I have a pinched nerve in my lower back, what should I do?

Nerve compression is an unpleasant and painful condition. Why does pinching occur? We offer effective methods for treating this disease.

Pinched nerve services are no longer offered by our clinic.

A pinched nerve in the spine is a condition in which a nerve is compressed by a spasming muscle, herniated disc, or intervertebral disc. The condition is characterized by acute or aching pain in the cervical, thoracic or lumbar spine.

What causes lower back pain?

Most often, a pinched lower back takes you by surprise: it becomes painful to move, and the person panicsly tries to figure out what to do. This condition can be avoided by knowing in advance what reasons lead to an unpleasant ending. Here are some of the most common factors:

Inadequate physical activity. For example, lifting heavy weights, especially in people with little training.
Displacement of the lumbar vertebrae, dislocation, and other dangerous back injuries.
Hypothermia, prolonged exposure to low temperatures (for example, in water).
Neoplasms of various types.
Osteochondrosis. Calcification of bone tissue and thinning of the cartilage of the intervertebral discs lead to a reduction in the distance between the vertebral bodies. Because of this, the nerve roots coming out of the spinal cord are pinched.
Protrusion of an intervertebral disc into the spinal canal (protrusion) or outward, with a herniated intervertebral disc. Even if the integrity of the cartilaginous ring is preserved, mobility is greatly affected.
Overweight. Additional kilograms increase the load on the spinal column. The process develops in a similar way when carrying a child, when additional kilograms and a shift of weight forward, onto the stomach, can lead to compression of the nerves.
Lack of vitamins and minerals. It occurs due to poor nutrition and leads to degenerative changes in the bones, including the development of osteoporosis.
Incorrect posture, scoliosis, stoop.
Sedentary work, lack of mobility. An uncomfortable sleeping place, leading to an unnatural posture in which the spine cannot fully straighten.

Signs of a pinched nerve in the lower back occur with pathological changes in the spine and intervertebral discs. The condition can be provoked by infectious diseases, degenerative changes in bone and cartilage tissue. Tolerating the sensations and hoping that it will go away on its own, or to self-medicate, is dangerous. It is necessary to find out why the disease occurred. Therefore, you need to contact doctors who specialize in treating the spine and joints. They recognize the problem in time and find a way to keep the patient healthy.

What is the zone of segmental innervation?

Spinal cord segment. Roots. Spinal nerve

After leaving the spine, each spinal nerve branches into nerves, like a tree trunk into branches. Next, these nerves go to a certain area of the body to provide innervation (nervous regulation) there. The area of the body that is innervated by nerves from one segment is called the zone of segmental innervation.

For example, the C5 spinal nerve innervates the C5 area, and the L4 nerve innervates the L4 area, etc. Moreover, please note that the nerve branches extending from each spinal nerve provide both types of innervation in their zone - both sensory and motor. Let's take a closer look at this drawing. It shows the zones of segmental innervation. As you can see, everything is simple and clear.

Types and symptoms of the disease

In addition to intense pain that can radiate to the legs or arms, there are many indirect signs of lumbar disease. When determining whether a nerve is pinched in the lower back, one should focus both on the intensity of the pain syndrome and on other signs that have arisen in areas of the body remote from the epicenter:

lower back pulls and burns;
the leg (or both legs) is numb, and the sensation does not go away for several days;
a certain muscle group moves poorly;
the gait became uncertain, constrained, shaky;
state of general weakness, rapid fatigue;
the pain intensifies not only with movement, but also with coughing, sneezing, even laughing;
if the nerve branch that goes to the internal organs is pinched, the heart, intestines, and stomach can hurt.

The pain is always present. The intensity depends on how much the nerves responsible for pain sensitivity are involved. Typically, a whole bundle of nerves is subjected to pressure, causing several symptoms at once.

Where does radicular syndrome occur?

As we have already found out, nerve impulses from the spinal nerve diverge throughout the entire zone of innervation of this nerve. Consequently, when a nerve is compressed, pain, muscle weakening, numbness, pins and needles and pins and needles will cover the entire area. It does not happen that radicular syndrome causes pain only in places, and there is no pain in the rest of the area. Remember, radicular syndrome is the simultaneous manifestations of pain, muscle weakness, numbness and other symptoms, covering the entire innervation zone.

In medical terms, radicular syndrome is:
Sensory disturbance (pins and needles, goosebumps, pain)
Muscle hypotension (weakness)
Decreased or complete loss of muscle reflexes
All of these symptoms develop within the zone of innervation of the corresponding spinal nerve.

Principles of treatment

The lumbar region consists of five vertebrae. Depending on the location of the problem, the types of disease and methods of treating the consequences of a pinched spinal nerve differ. Doctors differentiate sciatica, lumbago, and lumboischialgia. Sciatica is characterized by pain in the areas of the sacrum and gluteal muscles. The legs usually shoot in the posterior projection. The sensations are intense; between attacks, the patient experiences fear of a new attack, which leads to constant stress and chronic fatigue.

Lumbago is determined by throbbing pain in the lower back. It often occurs during a sharp turn or tilt. With lumboischialgia, pain varies in intensity, is transmitted to the leg and back of the thigh, movements become constrained. Sciatica or inflammation of the sciatic nerve occurs against the background of a hernia, infectious diseases, and diabetes.

When deciding what to do if a nerve is pinched in your back, you need to remember: see a doctor. Pinched nerve cells do not receive nutrition, they can begin to die, which will lead to serious consequences, including paralysis.

When deciding how to relieve a patient from the consequences of a pinched nerve in the lower back, doctors recommend complex treatment, which consists of providing competent first aid, specific studies, drug and non-drug therapy and mandatory rehabilitation:

To alleviate the condition, before the doctor arrives, it is necessary to remove all loads, protect the patient from drafts and cold, lay him on a flat mattress, bandage his back with a scarf or handkerchief, and, if necessary, give an analgesic.
At the doctor's discretion, a number of studies are carried out: medical history, x-rays, CT, MRI, and other hardware methods. This is necessary to make an accurate diagnosis.
The doctor prescribes specific medications and diet. At first, bed rest is observed.

If conservative methods do not help, surgery is prescribed. Sometimes surgery becomes necessary to relieve the effects of a hernia or nerve damage. After the acute phase of the disease passes, auxiliary measures and restorative procedures begin.

Errors in diagnosing radicular syndrome

A common mistake is that radicular syndrome is often confused with pseudoradicular syndrome.

Pseudoradicular syndrome is pain caused not by compression of the spinal nerve, but by muscle disease.

There is a muscle disease called myofascial syndrome. There is a detailed article about it on our website. And, in short, with myofascial syndrome, small spasmodic areas appear in the muscles - trigger points, which cause very severe pain. Sometimes the zone of myofascial pain can cover quite large areas of the body and resemble damage to the zone of segmental innervation in radicular syndrome. For example, pain from the lower back may radiate down the leg into the hip and lower leg. In such cases, it is customary to use the term “pseudo-radicular syndrome”. The figure below shows the L4 radicular syndrome zone - highlighted in blue and the pain zone with myofascial syndrome of the gluteus minimus - highlighted in red. Moreover, the localization of myofascial pain in the gluteus minimus muscle can have two options.

Pain areas. The spine is blue. Myofascial - orange

Isn't it true that the L4 radicular pain zone and the gluteus minimus myofascial pain zone are very similar to each other? Therefore, in this and many other cases, inexperienced doctors often confuse the manifestations of radicular and pseudoradicular (myofascial) syndromes. Just like an inexperienced mushroom picker runs the risk of confusing real and false honey fungus.

It is important to be able to distinguish radicular syndrome from pseudoradicular syndrome!

We will find out what causes the symptoms - radicular or “pseudo-radicular” myofascial syndrome, and test the muscles for the presence of active and latent trigger points.
Diagnostic duration is 30 minutes. This is a full-fledged examination, and not a 2-minute “feeling” for show.
The diagnosis is carried out personally by Dr. Vlasenko A.A., a doctor with 30 years of experience, an expert in the treatment of myofascial and radicular syndromes.

Dr. Vlasenko Alexander Adolfovich, neurologist, manual therapy doctor

Recovery from lumbar compression

To release a pinched nerve in the lower back, medication and diet are not enough. A set of additional classes is required. Physiotherapy treatments may be combined with massage specifically designed to help relieve pinched nerves in the lower back. Mud therapy and therapeutic exercises are also used. All measures are aimed at restoring mobility, strengthening muscles, and improving blood supply.

Special exercises to develop the lower back when a nerve is pinched consist of light daily exercise, swimming (necessarily in conditions of a comfortable water temperature). You should absolutely not overload your back. The patient should enjoy performing the techniques, then he will get used to leading an active lifestyle and benefit from it.

In addition to exercise therapy with a trainer, it is useful to perform some movements at home as exercise. The simplest of them are:

bending forward, to the sides (small amplitude);
walking with knees pulled up;
swinging legs (performed lying down, standing);
bending and pulling the knee joints to the chest (performed lying down);
clasping your knees with your hands, rolling back and forth on your back;
twisting the torso to the right, to the left (lying on the mat).

Each session lasts at least ten minutes. At the same time, blood flow and lymph outflow improve, muscles relax, and oxygen supply to tissues increases.

Gymnastics will benefit any person who complains that his back is stuck in the lower back and he does not know what to do in such cases. If there are no serious pathologies, regular exercise will serve as good prevention.

Massage and manual therapy for pinched nerves in the back should be carried out by a specialist with a medical education. You only need to contact professionals so as not to make things worse.

Prevention as the main means of fighting for spinal health

The question is often asked on the Internet: What to do if your back is locked? Most come to their senses only when the disaster has already happened. But the human body has a huge reserve of strength and the ability to heal itself. Therefore, preventive measures will help prevent muscle spasms, thinning of the cartilage layers, the occurrence of a hernia, and maintain healthy coordination of movements.

It's never too late to start. Restorative gymnastics for a pinched nerve in the lower back will help regulate the load and teach the muscles to stay in good shape. Muscle tissue, as the main protector of joints, should remain active at any age. It is especially important to remain active after menopause, when hormonal levels change and there is a predisposition to poor calcium absorption.

Regular training with an experienced mentor will teach you how to properly handle your spine, prevent recurrent attacks, and restore the joy of life, health and vigor.

Causes of radicular syndrome

For most people, the phrase “radicular syndrome” causes an association with disc herniation, protrusion or osteochondrosis. But, contrary to such a widespread and equally erroneous opinion, radicular syndrome is not at all a key symptom of these particular diseases. The presence of radicular syndrome merely indicates that the spinal nerve is under the influence of some pathology, and which one is a matter of further clinical analysis.

Radicular syndrome is the main clinical sign of spinal nerve damage.

Typically, radicular syndrome occurs with more severe pathologies than osteochondrosis. The most common causes of radicular syndrome are either circulatory disorders (radicular-vascular syndrome, spinal stroke, ischemic radiculopathy) or mechanical effects (bone fragment from a spinal fracture, benign or malignant tumor, cyst, etc.). Although, in fairness, it must be said that with osteochondrosis, disc herniation and protrusion, radicular syndrome also occurs, but extremely rarely and mainly in the cervical region.