Degenerative disc disease L5-S1: What to do? (full guide)

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Your doctor has finally prescribed an MRI to clarify your lower back pain. In the report ofmedical imaging, there is mention of L5-S1 degenerative disc disease. It can also be at the cervical level, L4-L5, or even associated with lumbar osteoarthritis or herniated discs.

Is that bad ? Can we treat it? Can you work with L5-S1 degenerative disc disease? And above all, what exactly is degenerative disc disease? We often hear about the herniated disc or disc protrusion, but what is the difference?

In this article written by a physiotherapist, we cover everything you need to know about L5-S1 degenerative disc disease, with an emphasis on simple, practical concepts. You will leave with a better understanding of your condition, as well as tools to help you treat your back problem.

Degenerative disc disease, what exactly is it?

It is impossible to explain L5-S1 degenerative disc disease to you without giving you a short anatomy lesson. As this diagnosis is related to intervertebral discs, let's start by identifying the main structures that are part of the spine :

The spine (or vertebral column) is made up of vertebrae superimposed. In the lumbar region (lower back), there are 5 vertebrae called L1, L2, L3, L4, and L5. Note that the spine ends with the sacrum, this triangular bone also composed of 5 welded vertebrae (S1, S2, S3, S4 and S5).

Between each vertebrate, there is a intervertebral disc. For example, the L4-L5 disc is the disc located between the L4 and L5 vertebrae. The L5-S1 disc, on the other hand, is located between the last lumbar vertebra (L5) and the first sacral vertebra (S1).

In summary, the intervertebral discs are structures located between 2 superimposed vertebrae. When we study the composition of these discs, we see that they look like pads. More specifically, they are composed of a gelatinous nucleus (Nucleus pulposus) in the central region, surrounded by a fibrous ring (Annulus fibrosus).

But what are intervertebral discs for? Their roles include:

  • The separation of the vertebrae from the spine
  • Shock absorption during movements involving impact (walking, running, jumping, etc.)
  • The distribution of pressures thanks to the gelatinous core
  • Mobility between the vertebrae

What happens in the presence of L5-S1 degenerative disc disease?

Progressive lesions are observed at the level of the L5 and S1 intervertebral discs. These may be the site of micro-tearing, dehydration, deformation or cracking.

The most common cause of degeneration is osteoarthritis, and thus leads to progressive wear of the discs. 

Why does it mainly affect the vertebrae in the lower back?

Quite simply because the L5-S1 vertebral segments represent a hinge zone (an intermediary between your lumbar and sacral vertebrae) which undergoes a lot of physical constraints due to its low position.

What is multi-stage degenerative disc disease?

In the case of disc disease, the term “staged” means that the damage concerns several discs and not just one.

This degenerative process can affect any disc in the spine, from the cervical region to the lumbar region. Symptoms develop slowly and gradually over time.

Where does degenerative disc disease come from? (9 possible causes)

What are the causes of intervertebral disc degeneration? Here's a look at the main contributing factors:

1. Natural aging

Aging is the most common cause of degenerative disc disease. With age, intervertebral discs gradually lose their water content and elasticity, making them less able to absorb shock. This dehydration and loss of flexibility can lead to cracks and disc degradation.

2. Genetic factors

Genetics plays a crucial role in the development of degenerative disc disease. If your parents or grandparents suffered from this condition, you are more likely to develop it too. Some people inherit more fragile discs or an increased susceptibility to degeneration.

3. Overweight and obesity

Excess weight puts additional pressure on the intervertebral discs. Being overweight can accelerate disc wear, especially in the lower segments of the spine, like L5-S1, which support much of the body's weight.

4. Injuries and trauma

Past injuries, such as car accidents, falls or sports injuries, can damage the spinal discs. This damage can trigger or accelerate the degeneration process, particularly if the disc has already been weakened.

5. Professional and physical activities

Certain professions or activities that involve intense physical effort, repetitive movements or restrictive postures can put excessive strain on the intervertebral discs. Heavy manual work and high-impact sports increase the risk of degenerative disc disease.

6. Sedentary lifestyle

A sedentary lifestyle is another important risk factor. Lack of regular exercise can weaken the muscles that support the spine, increasing pressure on the intervertebral discs and accelerating their degeneration.

7. Smoke

Smoking is known to reduce blood supply to the intervertebral discs, which can prevent them from receiving the nutrients needed to maintain their health. Additionally, chemicals in cigarette smoke can damage disc structures, increasing the risk of degeneration.

8. Bad posture and ergonomics

Incorrect and prolonged postural habits (sitting, standing, lifting heavy loads, etc.) can exert uneven pressure on the intervertebral discs, promoting their premature wear.

Poor ergonomics at work or at home, in some cases, can also contribute to disc degeneration.

9. Biomechanical factors

Structural or functional abnormalities of the spine, such as scoliosis, can cause uneven disc wear. These biomechanical dysfunctions can accelerate the degradation of intervertebral discs.

How to diagnose L5-S1 degenerative disc disease?

If you are reading this, you may have already had an MRI indicating one (or more!) levels have degenerative disc disease.

Currently there is only themedical imaging which is able to diagnose L5-S1 disc degeneration. A CT scan or X-ray will assess the height of the discs, as well as the integrity of the articular cartilage.

An MRI, on the other hand, will provide more details on the disc lesion (irritation of an associated nerve root, herniation or disc protrusionEtc.).

In the clinic, a healthcare professional can perform a neurological examination and put forward a hypothesis of disc damage. These tests include, among others:

  • reflexes
  • the myotomes (strength and endurance of the lower limbs)
  • dermatomes (tenderness in the legs)
  • nerve stress tests
  • etc.

However, these assessment tests have certain limitations that prevent an ultra-precise diagnosis from being made.

Degenerative disc disease and back pain (the symptoms)

Let's start with statistics which I hope will challenge your view of your degenerative disc disease: 

  • 96% of 80-year-olds with no lower back pain showed signs of degeneration on medical imaging
  • 68% of people in their XNUMXs with no lower back pain showed signs of degeneration on medical imaging
  • 37% of people in their twenties with no lower back pain showed signs of degeneration on medical imaging

But then, you will say to me, what is the connection between my degenerative disc disease and my back pain?

It's simple. If you have back pain and have been diagnosed with degenerative disc disease, it may be responsible for your pain.

In this case, the symptoms often encountered are localized pain (it can sometimes radiate into the buttocks), increased by prolonged static positions, and excessive effort. But the symptoms generally vary from one person to another, so much so that it is difficult to establish a typical clinical picture of degenerative disc disease.

If the disc disease is related to a disc herniation or protrusion, it is possible to observe an irradiation of pain of the type sciatica or cruralgia. This is probably due to nerve irritation of the nerves adjacent to the intervertebral discs.

But it is also possible that your L5-S1 degenerative disc disease is present long before the appearance of your symptoms, or that it is not unrelated to your low back pain.

Why ? Because the body has an extraordinary ability to adapt.

If the changes were ever gradual, your body may have adapted to disc degeneration. Also, if the disc does not come into contact with a nerve root, there may be no associated inflammatory process, and therefore minimal (or no) pain.

So what should we remember?

L5-S1 degenerative disc disease can sometimes cause symptoms, although it is asymptomatic in some people. It is therefore possible to live with L5-S1 degenerative disc disease without even knowing it!

In the presence of pain, it is absolutely necessary correlate observed findings to imaging with clinical evaluation.

Treatment of degenerative disc disease: What to do in practice?

If you're wondering about degenerative disc disease, it's probably because your back is hurting you. You may have understood by reading this article that the diagnosis in itself was not necessarily related to your symptoms. But you still have back pain.

What can you do to reduce your lower back pain and resume your activities?

Of course, consult a health professional will allow you to adapt the treatment according to your condition. Generally, we start with conservative treatments aimed at relieving you, in addition to restoring your movements and maximizing your function.

For example, a doctor may prescribe anti-inflammatory medications or muscle relaxants. A physiotherapist will be able to give you an exercise program aimed at toning your muscles and increasing your flexibility. An osteopath will be able to apply manual therapy techniques (massages, manipulations) to relieve you.

Here are 7 tips to reduce your symptoms and improve your quality of life.

7 tips to reduce back pain caused by L5-S1 degenerative disc disease

1. Get moving!

Let's start with the most important point: It is possible to improve the condition of your disks even after they have suffered degeneration. The solution: Exercise!

Certainly, some intense and demanding activities could accelerate the degradation of the discs. It's probably related to overload, and this approach is not recommended. On the contrary, it has been shown that activities involving dynamic movements at slow or moderate speed (and including axial compression) promote disc regeneration.

This thus confirms the adaptability of the discs, more precisely their positive adaptation to measured (and safe!) physical activity. 

2. Change your posture regularly

Notice to those who have a desk job. We often blame the bad posture as a cause of back pain or degenerative disc disease.

But it is above all the lack of movement which is most likely to cause disc degeneration.

As mentioned, regular movement can rehydrate the discs, and help prevent stiffness and muscle atrophy.

You probably know the solution: Get up regularly during your working hours, do certain postural exercises during the day, and adopt a lifestyle as active as possible!

3. Apply heat and/or ice

Sometimes the pain is so incapacitating that it prevents us from moving. Although you should stay active as much as possible, a temporary rest is sometimes necessary to relieve his symptoms.

Apply ice and/or heat to reduce your back pain. Which one to choose between the two? In short, the one that does you the most good! (For a more comprehensive answer, see next article.)

4. Apply meditation and breathing techniques

In addition to pain, low back pain comes with its share of stress. With this in mind, breathing exercises and/or meditation can help you overcome this difficult ordeal.

Take the time to relax your body and mind in an optimal relaxation environment. To do this, exercises diaphragmatic breathing or mindfulness can be useful and effective.

5. Lose your (a few) extra pounds

It may be relevant to lose extra pounds if you are overweight. Some studies have also shown a relationship between obesity and low back pain, although this relationship is not always so easy to highlight.

But more importantly, it is preferable to integrate regular physical activity adapted to your lifestyle. This will help maintain good back muscles, as well as favorable mobility and constant disc rehydration.

Weight loss will just be a bonus (especially if you adopt good eating habits!).

6. Adopt an anti-inflammatory diet

If one accepts the premise that inflammation is responsible for back pain, it is normal to find strategies aimed at reducing inflammation.

The anti-inflammatory diet can be interesting to achieve this goal (in addition to controlling weight). It is essential to avoid foods that promote an inflammatory process, and prioritize those that have an action against inflammation. For more details, an article is devoted to it here.

7. Quit smoking

Cigarettes come with their share of misdeeds. Among these, the accelerated degeneration of the intervertebral discs compared to those who do not smoke.

No need to say more !

Alternative treatments in the treatment of L5-S1 degenerative disc disease

There are also alternative treatments used in the treatment of back pain. Although they demonstrate a lack of scientific evidence, they are often used, sometimes successfully.

Here is a (non-exhaustive) list of alternative treatments that can be used to combat back pain to treat L5-S1 degenerative disc disease:

Back pain tools and accessories

In addition to the treatments mentioned above, there are several products and accessories available on the market to relieve lower back pain related to degenerative disc disease. It should be remembered that these tools generally provide temporary relief, and should be used sparingly.

Some of the most popular accessories include (click on the item you are interested in for purchase options):

acupressure mat
Wellax acupressure mat with cushion – specifically relieves tension and promotes circulation – massage mat in a set including acupressure cushion and carrying bag
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  • 🧘 𝐋𝐈𝐁È𝐑𝐄 𝐃𝐄 𝐋𝐀 𝐓𝐄𝐍𝐒𝐈𝐎𝐍 – Our fakir mat stimulates the muscles, promotes circulation and can thus effectively relieve tension. This is how you fight annoying back and neck pain!
  • 🧘 𝐃𝐈𝐒𝐒𝐈𝐏𝐄 𝐋𝐄 𝐒𝐓𝐑𝐄𝐒𝐒 𝐑𝐎𝐔𝐓𝐈𝐍𝐈𝐄𝐑 – Whether after a training session, a match or a hard day work: The Wellax acupuncture mat is the ideal support for releasing daily tension. Pure relaxation for body and soul!

Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

Lumbar belt heated
GINEKOO Heated Back Belt, Breathable Back Belt with Rechargeable Battery Heating to Relieve Lower Back Pain, Lumbar Support for Herniated Discs, Sciatica(XL)
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  • 【3 Heating Modes】The back brace for lower back pain contains a heating pillow fixed by Velcro, which you can easily operate via the controller. There are 3 heating settings (low, medium, high) that allow you to adjust the temperature as needed to promote blood circulation and relieve back pain.

Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

Ergonomic back cushion
Car Lumbar Cushion for Back Back Support for Office and Car Chairs, Ergonomic for Back Seat
  • ✨Premium Material: Our lumbar support cushion is filled with new temperature sensitive sponge, the lumbar support can adjust the contour of your back according to the temperature. The outer layer of lumbar cushion is made of high quality breathable fabric. The back support cushion fabric is comfortable and soft, not easy to fade. The parts of the lumbar cushion have been certified and are safe and harmless to human health.
  • ✨High-quality design: The back support cushion for chair is ergonomic, and the pillow for back pain has a partitioned design, the memory foam back cushion can support your back curve and promote healthy posture. The lumbar support cushion for chair uses elastic straps to keep the lumbar support cushion for sofa firmly fixed on the seat.
  • ✨Protect your health: With our car back support, you can better protect your spine, car back support office chair Helps relieve lower and middle back tension caused by prolonged sitting or driving. If you often experience back pain due to prolonged sitting, you should definitely try an office chair back cushion.

Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

massage gun
Muscle Massage Gun ALDOM Deep Muscle Massager Massage Device with 30 Adjustable Levels, 6 Massage Heads and LCD Display for Relieving Muscle Aches and Stiffness
  • DEEP TISSUE MASSAGE GUN – ALDOM Muscle Massage Gun for Athletes is ideal for relieving muscle pain, soreness and stiffness, promoting blood circulation and helps speed up warm-up and cool-down. It also helps restore the body faster and can be used as your percussion massager at the gym or sports club, is held with one hand and has a comfortable handle.
  • 6 MASSAGE HEADS + 30 SPEED - The deep tissue massage gun comes with 6 different massage heads to help relieve sore muscles, 30 adjustable speed modes, Choose the speed and massage heads that best suits your needs. your needs (1 to 800 pulses per minute) to target different body parts and muscle groups, Integrate a percussive massage experience. Reduce muscle recovery time.
  • SUPER QUIET AND POWERFUL MASSAGE GUN - Professional handheld percussion massager. Featuring a powerful, high-penetration motor, the deep tissue massager is designed to send waves of relaxation and relief throughout the body, and increase everyday mobility and flexibility with percussive therapy for pain relief joints and muscle pain and prolongs the duration of muscle massage
BURNNOVE Muscle Massage Gun 99 Adjustable Speeds Massage Gun Electric Deep Muscle Massager Portable 8 Heads 2550mAh 3300 RPM LED Touch Screen Low Noise Relieve Pain
  • 💪RELIEVE MUSCLE PAIN – Our massage gun can help relieve tight muscles, aches and stiff backs, relaxes tender tissues. The deep muscle massager quickly removes lactic acid produced after exercise, significantly reducing muscle recovery time.
  • 💪8 MASSAGE HEADS + 99 SPEEDS – The powerful massage gun contains multiple easy-to-replace massage heads that can care for different body parts and muscle groups. The 99 speed adjustment parameters allow you to better choose the vibration speed to reach you the most comfortable state.
  • 💪LED TOUCH SCREEN – The muscle massage gun is equipped with an LED screen, which can display the speed and battery percentage. You can increase or decrease the speed of the electric massager by simply pressing the "+" or "-" button, and it can be adjusted quickly with a long press, which is easy and convenient to use.

Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

Local alternative (French product)

Invasive treatments: ultimate solution?

Finally, invasive treatments are sometimes considered when pain persists and previous treatments have proven ineffective.

In general, they are considered when the L5-S1 disc degeneration is such that it affects the spinal cord and/or the corresponding nerve roots.

Anyway, it is advisable to consult your doctor who will be able to guide you in the process.

Here is a list of invasive treatments considered:

What about grandmother's remedies and natural products?

Although they are not supported by solid scientific evidence, several natural products and home remedies are used to treat various body pains, especially for their anti-inflammatory power.

Natural remedies that may relieve symptoms include (click on the product you are interested in for purchasing options):

Turmeric

Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.

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Ginger

In addition to the particular flavor it brings to cooking and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. THE gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).

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Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

Omega-3

Omega-3s are polyunsaturated fatty acids that play a very important role in the functioning of our body. They are provided by food in three natural forms: docosahexaenoic acid (DHA), alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). Beyond their action on the brain and the cardiovascular system, omega-3s prove to be very effective against inflammation. Indeed, they have the ability to act on the inflammatory mechanisms in osteoarthritis by slowing down cartilage destruction, thus they reduce the intensity of osteoarthritis pain. Sciatica, being most often linked to an inflammation secondary to a herniated disc, it can also respond to omega-3 provided it is consumed regularly. 

Omega 3 Wild Fish Oil 2000mg – 240 Capsules (120 Days) – High Concentration of EPA (660mg) & DHA (440mg) Supports Heart Function and Normal Vision – Manufactured by Nutravita
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  • ✔ WHY OMEGA 3? Each recommended daily dose of our premium Omega 3 fish oil supplement provides high-potency essential fatty acids – Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) which both help support various functions bodily, especially in the normal functioning of the heart. DHA supports the maintenance of normal brain function and normal vision. All these claims are supported by EFSA
  • ✔ WHAT INGREDIENTS ARE USED AT NUTRAVITA? – We have a dedicated team of pharmacologists, chemists and researchers who work to find the finest and most beneficial ingredients, allowing us to provide advanced, high strength vitamins and supplements that do not contain dyes or flavorings artificial. From *fish* which may NOT be suitable for people with allergies. The soft capsule is made from (bovine) gelatin.

Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

Lemon eucalyptus

Eucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.

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wintergreen

Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the essential oils most used in aromatherapy. This oil, extracted from the shrub of the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.

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Last updated on 2024-06-18 / Affiliate links / Images from the Amazon Partners API

Remember that these products do not replace medical treatment. Do not hesitate to consult for support adapted to your condition.

Conclusion (and take-home message)

So much for L5-S1 degenerative disc disease!

If your doctor has given you this diagnosis by medical imaging, the first thing is not to panic! Firstly, it is not guaranteed that it is degenerative disc disease which is responsible for your pain. A health professional will be able to confirm this for you. 

As soon as serious damage is excluded, it is possible to effectively treat L5-S1 degenerative disc disease. However, it must be understood that the pain won't go away while remaining inactive. Indeed, a proactive approach is THE solution of choice for those who wish to heal optimally, in addition to preventing recurrence of injury.

Among the treatments available are more natural or alternative techniques, and invasive methods to consider following the failure of conservative treatment. Be sure to find an experienced and trusted healthcare professional who will be your ally and your guide.

Good recovery!

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