A lumbar spine injury may happen when a person lifts a heavy object, twists the spine in an unnatural way or sustains an injury in a motor vehicle injury or sports-related injury. The main symptom is often pain down the back that can radiate down the leg in the area of the buttocks, numbness down the leg or tingling down the leg.
In treating lumbar injuries, it is important to know what the degree of injury is. Is there musculoskeletal injury only? Are the ligaments of the lumbar spine affected? Has there been a fracture and is the fracture dislocated? The worst case scenario is a fracture/dislocation of the lumbar spine. This involves intervention with a spinal orthopedist.
If a lumbar disc is injured, it can put pressure on the exiting nerve root so that there are shooting pains or shooting tingling down the buttock and onto the leg. The treatment can involve exercise to strengthen the disc’s protective outer coating. A surgeon can go in and trim away the part of the disc that is impinging on the nerve root.
If you have facet joint syndrome, you have a particular type of arthritis that affects the facet joints—the joints that allow movement of the spine. The symptoms are stiffness, pain and lack of mobility of the spine. The treatment can be ice, heat, anti-inflammatory medications or a spinal fusion that prevents movement at all from the joints so they don’t hurt.
In acute nerve root compression, there may be a case of lumbar disc prolapse. The disc falls out of its normal position and falls into the space occupied by the nerve root trying to exit an opening made by the disc and the spinous processes. The symptoms are pain, numbness or tingling along the path made by the nerve root. The treatment is disc removal in a diskectomy.
Muscle strain in the lumbar area is common during heavy lifting with the back, especially when using poor body mechanics. Sports injuries can lead to muscle strains. Symptoms include sharp pain in the low back made worse by movement, sneezing or coughing. Symptoms improve by lying down flat. The best treatment for muscle strain is to use heat alternating with ice (start with ice first to reduce inflammation) and physical therapy to strengthen the supporting muscles. Also, learning good ways to lift heavy objects will help reduce the likelihood of re-injury.
In the first 72 hours after a minor lumbar injury, you need to follow the RICE regimen. RICE stands for Rest, Ice, Compression and Elevation. This reduces inflammation and relieves pain. After treatment, strengthening exercises should be done but only if the following criteria are met:
- The injury is not painful in the morning
- The injury is not painful to the touch
- The injury is not painful with light to moderate activity
- The injury is not painful to stretching
After strengthening exercises, you can be considered to be healed from this condition.
In stenosis of the spinal canal, bony hypertrophy or a bulging/ruptured spinal disc disease places pressure on the spinal cord so that the spinal cord cannot transmit signals distally. The pain is poorly localized in the back and pain in the buttocks or groin. It is common in the elderly or in those who did a lot of heavy lifting in their lives. The treatment is surgical with attempts to open the spinal canal.
If there is lumbar instability due to an injury, this means that bones are fractured and ligaments are damaged. Symptoms include poor mobility, tightness in the lumbar region, and weakness in the lumbar spine with pain aggravated by movement. The treatment is usually surgical with things like spinal fusion to put the unstable parts together and seal them so there is no movement in the area.