L5-S1 disc herniation occurs when the spinal disc that functions as a cushion between these two vertebrae degenerates and ruptures, expelling part of its contents. In this article, our experts in spine pathologies at Instituto Clavel explain the causes, symptoms and treatments of this pathology.
The L5 vertebra, the last of the lumbar spine, and the S1 vertebra, the first of the sacrum, are connected at the back of the spine by the facet joints. This vertebral segment is known as the lumbosacral joint.
When a lumbar disc herniation of L5-S1 occurs, what happens is that the intervertebral disc that is located between both vertebrae ruptures, and part of its contents protrudes out beyond the limits of the fibrous ring of the disc. This can press on the nearby nerve root, causing low back pain or pain that radiates to the legs, among other symptoms that we will describe below.
Causes of L5-S1 disc herniation
As in any herniated disc, there can be various causes, and it is not always clear which one, since it even be a combination of factors. The most common cause, however, is the natural wear on the disc as we age. Consider that in the case of the lumbar spine, the discs are subjected to the weight of the body almost continuously over the years.
Some other possible causes are:
- Genetic predisposition.
- Incorrect postural habits.
- Lifting heavy loads, for example in jobs requiring physical labor.
- Excess weight or obesity, which causes overload on the lumbar discs.
- Use of tobacco, because it affects the supply of oxygen to the discs, which makes disc degeneration more likely.
- Injuries due to blows or falls.
Symptoms of L5-S1 disc herniation
The symptoms produced by a herniated disc in the lumbosacral joint can be lesser or greater, depending on how badly the intervertebral disc is affected, and how much it presses on the nerve root. The most frequent symptoms are as follows:
- Pain in buttocks, legs or feet. This usually noticed when making certain movements, or standing in certain positions, and it subsides when lying down.
- Weakness in the nearby muscles, which can lead to falls or stumbling, and problems of balance.
- Numbness or a feeling of tingling, radiating from the affected nerve to the legs.
Diagnosis of L5-S1 disc herniation
If you suffer any of the symptoms mentioned above, you need to see a spine specialist to be correctly diagnosed, and to find out if the pain is, indeed, caused by an L5-S1 disc herniation, or if it is due to some other problem.
At Instituto Clavel, we make our diagnosis based on a complete evaluation of the patient, including symptoms, physical examination, and imaging tests. For the latter, to get the most accurate diagnosis, our medical team uses the EOS scanner, which gives us a high-quality image of the patient’s entire body, with much less radiation than a conventional X-ray.
Once the evaluation is completed, we make a recommendation for the most appropriate treatment according to the patient’s condition and the possible evolution of the problem.
Treatments for L5-S1 disc herniation
The following list describes the three types of treatment for disc herniation at this level of the lumbar spine:
- Conservative treatments: This is usually the initial treatment protocol in early stages of the condition, and to limit its development. These treatments can range from pain relievers or muscle relaxants, to physical therapy and personalized exercises. Our team of experts will also provide recommendations for postural hygiene and changes to daily habits, according to the patient’s lifestyle.
- Intermediate treatments: If the condition is somewhat more serious, or if the conservative treatments fail to provide relief, we may propose other options such as epidural infiltrations, a minimally invasive technique consisting of injecting an anti-inflammatory to alleviate the lumbar pain.
- Surgical treatments: If the previous treatments do not prove effective, or if the severity of the patient’s condition is such that it’s not possible to wait, our medical team will recommend the appropriate surgical treatment. The choice of surgical treatment is based on a completely personalized evaluation of the patient’s case, however, at Instituto Clavel, we try to use the most minimally invasive option. For this reason, in most cases, we recommend lumbar microdiscectomy to remove the affected tissue of the L5-S1 disc hernia, and if necessary, partial emptying of the affected disc. In some cases, it may be necessary to perform Artificial Disc Replacement (ADR), or, if there are other damaged elements of the spine, Arthrodesis (fusion).
As you can see, there is a wide range of options for treating L5-S1 disc herniation, and the right one will depend on each case, so as we said earlier, if you suffer from any of the symptoms described here, we recommend that you consult a specialist to find answers to all your questions.