Acute compression of a nerve in the lower back (lumbar radiculopathy) is commonly referred to as a pinched lumbar nerve. It can occur as the result of various causes, and there are a variety of symptoms.
The type of treatment recommended and the length of recovery time depends on the specifics of the individual case.
¿What is a pinched lumbar nerve?
A pinched lumbar nerve usually occurs when an intervertebral disc becomes deformed or ruptures, resulting in a protrusion or lumbar disc herniation.
This condition is also called “impingement,” because when the intervertebral disc moves, it pinches or presses on the nerve.
It can also be due to acute inflammation in other parts of the spine, such as the intervertebral ligaments or synovial capsules.
The lumbar level is the most common location for a pinched nerve, but it can also occur in the cervical or thoracic levels of the spine.
The lower back and the base of the sacrum are the most susceptible areas because they bear the most weight.
This is why of a pinched lumbar nerve is most often located at L5-S1 and L4-L5. That is, this compression of the nerves tends to occur in the last two discs of the spine.
Symptoms of a pinched lumbar nerve
The symptoms of a pinched lumbar nerve can vary according to its cause and where in the spine it is located.
In addition, symptoms can appear suddenly, or gradually, the latter being the most common.
In any case, the symptoms of a pinched nerve at levels L5-S1 and L4-L5 are usually as follows.
Low back pain
Low back pain is a characteristic symptom of a pinched lumbar nerve. It is usually intense and can cause referred pain in the lower extremities.
Pain in the buttocks
A compressed nerve in the lower back can cause pain in the buttocks.
Leg pain
Another symptom of a pinched lumbar nerve can be pain in the legs, or all the way down to the feet, where it can be felt in the instep, sole of the foot, or toes.
Tingling
A pins and needles or tingling feeling in the legs is another of the most characteristic symptoms of a pinched lumbar nerve. Also, the sensation that your legs have 'fallen asleep.'
Numbness
Another symptom may be numbness or decreased sensitivity in the affected area.
Weakness
A pinched lumbar nerve can also be reflected in muscle weakness in the legs.
Causes of a pinched lumbar nerve
Compression of the nerves in the spinal cord can be caused by different things, and is often the result of a disc protrusion or lumbar disc herniation.
Other times they appear due to degenerative spinal pathologies such as osteoarthritis.
Lumbar disc protrusion
Lumbar disc protrusion appears when the intervertebral disc partially ruptures and loosens.
As a result, it moves out of its normal position and bulges towards the spinal canal where it can pinch or press on the nerves.
Lumbar disc herniation
A lumbar disc herniation occurs when the intervertebral disc ruptures and its contents extend beyond the edges of the disc.
If the hernia occupies the space where the nerve roots of the lumbar spine are located, it can press on them.
Osteoarthitis
Lumbar osteoarthritis is a degenerative disease in which the cartilage in the vertebrae of the lower back becomes worn.
This disease results in the formation of bone spurs, which are small boney growths that form in the joints.
When they reduce the space where through which the nerves pass, they can pinch or compress the nerves.
Sedentary lifestyle
A sedentary lifestyle is the main contributor to disc degeneration and, therefore, the main cause of nerve compression in the spine.
Lack of exercise contributes to the loss of muscle tone and bone mass, making the spine more vulnerable to damage.
For this reason, regular physical activity has a protective effect.
However, sometimes physical activity -- for example, lifting weight incorrectly -- can also be the cause of a pinched lumbar nerve if it results in injury.
When this happens, the patient will usually hear a cracking or clicking sound in the area.
Poor posture
Poor posture habits maintained over time can make nerve compression likely.
Other health factors
Other factors that can contribute to the likelihood of a pinched lumbar nerve include smoking or being overweight.
Smoking reduces the oxygen supply to the discs, which promotes their deterioration.
Excess weight, on the other hand, can overload the lumbar vertebral discs and contribute to their degeneration.
Injury
An accident or injury that affects the lower back can cause a vertebral fracture, which can also result in compression of the nerves.
This is known as spondylolysis.
How is it diagnosed?
A pinched lumbar nerve can only be diagnosed by a medical professional, who will evaluate your symptoms and perform a physical examination.
Additional diagnostic tests may be used as well, such as magnetic resonance imaging and, sometimes, a lumbar CT (Computed Tomography) scan.
Treatments for a pinched lumbar nerve
The treatment for a pinched lumbar nerve will depend on each case. That is why it is essential to see a medical specialist to get an accurate diagnosis.
As for the recovery time, this will also depend on the severity of the case and the type of treatment required.
For this reason, it is not possible to give a general estimate of how long recovery from a pinched lumbar nerve will take.
The most important thing is to consult a specialist as soon as possible.
For this reason, home remedies for a pinched lumbar nerve should be avoided, as they can make the problem worse.
Rest
Sometimes, it is necessary to reduce your physical activity. This means taking it easy for a while until symptoms improve.
Patients often ask if it’s good to walk with a pinched lumbar nerve. In general, walking can be beneficial, as it helps maintain the mobility of the spine and promotes blood circulation.
However, sports and physical exercise should be avoided while the level of pain is intense.
Medication
Along with rest, taking pain medication will help reduce pain.
Physical therapy
Manual therapy and/or active therapy led by a specialized physiotherapist can aid in the recovery process.
In the case of a pinched lumbar nerve, physical therapy exercises aim to strengthen and stretch the muscles in the affected area.
This helps relieve pressure on the nerve or structure suffering the compression or acute inflammation.
Epidural infiltrations
Epidural infiltrations in the lumbar spine consist of injecting steroidal anti-inflammatory medication into the area surrounding the membranes that surround the spinal cord.
This treatment, like rhizolysis, reduces or eliminates acute pain.
Surgery
When the symptoms of a pinched lumbar nerve do not improve with the above measures, surgery can be used to take the pressure off the nerve.
Currently there are minimally invasive surgical techniques available such as lumbar microdiscectomy, ADR disc replacement surgery or arthrodesis.
Can it be prevented?
The most effective way to keep from getting a pinched lumbar nerve is to exercise frequently and lead an active life.
It is also important to use good posture on a daily basis and avoid situations that put your back at risk (lifting weights incorrectly, sudden movements, etc.).
Likewise, avoiding tobacco and maintaining a healthy weight will help prevent back pain and keep your spine healthy.
Instituto Clavel, specialists in pinched lumbar nerve treatment.
At Instituto Clavel, our doctors and surgeons are experts in the diagnosis and treatment of pinched lumbar nerves and other pathologies of the spine.
We are also specialists in minimally invasive surgical techniques and we use the latest cutting-edge medical technology.
If you have any questions or want to make an appointment with one of our specialists, please don’t hesitate to contact us.
We will be happy to help you at Instituto Clavel.
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