Disc protrusion l4 l5 what is it

What causes protrusion of intervertebral discs l4-l5

A protrusion is the swelling of the intervertebral disc( fibrous ring).The designation L4-L5 indicates that the protrusion is marked between the 4th and 5th vertebrae located in the lumbar region. This condition of the vertebrae is considered a harbinger of the origin of the vertebral hernia, in which the fibrous ring loses its integrity. Among the total number of protrusions of the lumbar discs, the pathology of the l4l5 discs is noted in almost half of the patients who were diagnosed with the disease. In turn, out of this number of patients, in 35-40% it is combined with hernias or protrusions of other discs. The most common combination is L5-S1.

The main causes of the disease

This disease can be caused by various reasons. To medical factors that can give an impetus to the development of the disease include:

  • biochemical;
  • involution;
  • hormonal.

For biochemical reasons include a lack of calcium, vitamin D deficiency, metabolic disorders. At the same time, the area of ​​the intervertebral disc receives a minimum amount of nutrients, which is insufficient for normal functioning, which contributes to the appearance of microtraumas and cracks.

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With a weak( involutional) development of the vertebral apparatus and cartilaginous tissue, the disc falls in the interval L5-S1.

Hormonal alteration of the body can promote the prolapse of intervertebral discs. Treatment of the disease in the first place should reveal the main cause of the development of pathology.

The causes of the onset of this illness may be different. The most common of these:

  • vertebral trauma;
  • osteoporosis;
  • birth defects;
  • chronic osteochondrosis;
  • birth injuries;
  • pregnancy.

The most common development of this disease is caused by various injuries and constant overload of the spine, which can arise as a result of increased training related to lifting weights, working at the dacha. The cause of the disease can be hard work at various industrial sites.

The onset of a painful attack can be caused by an awkward movement that marks a click or crunch. This can cause cartilage damage, which arose against a background of osteochondrosis, which caused various degenerative-dystrophic processes of the intervertebral space. Treatment of the disease should be carried out only after a complete examination of the patient.

Disc protrusion and its varieties

This ailment is divided into several types. Disk protrusion is:

  • circular;
  • dorsal;
  • posterior diffuse;
  • central( median).

The most common pathology is the circular protrusion of L4-L5 disks. In the diagnosis of lumbar hernias, it occurs in 80-90% of cases. This form of the disease is a uniform protrusion in the horizontal plane, which has rounded outlines. Circular protrusion of the disc may provoke neurological symptoms of various kinds. Her treatment is quite long and should be conducted under the supervision of a specialist. Circular variety of the disease of intervertebral discs is uniform, circular-foraminal, circular-dorsal. Dorsal protrusion of L4-L5 disks is a bulging in the direction of the spinal canal. The dorsal variety of this pathology suggests that the integrity of the fibrous ring is still preserved. If treatment is not carried out in a timely manner, then a rupture of the fibrous ring may occur, leading to the formation of a hernia.

Rear diffuse protrusion of L4-L5 disks indicates that the protrusion is concentrated in the region of the spinal canal. In this case, the lesion of the disc is noted at 30-50%.Diffuse form of the disease is often the result of a sedentary lifestyle. If the diffuse variety of the disease is studied by the attending physician and the causes of its occurrence are revealed, then the treatment of the disease can give a favorable outcome.

Central protrusion of L4-L5 discs is a pathology, in which a disc is protruded to the center of the ponytail. The central protrusion of the lisque requires timely treatment, to avoid the occurrence of stenosis of the spinal canal or the appearance of compression.

The main thing - do not skip the symptoms of

The appearance of the first symptoms can actually pass unnoticed and be indicated by slight, tingling tingling in the lumbar region. Often the disease begins to develop at a young age - after 18 years. Periods of pain are most often observed in the spring or autumn period, increasing every year.

After a while these pains intensify and start to worry greatly during the exacerbation. If the patient during this period does not go to a medical institution and does not begin treatment, then the protrusion gradually passes into the intervertebral hernia.

The defeat of segment L4-L5 is accompanied by the appearance of pains in all areas of the foot. In this case, there may be a feeling of tension and stretching of the veins, tingling and numbness of the limb. The pain is mainly localized in the area of ​​the outer and anterior surface of the thighs, but pain symptoms can occur in the area of ​​the feet and big toes. This characteristic is a symptom of Lasega, who notes the occurrence of lumbar pain when trying to raise an even leg up. Pain can be caused by coughing, sneezing and ordinary laughter. If the pain in the gluteal region is diagnosed, then it indicates the lesion of the L4 disc, which is signaled by its nerve root.

Using MRI to diagnose the disease

For accurate diagnostic measures, the patient is recommended to undergo radiography or MRI.They are modern diagnostic methods that can detect the presence or absence of protrusion. MRI allows you to make an accurate diagnosis of lumbar discs, as well as to identify degenerative-dystrophic pathology of the intervertebral space.

In addition, by means of MRI, places susceptible to defeat, the stage of development of the disease, are determined. Only after such a study the doctor can prescribe the right treatment.


Dorsal protrusion of the intervertebral disc

Among the diseases of the spine of a degenerative nature the most common is osteochondrosis, one of the complications of which is the protrusion( protrusion) of the disc. Dorsal( dorsal) protrusion is the protrusion of the intervertebral disc towards the spinal canal, which in the absence of treatment can lead to damage to the structures of the spinal cord or roots of the spinal nerves.

How do I know what it is?

The vertebrae are joined together by intervertebral cartilage, consisting of a more gelatinous core in the central part and surrounding a dense ring of connective tissue. Due to degenerative processes and increased stress on some parts of the spine, the fibers of the fibrous ring are destroyed, so the pulpous nucleus of the disc begins to flatten and move to the side.

In its development the protrusion passes through several stages:

  1. The first stage. Loss of elasticity, flattening of the intervertebral disc, the appearance of cracks in the fibrous ring. Patients may complain of periodic acute local pain.
  2. The second stage. The nucleus is shifted towards the least resistance, the fiber of the fibrous ring is stretched, forming a protrusion 2-3 mm. At this stage, the pain can be very intense, spread along the nerves, and in the area of ​​the damaged disc there is a feeling of discomfort.
  3. The third stage. The disc protrudes even more, reaching 3-5 mm. When the fibrous ring ruptures, an intervertebral hernia forms.

Dorsal protrusion of the disc can occur almost anywhere in the spine, but is most often seen in the waist and cervical region. Depending on the location and nature of the protrusion, there is a medial, lateral( lateral) and dorsal diffuse protrusion of the disc.

The causes of protruding

The leading causes of protrusion of the intervertebral discs are:

  • microtrauma,
  • weakness of the muscular corset,
  • sedentary lifestyle,
  • overstrain of a certain muscle group, resulting in poor blood supply and tissue trophism,
  • incorrect posture,
  • age,
  • osteochondrosis,
  • heavy loads on the spine, for example, with improper lifting of weights).

How to distinguish a hernia from a protrusion?

It is believed that the hernia is the same protrusion, but larger in size than simply protrusion( usually from 5 mm).Clinically, the hernia has a more pronounced symptomatology and requires surgical intervention.

Protrusion in L5-S1

This is the most favored and most dangerous localization of dorsal protrusions, since in the case of a significant protrusion, a bundle of nerve fibers called the ponytail may become entangled.

The initial stage is characterized by the appearance of a small pain in the lumbar region, increasing after physical exertion or prolonged stay in an uncomfortable position.

During an exacerbation after a loud crunch, a strong pain appears in the spine, radiating to the buttock and lower limb. As a rule, it is difficult for a patient to walk during this period, and pain can increase even when sneezing or coughing.

Protrusion in L4-S1

In this case, protrusion L4-L5 is added to the protrusion of the discs between the last lumbar and the first sacral vertebrae. In the initial stage, the pain intensifies after a crunch in the vertebrae, an incorrect posture during sleep, and so on. With an exacerbation there is a drawing pain in the leg during walking, the tonus of the muscles of the lower limb decreases. This protrusion is characterized by increased pain when raising your straightened leg up.

Prevention and treatment of

To prevent protrusions or exacerbate existing changes in the spine, the following recommendations should be adhered to:

  • You can not lift weights by leaning forward - they should be raised with your back straight;
  • it is forbidden to lift a heavy load and at the same time turn to the side;
  • if the "lower back" was due to an unsuccessful tilt, then do not make sudden movements: to straighten out gradually, relying on a cane, the back of a chair or other improvised object;
  • with back pain should avoid those types of professional activities that are somehow associated with vibration or prolonged sitting( for example, a driver, an office worker).

When pain occurs, it is necessary to maximally relieve the spine and provide him with peace: in the early days - bed rest and wearing a corset, which the doctor will recommend. In addition, it is useful to stretch on special tables and apparatus.
From drugs prescribed painkillers and anti-inflammatory drugs, B vitamins, drugs that improve trophicity and blood supply.
In the case of the formation of a hernia, removal of the pulpous core, plastic of the vertebrae and other types of surgical intervention are carried out.


Disc protrusion l4 l5, treatment, symptoms

The appearance of such a pathology of the intervertebral disc, as protrusion or hernia, is associated with degenerative-dystrophic processes of the spine, leading to loss of elasticity of the cartilaginous tissue and the formation of protrusion of the fibrous ring.

These changes are most often formed in the lumbar region.

This is caused by the maximum load on this part of the spine and, accordingly, on its vertebral-motor segments.

Very often the protrusion of the disc is detected between the fourth and fifth( l4-l5) vertebrae of the lumbar region.

It is important to timely detect this pathology, as adequate treatment can stop the pathological process and can prevent the increase in the size of the protrusion and its transformation into herniated disc.

Why does the disease occur?

It is known that the protrusion of the disk l4-l5 develops most often against the background of the osteochondrosis of the spine.

The processes occurring in this process contribute to the loss of the damping properties of the disk, to a decrease in its elasticity.

Therefore, any provoking factors( lifting weights, jumping, falling) can cause the appearance of this pathology.

Very often, the disease occurs in people whose profession is associated with heavy physical labor, athletes.

In addition, protrusion of the disc may appear against the background of diseases associated with metabolic disorders or after severe infectious diseases.

How does the disease manifest itself?

Symptoms of the disease largely depend on the type of protrusion. Specialists distinguish the following types:

  1. Dorsal( posterior) directed towards the spinal canal;
  2. Lateral or lateral, forming towards the spinal roots;
  3. Diffuse, with uneven protrusions;
  4. Circular, uniform protrusion of the disk in all directions.

The main symptoms of protrusion l4-l5 are pain in the lumbar region, especially after physical exertion.

If there is a lateral protrusion, the pain radiates to the lower limb, spreading over the outer surface of the thigh and lower leg.

Circular protrusion in the initial stages may not give a strong pain, so it often goes unnoticed.

As the disease progresses, sensitive disorders are added in the form of numbness of the outer surface of the shin, toes of the foot. The most dangerous is considered dorsal protrusions, because it can cause compression of the anatomical structures of the spinal canal.

The appearance of the above symptoms is an indication for an MRI or CTG of the spine. Such a diagnostic study can not only reveal the protrusion of the intervertebral disc, but also determine its size, location, structure.

Usually clinically significant, that is causing the expressed symptomatology, the size of protrusion for the lumbar region is from 3 to 5 mm. For comparison, the protrusion at the level of c4-c5, having a size of 2-3 mm, can cause significant neurologic disturbances.

How is protrusion treated?

If a patient has a protrusion of the 4-L5 disk, then first of all it is necessary to exclude factors that may contribute to the progression of the disease.

Avoid heavy lifting, vibration, sudden movement or jumping. Patients, whose work is associated with heavy physical exertion, it is necessary to move to easier work.

Treatment of protrusions, as a rule, includes a whole complex of measures. At the forefront of this are non-medicament means: physiotherapy, massage, acupuncture, pharmacopuncture, osteopathy, manual techniques. Also recommend therapeutic gymnastics or yoga.


L4-L5 disc protrusion: varieties, causes, symptoms

L4-L5 disc protrusion is a protrusion or displacement of a disc located between 4 and 5 vertebrae. This disease is the initial stage of the formation of the intervertebral hernia. A characteristic feature of the disease is the preservation of the integrity of the fibrous ring.

Warning! Protrusion in the area of ​​the L4-L5 disc occurs in 40% of all lumbar diseases. In 45% of cases it develops together with other lumbar diseases or hernias.

Causes of development of

The disease begins to form due to chronic and excessive loads exerted on the spinal column and separately on the lumbar region.

The disease develops for a long period of time, but the first symptoms begin to appear after awkward twists and turns, heavy lifting of weights. In most patients, painful attacks begin after a crunch or a click.

The cause of the disease is degenerative-dystrophic changes, cartilage damage and osteochondrosis. One common cause is spine injury. Factors influencing the development of the disease include:

  • Drinking alcohol and nicotine. These substances delay the blood circulation and slow it down, which negatively affects the affected area. Due to a violation of blood supply with microelements, some cells begin to die, which leads to the development of the disease;
  • Diseases of the spine. Often they begin their development from childhood. These include lordosis, kyphosis, scoliosis;
  • Incorrect food, which leads to metabolic disorders. This adversely affects the supply of nutrients to the lumbar spine.

Variety of diseases


  1. Circular variety. This is a frequent pathology of the disc, occurring in 80% of cases with the development of lumbar hernias. This uniform protrusion has a circular shape and a horizontal surface. The disease leads to the defeat of 4 and 5 nerve roots. Compression occurs in particularly severe cases. Circular protrusion is accompanied by pain in the back, which "gives" to the lower limbs. Absence of treatment leads to disability or loss of efficiency;
  2. Dorsal or posterior protrusion is the displacement of the disk in the direction of the spinal canal. Due to its location, this protrusion can lead to irritation of nerves and compression of nerve fibers. At the same time, pain sensations "give" in the big toe. In the early stages of the formation of the disease, only a mild pain syndrome appears;
  3. The posterior diffuse type of protrusion affects the intervertebral disc by 25% and is directed to the area of ​​the spinal canal. In this case, the pain is characterized by a paroxysmal character. In the absence of proper treatment, a symptom of Legas is manifested - when raising a leg, there are pains in the back, knee-jerk reflex. This disease often flows into the hernia of the disc, only in some cases it is accompanied by leg paresis, incontinence;
  4. Median protrusion - with it the disk is shifted towards the nerve fibers, called the ponytail. With this disease, the risk of compression or stenosis of the spinal canal increases. Without treatment, this type of disease is a dangerous pathology, eventually flowing into a hernia and acute exacerbations.

Symptoms of

The first symptoms begin to appear at a young age, most often in twenty years. At the same time, there is a slight pain in the lower back, which becomes more acute with time. Especially often it manifests itself in the spring-autumn season. After a few more years, acute attacks of pain syndrome appear.

If you do not visit the doctor on time and do not consult, the protrusion will develop into a herniated disc.

Other symptoms of lesion of L4-L5 include:

  • Pain in the leg, loss of sensation( numbness), "muscle tension", some patients complain of tingling in the lower back;
  • Pain on the outside of the thigh, stop, "recoil" in the upper finger. When you cough or laugh, the pain increases;
  • Knee reflex modification.


It is possible to diagnose protrusion on an MRI.This also allows you to track degenerative-dystrophic processes, changes in discs, narrowing of the dural space. MRI can detect the presence of concomitant diseases, including tumors and hemangiomas.

Without treatment, the prognosis of L4-L5 disc lumbar spine is unfavorable. Even if the waist carries daily loads, the further formation of the disease still continues. Possible complications and consequences:

  • Infringement of nerve roots and horse tail;
  • Lower paraparesis, femoral muscle paresis, difficulty with extension of the big toe;
  • The disease leads to disability, loss of ability to work.

Treatment of

Treatment of protrusion occurs without an operation in the early stages of the disease, when it did not flow into the intervertebral hernia. At the same time, the main task is to eliminate the cause of the disease and remove painful sensations.

So, among the measures that are included in conservative treatment, are:

  • With excess weight, a strict medical diet is required. Simply diet food will be required in any case if a protrusion is detected;
  • Therapeutic gymnastics. It is the main place among all the conservative ways of treatment. When it is done, there should not be discomfort, it is recommended to exercise on a special mat twice a day;
  • Treatment of protrusions requires mandatory refusal to lift weights, a long stay in one position, going to the gym and playing mobile games;
  • Massage, manual therapy, physiotherapeutic procedures;
  • In some cases, a doctor may prescribe medications. Their action is aimed at removing the pain syndrome and strengthening the muscular corset of the lumbar spine.

To perform the massage it is recommended to use the services of a specialist, otherwise complications of the disease may occur. If there is no possibility to attend massage sessions, then the procedure is required at home.

For this you need to prepare essential oil. It will be required to improve blood circulation, the intake of more nutrients in the affected department. It also positively affects the condition of the muscles, nourishes and strengthens them.

To perform the massage, the patient must lie on his stomach. Do not press on the affected area and protrusion. First, by light massage actions, it is necessary to develop an area around the hearth.

Over time, the movements should become stronger and more persistent. If redness occurs, do not be afraid and stop the procedure. On the contrary, this indicates that the blood circulation has been improved and comes back to normal.


  • Massage session is recommended to continue for about twenty minutes;
  • The patient should be in a relaxed state;
  • If discomfort or characteristic pain occurs, the session should be immediately discontinued;
  • After the end, it is recommended to apply a warming ointment of light effect around the protrusion.

After massage, you can tie the seat with a compress. For its preparation, it is recommended to use horse fat. It is required to melt and apply on polyethylene film, then put in the right place, on top wrap with cotton cloth. Leave the compress on all night.

The intervertebral disc L4-L5 at displacement can lead to negative consequences. That is why it is recommended to start treatment immediately if the first symptoms of the disease are found. To do this, you need to visit a doctor and undergo a thorough examination.


One of the most common diseases of the spine is the protrusion of the disk l5 s1.

In the early stages, when there is a slight aching pain in the back, it is written off for fatigue or physical overstrain. In fact, this is a warning about the possibility of a serious illness, such as a protrusion of the intervertebral disc. L5 s1

Prothrustion of the intervertebral discs

Protrusion( displacement or extension of the spinal disc beyond the vertebral column) is not an independent disease, but is a harbinger of osteochondrosis and vertebral hernia. According to statistics, problems with the I5s1 disc occur in half of all cases with the spine, but only 10% of the patients are diagnosed.

With a constant increase in the load on the dorsal column, the vertebrae gradually compress the gelatinous filling of the discs( pulpous core), eventually leading to its protrusion. At first, the main fibrous ring is not ruptured by the nucleus, but only greatly stretches, provoking the formation of cracks. If the load on the back is still increasing, the disc is squeezed out into the vertebral canal. The tissue of the pulpous core begins to lose the water present in it, which causes a decrease in the height of the disc.

Changes in intervertebral disks l4 l5 l5 s1 are divided into several types:

  1. Central protrusion of disk l5 s1( also called median) is the curvature of the vertebral disc towards the bundle of nerve fibers of the spinal canal.
  2. Rear dorsal protrusion of the disk l5 s1( posterior protrusion).Disk protrusion occurs in the direction of the spinal canal between the 5 lumbar and 1 sacral vertebra.
  3. Circular protrusion is expressed by a uniform protrusion of the disk in the horizontal plane.
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Protrusion of the intervertebral disc l5 s1

When l5 s1 protrusions, the nerve roots in the lumbar region and the ligament of nerve fibers located in the spinal canal often occur. At the initial stage, the disease manifests itself in small back pain, which can begin with a 15-year-old age. In the future, pain becomes stronger, appearing after physical work, playing sports and even after sleep. Usually the pain subsides quickly.

When the protrusion of the intervertebral disc l5 s1 develops, pains appear more often, a crunch arises in the affected vertebra. Begin to manifest painful sensations from the outside of the thighs and in the calf muscles. The patient becomes difficult to walk, tingling in the legs or numbness appears. Muscles can decrease in size from one side of the leg.

With regular pain in the spine, consult a doctor.

The sooner the disease is diagnosed, the easier it is to cope with it. Without proper treatment, protrusion of the intervertebral disc I5s1 can develop into a vertebral hernia.

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Methods for Treating the Disc Protrusion

The primary method for determining protrusion of intervertebral discs is to perform a specialist examination. The protrusion of the pulpous nucleus and deformation of the disc is felt during palpation. But it is possible to determine the exact size of lesions of the fibrous ring only with ultrasound examination or with an X-ray.

If a protrusion is detected in the patient, any strain on the spine should be immediately eliminated. The best option is a strict bed rest. First of all, it is necessary to remove pain and to stop inflammatory processes. The patient is prescribed analgesics, muscle relaxants and non-steroidal anti-inflammatory drugs.

The treatment procedure directly depends on the degree of protrusion and the presence of concomitant diseases in the patient. Complex treatment consists of using several methods at once:


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