01 — What it is
The lowest lumbar discs carry more load than any other segment of the spine, and they are where degenerative change often appears first. Symptoms range from mechanical back pain that is worse with sitting, to sciatica, where a compressed nerve root causes pain travelling into the leg.
02 — Symptoms
- Low back pain, worse with sitting, bending or lifting
- Sciatica: pain through the buttock and down the leg
- Numbness in the foot or calf
- Weakness lifting the foot or pushing off
03 — Causes
- Age-related loss of disc height and hydration
- Occupational lifting and repetitive loading
- Prior injury or a previously operated level
- Smoking, which is associated with impaired disc nutrition and bone healing
04 — How it is diagnosed
Standing X-rays show alignment and disc height under load. MRI defines the disc and the nerve. Where more than one level appears abnormal, diagnostic injections can help identify which one is generating symptoms.
05 — Treatment approach
A structured non-surgical program is generally the starting point. If surgery is considered, the question is whether decompression alone is sufficient or whether the segment also needs to be stabilized, and that is decided on the imaging and the examination.
General information only. Your own diagnosis and plan depend on your examination and imaging. Nothing here replaces a consultation.
