What is the lumbar spine?

​

The lumbar spine consists of five bones, called vertebra, in the lower back. The lumbar vertebrae, named L1 to L5, are the largest bones in the spine. The lumbar spine is located below the 12 thoracic vertebra and above the five fused bones that make up your triangular-shaped sacrum bone.

​

Compared with other spine vertebrae, the lumbar vertebrae are larger and thicker and are similar to blocks. These bones provide stability for the back and spinal column, and attach many muscles and ligaments. The lumbar vertebrae are responsible for supporting the weight of the body and providing the center of balance. The lumbar spine and associated muscles and ligaments allow walking, running, sitting, lifting and move your body in all directions.

​

The lumbar spine has a slight inward curve called a lordotic curve.

​

Disks in the lumbar spine

​

Intervertebral disks are the shock absorbers that sit between each vertebra. Especially in the lumbar spine, these disks help support the body’s weight by bearing the load coming down the spine during activities such has walking and allow movement between each vertebra. The disks in the lumbar region are most likely to degenerate or herniate because of the pressure they withstand, which can cause pain in the lower back or down theh legs.

​

Spinal cord

​

The spinal cord is a bundle of nerve tissue that extends from the lower part of your brain to about your L1 vertebra. It carries messages between your brain and muscles. The remaining nerve roots, called the cauda equina, descend down the rest of your spinal canal.

​

Nerves of the lumbar spine

​

There are five pairs of lumbar spinal nerves that exit the spine on both the right and left sides of L1 to L5. The nerves run down from thhe lower back and merge with other nerves to form nerve bundles that control both pain signals and the movements of the lower limbs. For example, the sciatic nerve consists of the L4 and L5 nerves plus other sacral nerves. The sciatic nerve starts in the rear pelvis and runs down the back of the leg, ending in the foot.

​

What diseases and disorders affect your lumbar spine?

​

Many problems can occur in the lumbar spine. These problems can limit motion in the back or hips and cause pain, weakness, and numbness or tingling in your back, hip, thigh or leg.

​

Diseases, disorders and conditions affecting your lumbar spine include:

​

• Lower back pain

• Lumbar stenosis

• Spondylolisthesis (slipped disc)

• Vertebral fracture

• Sciatica

• Herniated disks

• Lumbar lordosis

• Muscle spasm

• Degenerative disk disease

• Adult scoliosis (adult spinal deformity)

• Cauda equina syndrome

​

How are lumbar spine health issues treated?

​

Both nonsurgical treatment options and surgery are available to treat many of the conditions that affect the lumbar spine. The choice depends on the cause of the lumbar spine issue and its severity.

​

What are the nonsurgical treatment options for lumbar spine conditions?

​

Generally, less invasive approaches for lumbar pain are recommended first. Once these options are exhausted, surgery may be considered. Some common nonsurgical treatment options include:

 

• Rest

• Ice or heat

• Avoid strenuous or aggravating physical activity

• Physical therapy

• Medications, including muscle relaxants, pain relievers (such as acetaminophen) and anti-inflammatories (such as ibuprofen and naproxen)

• Corticosteroid injections

• Medical branch block and radiofrequency ablation

​

What surgical treatment options are available for lumbar spine conditions?

​

Common surgical approaches include:

​

• Lumbar spinal decompression surgery

  • Lumbar discectomy

  • Lumbar laminotomy or laminectomy

  • Lumbar foraminotomy 

  • Lumbar corpectomy

• Lumbar disk replacement surgery

• Lumbar spinal fusion

• Functional electrical stimulation for spinal cord injury

• Spinal cord stimulation