When Looking For The Culprit Behind Foot Pain Tingling And Strange Nerve Sensations Start At The Source: The Lower Back
Again, odd nerve sensations in the feet and lower extremities could be caused by any number of conditions. Properly diagnosing the cause and determining an appropriate treatment could require extensive testing and some measure of trial and error. Each patient case is unique.
That said, the lower back can be a good place to start the discovery process. Since the major nerve conduits start here, resolving the issue close to the spine can relieve symptoms all the way down the leg. Further, many individuals suffer from lower back issues that can create symptoms in the lower nervous system, especially in individuals over 30 years of age.
Addressing stress factors placed upon your lower back can also have the effect of improving your overall health, helping you strengthen blood flow and nervous system functioning from the waist down.
Lower Back Pain: What Could It Be
Do you have lower back pain? You are not alone. Anyone can experience lower back pain at any time, even if you dont have a prior injury or any of the risk factors. It is not always serious and can often get better on its own. But in some cases pain is your bodys way of telling you that something isnt right.
Learn more about lower back pain and what causes it from rehabilitation physician Akhil Chhatre, M.D., who specializes in back pain in the Johns Hopkins Department of Physical Medicine and Rehabilitation.
Diagnosis/tests For Sciatic Nerve Pain
A doctor typically starts by asking questions about your medical history and your symptoms. From there, they conduct a physical examination that includes directing you to assume various positions like:
- Walking on your heels and toes
- Raising your leg straight in front of you
Your doctor may order additional imaging to help locate the source of your sciatic nerve pain, including:
- Computed tomography scan
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Spinal Stenosis And Sciatica
Degeneration and osteoarthritis can cause pain, numbness, tingling and weakness from pressure on the spinal nerves and/or spinal cord.
This pressure may be a result of an osteophyte formation, as well as hypertrophy of the spinal ligaments and facet joints. The spinal canal may be narrowed , and the area just underneath the facet joints may also be reduced in size .
Osteophytes are abnormal bony spurs which form as part of the degenerative process or following a longstanding disc prolapse. This extra bone formation can cause spinal stenosis as well as intervertebral foraminal stenosis, both of which result in compression of the spinal cord and/or spinal nerves.
As the spinal nerves leave the canal, they need to travel through the intervertebral foramen to get to the legs. This tunnel may be narrowed by a number of degenerative and other processes, including:
Sciatic pain as a result of spinal stenosis is frequently worse on standing and walking, and improves on sitting. This pain pattern is known as neurogenic claudication.
Common Sciatica Cause #: Spondylolisthesis
Spondylolisthesis is a disorder that most often affects the lumbar spine. It occurs when one vertebra slips forward over an adjacent vertebra. When the vertebra slips and is displaced, it presses on the nerves or nerve roots below it. This ultimately causes compression and often results in sciatica symptoms.
Youre either born with developmental spondylolisthesis or it develops during childhood. On the other hand, acquired spondylolisthesis can be caused by:
- Parts of the spine breaking down over time
- Physical stress from activities like weightlifting or gymnastics
- Trauma, such as from a car accident
On physical examination, the patient will often complain of increased back pain when arching into extension due to irritation of the facet joints. The diagnosis can often be made with simple plain radiographssuch as an X-raydone in the standing posture, says Dr. Subach.
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Can Spinal Cord Compression Be Prevented
Many causes of spinal cord compression cant be prevented. You can help prevent symptoms of spinal cord compression caused by gradual wear and tear by keeping your back as strong and healthy as possible.
Get regular exercise. Exercise strengthens the muscles that support your back and helps keep your spine flexible.
Maintain good posture and learn how to safely lift heavy objects. Other good body mechanics include sleeping on a firm mattress and sitting in a chair that supports the natural curves of your back.
Maintain a healthy weight. Excess weight puts more stress on your back and can contribute to developing symptoms of spinal compression.
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Arthritis Of The Spine
Arthritis of the spine the slow degeneration of the spinal joints is the most frequent cause of lower back pain. All of us experience wear and tear as we age, and it is normal for your lower back to start acting up as you get older. As the cartilage breaks down between the spinal joints, surrounding tissues may become inflamed. The inflammation and the thinning of cartilage increase friction in the joints, which may cause pain in the lower back.
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How To Recognize And Manage Neuropathic Pain
When you feel pain, it is due to certain chemical and electric signals that are exchanged between the site of injury and the brain. These signals are carried through your nerves. Neuropathic pain occurs when there is an injury or damage to a single nerve or group of nerves.1
Neuropathic pain is caused by malfunction, disease, or injury to the central nervous system or peripheral nervous system. ReadAll About Neuropathy And Chronic Back Pain
Neuropathic pain differs from the more commonly understood nociceptive pain.
- Neuropathic pain occurs due to inflammation, irritation, or compression of the neural tissue.
- Nociceptive pain is the bodys response to painful stimuli, such as a pulled back muscle or broken bone, and does not relate to an injury of the nerve itself.2
Here are a few pointers to help you identify neuropathic pain and its common treatment methods.
Can Lower Back Pain Be Related To Weather
If you feel like your lower back pain worsens on days when its cold or the weather is changing, you are not imagining things. Back pain can indeed be related to barometric pressure and outdoor temperature. Changes in pressure can sometimes cause pain in arthritic joints, including the spine. Muscles and joints in general react to the environment, which can make them stiffer and more likely to suffer an injury.
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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.
Common Sciatica Cause #: Piriformis Syndrome
Piriformis syndrome is named for the piriformis muscle and the pain caused when the muscle irritates the sciatic nerve. The piriformis muscle is in the lower part of the spine, connects to the thighbone, and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle.
The piriformis is a hip muscle that can compress the sciatic nerve when it becomes inflamed.
Piriformis syndrome can cause sciatica when the muscle spasms or becomes inflamed. Inflammation can cause the muscle swell and compress the sciatic nerve whereas the muscle spasms may impact people whose sciatic nerve runs through the muscle itself this is because the sciatic nerve gets squeezed as the muscle contracts.
It is worth noting that piriformis syndrome may be difficult to diagnose and treat due to the lack of X-ray or MRI findings. Dr. Subach notes: Having an experienced neurosurgeon or orthopedist perform your physical exam will make all the difference in the world, given the normal X-rays and normal MRI scans that typically accompany this cause of sciatic nerve irritation.
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What Is Sciatica Nerve Pain
Sciatica is a medical condition where an individual feels pain radiating from the sciatic nerve. This nerve begins in the lumbar spine and runs down to the legs. The sciatic nerve is the largest in the body and can reach up to 2 centimeters in diameter.
Its responsible for providing motor function to lower parts of the body like the hamstrings, lower leg muscles, and some foot muscles. Pressure on this nerve can cause you to experience sciatica.
Unexplained Acute Low Back Pain
Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.
- Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
- Ankylosing spondylitis, a form of arthritis.
- Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
- Certain types of cancer, in rare cases.
Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.
If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.
An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.
Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.
Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.
Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain
Symptoms that always occur with unexplained acute low back pain:lower back pain
Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever
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Can Knee Pain Come From Your Spine
Most people assume if they have knee pain, it is due to a problem with the knee joint. This is not always the case. While the discomfort can be due to a knee condition, it can also be the result of a disc protrusion or a pinched nerve in your lower back. Working with your doctor and a physical therapist can help determine if that is the case.
What Causes Spinal Cord Compression
One of the most common causes of spinal cord compression is the gradual wear and tear on the bones of the spine, known as osteoarthritis. People who develop spinal cord compression from this are usually older than 50.
Other conditions that may cause spinal cord compression can develop more quickly, even very suddenly, and can occur at any age:
Abnormal spine alignment
“Foot drop,” weakness in a foot that causes a limp
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Pressure on nerves in the lumbar region can also cause more serious symptoms known as cauda equina syndrome. If you have any of these symptoms, you need to get medical attention right away, typically in the emergency room:
Loss of bowel or bladder control
Severe or increasing numbness between the legs, inner thighs, and back of the legs
Severe pain and weakness that spreads into one or both legs, making it hard to walk or get out of a chair
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How Is Back Pain Treated
Acute back pain usually gets better on its own. Acute back pain is usually treated with:
- Medications designed to relieve pain and/or inflammation
- analgesics such as acetaminophen and aspirin
- non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be sold over the counter some NSAIDS are prescribed by a physician
- muscle relaxants are prescription drugs that are used on a short-term basis to relax tight muscles
- topical pain relief such as creams, gels, patches, or sprays applied to the skin stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain. Common topical medications include capsaicin and lidocaine.
Exercising, bed rest, and surgery are typically not recommended for acute back pain.Chronic back pain is most often treated with a stepped care approach, moving from simple low-cost treatments to more aggressive approaches. Specific treatments may depend on the identified cause of the back pain.
Possible Solutions For Pinched Nerves
A pinched nerve should be treated as soon as possible. If neglected, compressed nerves can cause both temporary and long-term issues. Long-term damage could include a loss of sensation or weakness in some of your muscles. However, recovery from a pinched nerve is often achieved within a few days or weeks with rest and other conservative treatments. A spine specialist, like those at New Jerseys Spine Institute of North America, can accurately diagnose a pinched nerve in the back or neck and help you find the right treatment for pain relief.
After receiving your diagnosis, your doctor will primarily focus on conservative treatment because most people respond to a combination of these options:
- Rest from activities that aggravate nerve compression
- Wearing a brace to immobilize the affected area
- Physical therapy to stretch and strengthen muscles in the affected area
- Medications or injections to help manage pain and reduce inflammation
If after a few weeks or months of conservative treatment your pinched nerve does not recover, it may be time to consider a least invasive surgical option provided by the team at Spine Institute of North America. The doctors here create an honest environment to ensure you fully understand all treatment available to you and can make an educated decision. The helpful and friendly staff will be with you every step of the way so that you can go back to doing the things you love.
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How Can I Tell If Pain In My Hip Is A Hip Issue Or Sciatica
Hip problems, such as arthritis in the hip, usually cause groin pain, pain when you put weight on your leg, or when the leg is moved around.
If your pain starts in the back and moves or radiates towards the hip or down the leg and you have numbness, tingling or weakness in the leg, sciatica is the most likely cause.
Gluteal Muscle Tear Or Avulsion
The gluteus medius is a muscle that sits on the outside of the hip area. This muscle is used for standing upright and walking. When injured, these muscles will cause a limp. If these muscles are torn, it can cause severe pain when walking, sitting, or sleeping. Treatment usually involves rest, physical therapy, and sometimes surgery to repair the torn muscle, if no other treatments bring relief from pain.
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Bulging Or Herniated Disc
A lumbar bulging or herniated disc is the most common cause of sciatic nerve pain. Research suggests that herniated discs are responsible for 90% of sciatica cases.
Intervertebral discs sit between vertebrae in the spine, providing support, cushioning and shock absorption. Each disc contains a soft, jelly-like nucleus surrounded by a tough outer shell. Age and natural wear and tear over time cause spinal discs to dry out, weaken and develop tiny tears. The supporting ligaments start to weaken as well, causing the disc to slip and bulge out of place. Eventually, pressure and degenerative changes can lead to the jelly-like nucleus leaking out of a tear in the outer shell a condition called a herniated disc. A herniated disc can also occur suddenly from a traumatic accident like a fall, car crash or sports accident.
A disc thats bulging out of place can irritate, rub against or place pressure on nearby structures including the sciatic nerve. Similarly, pieces of a herniated disc can press against or compress the sciatic nerve root. And the jelly-like disc nucleus contains a chemical irritant that causes nerve inflammation when released into the spinal space.
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 physician 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 doctor. 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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