A pinched nerve in your lower back, or lumbar radiculopathy, can be painful and debilitating. This condition occurs when something puts pressure on the nerves near the last five vertebrae in your back.
The symptoms of this condition can affect your:
Often, you can treat the condition with over-the-counter pain relievers, physical therapy, and other lifestyle adjustments. Sometimes your doctor will need to treat the pinched nerve with more invasive measures, such as spinal injection or surgery.
There are several symptoms you may experience with a pinched nerve in your lower back:
- sciatica, which includes pain, tingling, numbness, and weakness that occurs in the:
- lower back
- ankles and feet
- sharp pain
- muscle spasms
- reflex loss
This condition may appear out of nowhere or it could be the cause of a traumatic injury. You’re more likely to experience symptoms if you’re between age 30 and 50. This is because your vertebrae compress with age and the discs in your vertebrae degenerate over time.
Some causes of a pinched nerve in the lower back include:
- herniated disc
- bulging disc
- trauma or injury, such as from a fall
- spinal stenosis
- mechanical stretching
- bone spur formation, also known as osteophytes
- foraminal stenosis
- rheumatoid arthritis
A common cause of a pinched nerve in the lower back is a herniated disc. You may experience this condition because of aging, a defect in your vertebrae, or wear and tear.
The cushioning between your spine lessens as you age and can leak, leading to nerve pain. Bone spurs and other degenerative conditions can occur as you age as well, leading to a pinched nerve.
Your doctor will first perform a physical exam to determine your condition. Your doctor will check for symptoms near the spine. These include:
- limited range of motion
- balance problems
- changes to reflexes in your legs
- weakness in the muscles
- changes in sensation in the lower extremities
Your doctor may not be able to diagnose the pinched nerve from a physical examination alone. Additionally, they may want to know more about the cause of the pinched nerve.
Your doctor may use the following tests to get more information:
- X-ray: shows the bones in your vertebrae
- MRI: shows your soft tissues, including the discs in your vertebrae, your spinal cord, and the nerves in your lower back
- CT scan: shows a very detailed picture of your lower back and measures the function of your nerves
A physical exam and imaging procedures will help your doctor determine the proper treatment for a pinched nerve in your lower back.
Once your doctor diagnoses the pinched nerve in your lower back, you can begin to consider treatment options.
Your doctor will likely recommend noninvasive, baseline treatments for your pinched nerve first. In 95 percent of cases, nonsurgical measures will relieve your symptoms.
You may try nonsteroidal anti-inflammatory drugs (NSAIDs) to treat the pinched nerve first. These types of medications can lessen inflammation and reduce pain.
Your doctor may also prescribe oral steroids to treat the condition if NSAIDs and other treatments are ineffective.
You may work with a physical therapist to target the symptoms caused by your pinched nerve. Your physical therapist will provide you with instructions for stretches and exercises that will stabilize your spine.
Your doctor may recommend that you make lifestyle modifications to help with the symptoms of a pinched nerve in your lower back. Some of these treatments may help in your management plan.
- Rest. You may find that certain seated positions or activities that cause you to twist or lift make your pinched nerve worse. Your doctor may recommend bed rest for a day or two or avoidance of activities for a period of time to alleviate symptoms.
- Ice and heat. Applying ice or heat for 20 minutes a few times a day may reduce pain and muscle spasms.
- Frequent movement. Exercising regularly may help avoid the onset of nerve pain or relive symptoms.
- Sleeping position modifications. Your sleeping position may aggravate the symptoms of your nerve pain. Discuss the best sleeping position for the pain with your doctor and determine how to practice proper sleeping habits. This may include adjusting your sleeping position or sleeping with a pillow between your legs.
When the baseline treatments for a pinched nerve don’t offer relief, your doctor may recommend more aggressive strategies for treatment.
Your doctor may recommend an injectable steroid if your symptoms persist. You can treat severe pain by receiving an epidural injection of steroids in your doctor’s office or under fluoroscopy in an X-ray department. This can relieve swelling and other symptoms in the affected area.
The last resort for treating a pinched nerve in your lower back is to undergo surgery. There are many surgical methods, and your doctor will recommend a procedure that will target the cause of the condition.
For example, those who have a herniated disc in their lower back may be candidates for a microdiscectomy. This procedure involves a small incision in your back.
Keep in mind that surgeries come with risks and sometimes long recovery periods, so you’ll want to try less invasive methods before opting for surgery.
Discuss these stretches and exercises with your doctor before you try them. Make sure you don’t worsen your symptoms or do anything that causes more pain.
Use a yoga mat, towel, or carpet to lie on when engaging in these stretches. You should do two to three repetitions of these stretches each time, and make sure to take deep breaths while stretching.
1. Knee to chest
- Lie on the floor.
- Elevate your head just slightly with a pillow or other object and tuck in your chest.
- Bend both knees and point them up toward the ceiling. Your feet should be on the floor.
- Bring one knee up to your chest and hold it there for 20 to 30 seconds.
- Release your leg and repeat the stretch on your other leg.
2. Mobilizing stretch
- Keep the same inactive position as in the knee to chest stretch.
- Instead of bringing your knee to your chest, extend your leg so your foot points to the ceiling — don’t point your toe.
- Hold it in the air for 20 to 30 seconds and then release the hold.
- Repeat this with the other leg.
3. Gluteal stretch
This exercise also begins in the same position with head support and knees pointed to the ceiling.
- Bring one of your legs up and rest your foot on your other bent leg. The knee of your raised leg will be perpendicular to your body.
- Grab the thigh that’s holding up your foot and pull it toward your chest and head.
- Hold the position for 20 to 30 seconds and release.
- Repeat this on the other side of your body.
You should see a doctor if the symptoms of your pinched nerve interfere with your daily life or if your symptoms persist after attempting to treat the condition at home.
There are many possible treatments for a pinched nerve in your lower back. You will want to try baseline approaches at home before pursuing more invasive methods of treatment.
Using NSAIDs, stretching and staying active, and resting your back may be the first line of treatment for your condition. A doctor should diagnose and treat persistent or severe pain caused by a pinched nerve in your lower back.