What is it?
Lumbar (lower back) nerve root irritation or “pinched nerve” is a common disorder occurring with compression of the nerves of the low back as they exit the spine. The nerve roots exit through a tunnel, known as the lateral foramen, made up by 2 adjoining vertebrae. Compression of the nerve root can result from anything that acts to restrict the size of the tunnel such as disc bulges, loss of disc height and bony growths, or by anything that winds up the tension of the nerve as it passes through the tunnel. Compression of the nerve can lead to symptoms in the lower back, hip and own the leg.
Symptoms
Symptoms of lumbar nerve root irritation can vary significantly in intensity and severity and include:
- Pain will generally be on one side and may be across the back, into the buttock and hip or in more severe cases radiate down the leg.
- Pain, pins and needles, burning sensations or numbness are common.
- In some cases, there will be weakness of the muscles supplied by the effected nerve.
- Protective muscle spasm can occur in the surrounding areas of the back, hip and buttocks.
- The movements which trigger and relieve pain will vary depending on the structures involved.
Risk Factors
- Individuals aged 45-65 are more likely to develop an injury, however they can occur at any age.
- Individuals who smoke have an increased incidence of lumbar nerve root irritation.
- Strenuous and repetitive physical activity.
- Individuals who have prolonged static positions with poor functional control.
- Previous lower back injuries can increase your likelihood of lumbar nerve root irritation, especially that of a herniated disc.
Diagnosis
Diagnosis of nerve root injury can generally be made in the clinic based on your history, symptoms and movement patterns. Your Physio will conduct a physical examination including range of motion, strength, sensation, reflexes and neural tension tests to determine how much stress the nerve is under. Imaging is generally not required for diagnosis but may be considered in the presence of signs that the nerve is under significant compression.
Management
Management of a lumbar nerve root irritation injury depends on the contributing factors but aims to decrease pressure on the nerve and calm the sensitive neural tissue down. Typically, it will include;
- Education around the injury, management, and prognosis.
- Education around minimising aggravating activity to help the nerve settle and postural advice where appropriate.
- Anti inflammatory medication and pain relief are often helpful.
- Manual therapy and exercises aimed at reducing compression of the nerve and restoring joint mechanics.
- Neural mobilisation techniques are often used to get the nerve gliding more freely.
- Strengthening of the lower back, core, and hip musculature is typically a mainstay of treatment.
- In severe cases with signs of significant neural compression, nerve root injections and surgical consult may be considered.
If you’re suffering from lumbar pain book in with one of our experienced Physiotherapists today to get you back on your feet as soon as possible!
