse.

Also read: 11 Exercises against Ishialgi

Self-treatment: Recommended Pain Relief and Relief Measures

One of the most important things you do yourself is to keep moving. Move at your own pace and pay attention to your pain. Try to get at least one daily walk in rough terrain to maintain blood circulation in your back.

Surgery and Operation of Prolapse in the Lumbar Spine

Neurosurgeons and orthopedic surgeons in the public sector work in accordance with national and clinical guidelines - which means that they are very strict about whether you should have surgery or not. The reason why they make such high demands is that the surgical operations themselves involve a high risk - and especially in the long term.

There are particular criteria that must be considered orthopedic:

Significantly Impaired Neurological Function in Both Legs (Red Flag - Must Be Assessed by Emergency Department)
foot drop
Symptoms and Pain that will not improve for 6 months
Loss of Bladder and Anal Sphincter Function (Signs of Cauda Equina Syndrome - contact a doctor or emergency room immediately if you experience this)

Research has shown that many surgeries can show a good short-term effect, but that in the long run it can actually lead to an increase in symptoms and pain. Injury tissue and scar tissue in the operated area is the most common cause of this - and can not be operated away after it has occurred.

Lumbar surgery also involves a certain risk associated with the operation itself - and that the surgeon can damage the nerves which thus causes worsening symptoms. Although this only occurs very rarely, it is worth knowing about.



Exercises and Training against Prolapse in the Lumbar

It is important that the training is adapted to you, your pain and your capacity. That is why we recommend that you get help to set up the right exercise program for you via a physiotherapist or modern chiropractor. Earlier in the video, we showed you two videos with generalized exercises that may be suitable for you with lower back prolapse - so scroll up again and look at them if you have not already done so.

One of the most important things about lower back prolapse exercises is that they help you relieve the pinched nerve, contribute to increased blood circulation and repair in the area, as well as contribute to nerve mobility (ie, the nerve becomes more moving and less irritated).

Also read: - 10 Exercises for Bad Hips

Feel free to share knowledge about prolapse

Knowledge among the general public and health professionals is the only way to increase focus on the development of new assessment and treatment methods for prolapse problems - a problem that bothers many people. We hope you take the time to share this further on social media and say thank you in advance for your help.

Feel free to press the button above to share the post further.

NEXT PAGE: - You should know this about Osteoarthritis of the back

osteoarthritis

Click on the image or link above to read more about it spinal osteoarthritis, abrasions and calcifications in the back.

 

Frequently Asked Questions about Prolapse of the Lumbar and Disc Injuries

Should you get sick leave in case of lower back prolapse?

Whether you need a sick note or not depends entirely on the prolapse and the work you do. Due to the fact that it is recommended to keep moving, it is normally not recommended to take full sick leave - except if the pain is of such a nature that you cannot work.

The solution for many is a graded sick leave in the acute phase of the disc prolapse. This also gives them enough time to rest and exercise - in addition to being able to continue working.

Is laryngeal prolapse dangerous?

To a certain extent, prolapse in the lower part of your back can be dangerous, but it all depends on your prolapse problem. A prolapse can be dangerous if it is of such a serious nature that it squeezes your spinal cord and leads to Cauda Equina Syndrome - which can mean, among other things, that you lose the feeling in the skin at the back of the buttocks (breeches paresthesia), control over your anal sphincter (stool goes straight into your pants) and that you are unable to start a urine stream.

This is a rare, but very serious case, which will require decompression surgery and the removal of pressure from the affected nerves. Signs of Cauda Equina Syndrome are classified as red flags and mean you must call your doctor or emergency room immediately.

Prolapse can also be dangerous in that it can lead to lifelong nerve damage in both sensory and motor components if not taken seriously (3).

 

Pregnant with Prolapse in the lower back

If you are in pregnancy and are pregnant, you can still get help and treatment for lower back prolapse. One of the only differences, of course, is that you cannot receive pain medication on par with those who are not pregnant.

When you are pregnant, the altered pelvic position (front tip) will also result in a higher pressure on the lower discs in your back.

Some also experience that they get a prolapse after birth - which can be directly related to the incredibly high abdominal pressure you go through at delivery.

What prolapse in the lower back hereditary?

One can inherit certain anatomical factors that make one have a higher risk of developing a prolapse in the lower back - so indirectly one can say that prolapse in the lower back can be hereditary.

You can inherit a very straight back from your father - or a weaker slice structure from your mother.

What does it mean to have a lower back prolapse in levels L4-L5 or L5-S1?

Lumbar prolapse can occur at different levels. The lumbar spine is divided into five vertebrae - from L1 (upper vertebra) and down to L5 (lower vertebra). S1 is the term used for the first sacrum vertebra.

A prolapse in L4-L5 thus means that the disc injury is located between the fourth and fifth lumbar vertebrae. If the level is L5-S1 then this means that there is a disc prolapse in between the lower vertebra and the sacrum.

What is the lumbar spine in English?

Prolapse of the lower back is called lumbar disc herniation in English if translated from Norwegian. The radiating pain you experience is called radiculopathy - and the sciatic nerve is called the sciatic nerve. And sciatica is called sciatica in English.

How can you tell if you have a beginning laryngeal prolapse?

The precursor to a prolapse is called disc bending. This means that the soft gel mass inside one of the intervertebral discs pushes against the outer wall, but without the wall around it having cracked yet.

If disc bends have been detected on image examinations then it may be advisable to be extra conscious about back health and exercise.

Can children have prolapse in the lower back?

Yes, children can also suffer from prolapse of the lower back, but it is very rare. These are also usually treated only conservatively - unless it is a very unusual case.

Can a dog also have a lumbar spine?

Like us, dogs are made of muscles, joints and a bunch of other biomechanical components. A dog can also be affected by a prolapse in the lower back - and the symptoms may vary depending on the size of the prolapse.

Can you have a double prolapse in the lower back?

Some are so lucky that they get what we call a double prolapse in the lower back. A double prolapse means having two different prolapses at different levels of the back. The most common is that these occur side by side. For example, the most common double prolapse is that one has a prolapse in L4-5 and another prolapse in L5-S1. This can make healing and treatment more extensive than if there had been talk of a prolapse.

Double prolapse. Double pleasure.

Can prolapse cause pain in the knees and skins?

Yes, prolapse of the lower back can refer pain down to the knees and calves. This will usually occur on one side only, as a prolapse is often right or left. If you experience pain on both sides, there is less chance that it is a prolapse in the lower back - although this can also occur with a central prolapse that presses against both nerve roots. Normally, such pain will be accompanied by other nerve symptoms / ailments, such as numbness, tingling, tingling and muscle weakness.

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Sources:
  1. Ropper, AH; Zafonte, RD (26 March 2015). "Sciatica." The New England Journal of Medicine.372 ( two:10.1056 / NEJMra1410151.PMID 25806916.
  2. Leininger, Brent; Bronfort, Gert; Evans, Roni; Reiter, Todd (2011). «Spinal Manipulation or Mobilization for Radiculopathy: A Systematic Review». Physical Medicine and Rehabilitation Clinics of North America. 22 ( two:10.1016 / j.pmr.2010.11.002. PMID 21292148.