Domino Effect of Lumbar Disc Problem on the Lower Limbs

https://chiro.org/Low_Back_Pain/Influences_of_Lumbar_Disc_Herniation.shtml

I came across this really interesting article on the effect of lower back pain, in particular when generated by a lumbar disc herniation, shortly after a patient asked me if there was a correlation between an injury they suffered at work a year ago, and a variety of new problems cropping up in multiple areas of one leg. Apparently, this is a question that folks around the world must be asking and prompted Chinese colleagues to methodically investigate by taking controlled measurements of what happens to the pelvis rotation and leg function during several common daily activities.


The effect of lumbar disc herniation on the lower extremity is especially two-fold: rotational stress from the pelvis is transferred downward, and the knee in particular is not equipped to deal with the constant shear force on the meniscus ( a problem I see commonly ). Second, the leg is maintained in a slight state of flexion at the hip and knee, resulting in increased weightbearing stress on the midfoot and plantar fascia and malposition of the patella. If the lumbar problem is not resolved, the structures of the knee and foot will start breaking down over time. This is true even if the lower back pain starts improving , since the protective posture of hip rotation and leg flexion can persist long past the original acute lumbar pain.


The moral of the story: yes, you absolutely can develop lower extremity repetitive injuries from an acute lumbar disc and those injuries can outlast the acute low back pain. But treating those injuries without addressing the compensatory postural adaptation is doomed to give you paltry results