Common Symptoms Of Neuropathic Lower Back Pain
Neuropathic pain symptoms may be variable and unpredictable. It is also common for neuropathic and nociceptive pain to occur together in the lower back.2,3
A few common features of neuropathic pain include2:
- Sharp, stabbing, shooting, and/or shock-like pain that radiates from the lower back into your leg
- Burning sensation in your lower back and/or legs
- Pricking sensation in your back and/or legs
- Tingling, weakness, and/or numbness, typically felt in your legs
Acute, localized pain or a dull ache may occur your lower back in case of discogenic pain.
See Understanding Neuropathy Symptoms
Should I Rest If I Have Sciatica
Some rest and change in your activities and activity level may be needed. However, too much rest, bed rest, and physical inactivity can make your pain worse and slow the healing process. Its important to maintain as much activity as possible to keep muscles flexible and strong.
Before beginning your own exercise program, see your healthcare provider or spine specialist first to get a proper diagnosis. This healthcare professional will refer you to the proper physical therapist or other trained exercise or body mechanics specialist to devise an exercise and muscle strengthening program thats best for you.
Why Is Lower Back Pain Such A Common Problem
The bottom part of your back typically has just five vertebrae fewer than your neck and mid-back. And these vertebrae do a lot of heavy lifting! Your lower back is where your spine connects to your pelvis, bearing the weight of your upper body. This area experiences a lot of movement and stress, which may lead to wear, tear and injuries.
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Signs Your Back Pain Might Be An Emergency
In our 20s and 30s, normal back pain often can be attributed to factors of daily life, such as sitting too long, picking up children, or overdoing it while exercising.
In our 40s and older, work injuries and the beginnings of arthritis and degenerative conditions are more common.
Back pain is so common, in fact, that many patients shrug off symptoms that might indicate a medical emergency.
Approximately 80% of adults will experience back pain in their lives, so its important to be able to identify the severity of your symptoms and track how long the pain lasts.
If back pain can be associated with a specific activity, such as lifting or twisting wrong, and the pain goes away within 72 hours after resting and applying ice, its usually nothing to worry about. However, if pain creeps on gradually, appears suddenly, or doesn’t go away, you might have a more serious condition.
How Is A Pinched Nerve Treated
In many cases, these simple steps may treat your symptoms:
- Medicine such as nonsteroidal anti-inflammatory drugs , narcotic medicines for more severe pain, and muscle relaxants
- Losing weight, if needed, with diet and exercise
- Physical therapy or a supervised home exercise program
- For a pinched nerve in the neck, wearing a soft collar around your neck for short amounts of time
Some people need more advanced treatments. Your healthcare provider might suggest injections of steroid medicine in the area where a disk is herniated. Some people might benefit from surgery. During a surgical procedure called a discectomy, the surgeon removes all or part of the disk that is pressing on a nerve root. Along with this procedure, the surgeon may need to remove parts of some vertebrae or fuse vertebrae together.
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What Are Symptoms Of Sciatica
Symptoms of sciatica usually originate from the sciatic nerve in the lower back, and run from the hip, down the back or side of the leg, to the foot or ankle, and include:
- Pain that feels like a bad leg cramp
- Sharp, knife-like, or electrical-feeling pain
- Cramps that may last for weeks
- Pain can occur particularly when moving, sneezing, or coughing
Top Warning Signs You Have A Pinched Nerve
Pinched nerves arent uncommon, but when they occur, they can cause a lot of pain and discomfort. At The Spine Institute of Southeast Texas, we help people relieve pain and other symptoms caused by pinched nerves. The first step in getting relief: making sure nerve compression is really to blame. Here are eight of the most common symptoms you might experience if you’ve got a pinched nerve:
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Quadriceps Or Hamstring Tendonitis
Overuse and repeated stress to your thigh muscles may cause inflammation in your tendons. This condition is known as tendonitis.
Symptoms of quad or hamstring tendonitis include:
- Pain in the front or back of your thigh, usually near your knee or hip
- Difficulty walking or climbing stairs due to pain
- A feeling of weak muscles in the front or back of your thigh
Symptoms usually last for four to six weeks and slowly get better with gentle exercises such as walking, leg raises, wall squats, and the Nordic hamstring stretch.
What Is A Herniated Disc
Herniation describes an abnormality of the intervertebral disc that is also known as a “bulging,””ruptured,” or “torn” disc. This process occurs when the inner core of the intervertebral disc bulges out through the outer layer of ligaments that surround the disc . This tear in the annulus fibrosis causes pain in the back at the point of herniation. If the protruding disc presses on a spinal nerve, the pain may spread to the area of the body that is served by that nerve. Between each vertebra in the spine is a pair of spinal nerves, which branch off from the spinal cord to a specific area in the body. Any part of the skin that can experience hot and cold, pain or touch, refers that sensation to the brain through one of these nerves. In turn, pressure on a spinal nerve from a herniated disc will cause pain in the part of the body that is served by that nerve. Most disc ruptures occur when a person is in their 30s or 40s when the nucleus pulposus is still a gelatin-like substance.
Four Degrees of Disc Herniation
Nuclear Herniation
Sequestered Nucleus
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What Can I Expect If I Have Been Diagnosed With Sciatica
The good news about sciatic pain is that it usually goes away on its own with time and some self-care treatments. Most people with sciatica get better without surgery, and about half of these recover from an episode fully within six weeks.
Be sure to contact your healthcare provider if your sciatica pain is not improving and you have concerns that you arent recovering as quickly as hoped.
Reasons For Sciatic Nerve Pain
The reasons for sciatic nerve pain could vary, but most commonly, it is due to aging. The reason is that with the passage of time, certain degradation occurs in an individuals physical state. The vertebrae may exert pressure or pressurize the sciatic nerves, which travel through them if degeneration of the spine develops.
However, all they aim to do is relieve the patients sciatic nerve pain. It all depends on the patients preferred method of treatment.
Herniated discs and disc herniation are some of the causes of sciatic nerve pain. The injury can occur when someone lifts objects that are too heavy or exercises improperly or when an injury happens. If the cartilage between the vertebrae stretches into the disc, a herniated disk is the result. This can cause pressure or strain on the sciatic nerve leading to sciatica.
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When Is Surgery Considered
Spinal surgery is usually not recommended unless you have not improved with other treatment methods such as stretching and medication, your pain is worsening, you have severe weakness in the muscles in your lower extremities or you have lost bladder or bowel control.
How soon surgery would be considered depends on the cause of your sciatica. Surgery is typically considered within a year of ongoing symptoms. Pain that is severe and unrelenting and is preventing you from standing or working and youve been admitted to a hospital would require more aggressive treatment and a shorter timeline to surgery. Loss of bladder or bowel control could require emergency surgery if determined to be cauda equine syndrome.
The goal of spinal surgery for sciatic pain is to remove the pressure on the nerves that are being pinched and to make sure the spine is stable.
Surgical options to relieve sciatica include:
Microdiscectomy: This is a minimally invasive procedure used to remove fragments of a herniated disk that are pressing on a nerve.
- Laminectomy: In this procedure, the lamina that is causing pressure on the sciatic nerve is removed.
The Top Causes Of Nerve Pain Explained
Nerve pain is almost always a chronic pain, and is a very complex condition. Most people develop it as a result of injury to the tissue, when nerve fibers become injured, dysfunctional, or damaged. Once the nerves are damaged, the messages they send to the pain centers are disrupted.
Nerve pain, or neuropathic pain, can have a range of different causes. Unfortunately, in many cases, there seems to be no obvious cause for nerve pain. However, below are the most common clear causes of the condition.
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Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
Symptoms Of Pinched Nerves
With nerve compression, sometimes pain may be your only symptom. Or you may have other symptoms without pain.
These are some of the more common symptoms of compressed nerves:
- Pain in the area of compression, such as the neck or low back
- Radiating pain, such as sciatica or radicular pain
- Numbness or tingling
- “Pins and needles” or a burning sensation
- Weakness, especially with certain activities
- The feeling of having a foot or hand “fall asleep.”Ã
Sometimes symptoms worsen when you try certain movements, such as turning your head or straining your neck.Ã Early diagnosis is important to prevent further damage or complications. A pinched nerve is a common cause of on-the-job injury.
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Causes Of Pinched Nerves
The term “pinched nerve” describes one type of damage or injury to a nerve or set of nerves. A pinched nerve happens when there is “compression” on a nerve.
The pressure may be the result of repetitive motions. Or it may happen from holding your body in one position for long periods, such as keeping elbows bent while sleeping.
Nerves are most vulnerable at places in your body where they travel through narrow spaces but have little soft tissue to protect them. Nerve compression often occurs when the nerve is pressed between tissues such as:
- Ligament
- Tendon
- Bone
For example, inflammation or pressure on a nerve root exiting the spine may cause neck or low back pain. It may also cause pain to radiate from the neck into the shoulder and arm . Or pain may radiate into the leg and foot .
These symptoms may result from changes that develop in the spine‘s discs and bones. For example, if a disc slips out of place or protrudes — known as a herniated disc — pressure can get put on a spinal nerve.
Nerve compression in your neck or arm may also cause symptoms in areas such as your:
The scarring may interfere with the nerve’s function.
What Are The Risk Factors For A Pinched Nerve
Anything which increases pressure around a nerve can cause a pinched nerve. Common causes include body position such as leaning on elbows, habitually crossing legs, or poor posture. Over time this may lead to pressure injury to nerves in these regions.
- Disc herniation or bulging discs and arthritis in the spine can cause pressure on nerve roots which leads to the nerve pain or discomfort associated with a pinched nerve.
- Weight gain or water retention can predispose people to developing pinched nerves thyroid disease can contribute to both water retention and weight gain and can increase the risk of certain types of pinched nerves.
- Pregnancy, which is associated with increased weight and occasionally associated with water retention, is also a common risk factor for developing certain types of pinched nerves.
- Repetitive activities can also increase swelling around specific nerves and lead to symptoms of a pinched nerve.
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Is The Weight Of Pregnancy The Reason Why So Many Pregnant Women Get Sciatica
Its true that sciatica is common in pregnancy but increased weight is not the main reason why pregnant women get sciatica. A better explanation is that certain hormones of pregnancy cause a loosening of their ligaments. Ligaments hold the vertebrae together, protect the disks and keep the spine stable. Loosened ligaments can cause the spine to become unstable and might cause disks to slip, which leads to nerves being pinched and the development of sciatica. The babys weight and position can also add pressure to the nerve.
The good news is there are ways to ease sciatic pain during pregnancy, and the pain goes away after birth. Physical therapy and massage therapy, warm showers, heat, medications and other measures can help. If you are pregnant, be sure to follow good posture techniques during pregnancy to also ease your pain.
When Should I Contact My Healthcare Provider
Get immediate medical attention if you experience:
- Severe leg pain lasting more than a few hours that is unbearable.
- Numbness or muscle weakness in the same leg.
- Bowel or bladder control loss. This could be due to a condition called cauda equina syndrome, which affects bundles of nerves at the end of the spinal cord.
- Sudden and severe pain from a traffic accident or some other trauma.
Even if your visit doesnt turn out to be an emergency situation, its best to get it checked out.
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What Is A Pinched Nerve
Your spine is made of many bones called vertebrae. Your spinal cord runs downward through a canal in the center of these bones. Nerve roots branch off the cord and go between each vertebrae. When problems affect these nerve roots, the condition is called radiculopathy, or more commonly, a pinched nerve.
This problem is most likely to occur in your lower back , but it can also affect your neck or other parts of your spine. Nerves can also get pinched by tendons and ligaments as they course through your arms or legs. This is called mononeuropathy.
How The Spine Causes Knee Pain
The nerve roots that transmit the sensation of pain to the legs and feet are located in the lower back. Occasionally with age or injury, the discs between the vertebrae can degenerate or bulge out and press on these nerves.
When this occurs, the nerve becomes irritated and sends out pain signals. The location of the pain depends on which disc is protruding.
The severity of the pain depends on how much of the disc is pressing on the nerve. The nerves that send fibers to the knee are located at the second, third, and fourth lumbar vertebral levels in the lower back area.
If a bulging disc, bone spur, or arthritic joint in the second, third, or fourth lumbar vertebra compresses a nerve, the referred pain will often be felt in the knee.
Referred pain is pain perceived at a location other than where the cause is situated. It is the result of pain signals being sent along the network of interconnecting sensory nerves.
This condition can be diagnosed by your healthcare provider with a thorough history and physical exam. If the nerve that travels to your thigh and knee is irritated or pinched, you may feel a host of symptoms, including:
- Pain in the front of your thigh
- Knee pain
- Numbness or tingling in your thigh
- Weakness in your hip or quadriceps muscles
If you have any of these symptoms, see a healthcare provider. In some cases, the hip may be the culprit, so a careful examination is necessary to find the true cause of your knee pain.
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Chiropractic Care Is A Type Of Treatment
A chiropractor manipulates the lower leg of a patient.
Lower Back Chiropractic Adjustment Video to Watch
This procedure may aid in treating the underlying causes of sciatic nerve discomfort, such as herniated discs or spinal stenosis. Manual manipulation can also help to improve the healing process and should not be uncomfortable.
Treatment Options For A Pinched Nerve
Non-Operative Treatment for Pinched Nerves
Your doctor will want to start with conservative treatments for your pinched nerve. These benefit most patients with pinched nerve symptoms. Conservative treatments include:
- Pain medication, including muscle relaxers, anti-inflammatories, and sometimes even narcotic painkillers.
- Alternating cold and hot compresses for the first twenty-four to forty-eight hours.
- Physical therapy to stretch, massage, and strengthen your back.
- Epidural steroid injections to reduce your inflammation and help your spine specialist pinpoint the exact location of your pinched nerve.
Least Invasive Endoscopic Procedure Options for Pinched Nerves
If you are still experiencing pinched nerve symptoms after attempting conservative treatments, then it may be time to consider a surgical option. The following procedures offer up to a 90% success rate in treating bulging discs and pinched nerves.
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