Disabling Effects

People with this level of restriction would normally have some pain and discomfort in the lower back and possibly in the buttocks and thighs as well. They may experience discomfort from tightening of the neck or back muscles. Their discomfort is likely to be more noticeable on physical activity, but these periods of increased discomfort are likely to be infrequent and of short duration.

Mobility

People with such a restriction would normally be able to walk several hundred metres at a normal or near normal speed. They would be unlikely to suffer from falls. If an acute flare up occurs, mobility may be more severely affected but this would be for the minority of the time. There would be no need for guidance or supervision outdoors.

Care

People with this level of functional restriction would normally be able to safely manage all aspects of their personal care. More difficulty with personal care tasks may arise if flare-ups occur, but this will be for the minority of the time. Specifically there would normally be no significant difficulty in getting out of a normal height chair, getting in and out of bed and the bath, rising from the toilet and coping with personal hygiene or climbing stairs safely. There would normally be no significant difficulty in dressing, using appropriate aids where necessary, or with feeding, washing, shaving and aspects of main meal preparations such as lifting pans and peeling vegetables. Some difficulty may be experienced in bending however, if hip and knee function are preserved, and a functional range of hip and knee movements are present, this can usually be overcome by bending at the hips and knees.

People with such a condition would not normally suffer from falls and there would be no requirement for supervision and watching over.

Disabling Effects

People with this level of functional restriction are likely to experience pain and discomfort in their neck or lower back for most of the time. The pain may radiate into one buttock predominantly and travel down that leg below the knee into the foot and toes. The leg pain is often accompanied by numbness and tingling on the affected side in the specific region supplied by the nerve root. They may also experience discomfort from tightening of the back muscles. In the case of cervical prolapse (herniation), pain may radiate from the neck to the arm, and is often associated with numbness and tingling.

Mobility

People with such a restriction will be able to walk at least a few hundred metres at a normal or near normal speed. They should be able to walk with a mild limp, and they would be unlikely to suffer from falls. There would be no need for guidance or supervision outdoors.

Care

People with this level of functional restriction could have difficulty coping with some activities of daily life in particular dressing their lower garments e.g. trousers and socks due to bending difficulties but technical aids are available to overcome this if present. They would normally be able to carry out other personal care tasks such as rising from a normal height chair, getting into and out of bed and the bath and climbing stairs. However, despite the presence of pain or discomfort, functional limitations in performing these activities are likely to be minimal in the majority of cases. Especially if the upper limbs are affected, aspects of main meal preparation such as lifting pans and peeling vegetables would normally be possible, albeit with some discomfort. Simple aids such as a light saucepan are helpful to overcome any difficulties. There is likely to be some restriction of spinal movements, e.g. limitation of forward flexion and extension of the back, and reduced sideways (lateral) flexion on one side. However, If good hip and knee movements are present, bending can be achieved even with minimal back movements by bending at the hips and knees.

People with such a condition would not normally suffer from falls and there would be no requirement for supervision and watching over.

Disabling Effects

People with this level of functional restriction are likely to experience constant severe pain in their lower back for most of the time. The pain is likely to radiate into one buttock predominantly and travel down that leg below the knee into the foot and toes. The leg pain is often more severe than that experienced in the back, and is usually accompanied by numbness and tingling on the affected side in the specific region supplied by the nerve root. Tightening of the back muscles may add to the overall level of pain. Sleep may be disturbed by pain in some people. Moderate to strong analgesia may not be fully effective in relieving symptoms. Flexion of the spine is likely to be significantly restricted. Marked weakness of the thigh muscles may be present and there may be associated muscle wasting. Foot drop may be present. In cervical involvement, constant severe upper limb pain, weakness and abnormal sensation are present.

Mobility

Walking would normally be restricted in terms of distance (this may be in the range of 40 to 100 metres) and speed due to severe pain in the lower back and leg. They would normally have an abnormal gait, walking with a limp. There may be an increased risk of falls due to leg weakness, loss of sensation and foot drop although walking aids may help with mobility. There may be a need for guidance or supervision outdoors.

Care

People with this level of functional restriction would normally have difficulty coping with many activities of daily life. They may have considerable difficulties getting out of bed and out of the bath. They are likely to have difficulties with dressing, particularly with their lower garments e.g. trousers, socks due to bending difficulties. There may be considerable difficulty with other personal care tasks, such as rising from a normal height chair, climbing stairs and aspects of main meal preparations such as lifting pans, and bending to a traditional oven to insert and remove items. Due to leg weakness on one side, loss of sensation and possible foot drop, a risk of falls may be present. There may be a requirement for supervision and watching over if falls occur even with the use of walking aids. If affected on both arms there may be marked problems with dressing, preparing a main meal and toileting. If however only one side is involved, only bimanual tasks are affected.