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After age 50 or 60, osteoarthritic degeneration (spondylosis) or spinal stenosis are more likely causes of low back pain or leg pain. 4.8% of males and 2.5% of females older than 35 experience sciatica during their lifetime. Of all individuals, 60% to 80% experience back pain during their lifetime. In 14%, pain lasts more than two weeks.
Left: Illustration of herniated spinal disc, superior view. Right: MRI showing herniated L5-S1 disc (red arrow tip), sagittal view. Intraspinal, or discogenic sciatica refers to sciatica whose pathology involves the spine. In 90% of sciatica cases, this can occur as a result of a spinal disc bulge or herniation.
Lumbar disc disease is the drying out of the spongy interior matrix of an intervertebral disc in the spine. Many physicians and patients use the term lumbar disc disease to encompass several different causes of back pain or sciatica. In this article, the term is used to describe a lumbar herniated disc.
Signs and symptoms include low back pain, pain that radiates down the leg, numbness around the anus, and loss of bowel or bladder control. [1] Onset may be rapid or gradual. [1] The cause is usually a disc herniation in the lower region of the back. [1] Other causes include spinal stenosis, cancer, trauma, epidural abscess, and epidural hematoma.
Medical focus on herniated discs was further forwarded by the invention of the MRI in 1977. [31] Over-diagnosis and attention on herniated discs has led to the SI joint becoming an underappreciated pain generator in an estimated 15% to 25% of patients with axial low back pain. [1] [8] [3] [5] [6] [7]
The part of the spinal cord that was damaged corresponds to the spinal nerves at that level and below. Injuries can be cervical 1–8 (C1–C8), thoracic 1–12 (T1–T12), lumbar 1–5 (L1–L5), [9] or sacral (S1–S5). [10] A person's level of injury is defined as the lowest level of full sensation and function. [11]
Lumbar provocative discography (also referred to as "discography" or discogram) is an invasive diagnostic procedure for evaluation for intervertebral disc pathology. It is usually reserved for persons with persistent, severe low back pain (LBP) who have abnormal spaces between vertebrae on magnetic resonance imaging (MRI), where other diagnostic tests have failed to reveal clear confirmation ...
Because the leg symptoms in lumbar spinal stenosis (LSS) are similar to those found with vascular claudication, the term pseudoclaudication is often used for symptoms of LSS. [5] These symptoms include pain, weakness, and tingling of the legs, [5] which may radiate down the legs to the feet. [6]
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