A pinched nerve in your lower back occurs when there’s excessive pressure on the nerves near the last five vertebrae in your back. This condition can be painful and may gradually impact your overall quality of life.
If you’re experiencing ongoing pain in your lower back despite rest, it’s important to see your doctor for a proper diagnosis.
Learn more about the possible symptoms and causes of a pinched nerve in your lower back and what treatment measures your doctor may recommend for both short-term and long-term relief.
There are several symptoms you may experience with a pinched nerve in your lower back, including sharp pain and numbness. The pains may come and go, creating stabbing sensations.
Additionally, you may also experience:
- muscle spasms
- reflex loss
Sciatica describes symptoms that relate to issues with the sciatic nerve that extends between your lower back and feet. When the sciatic nerve is either injured or compressed, you may experience sciatica.
Sciatica causes sharp pain, tingling, numbness, and weakness that may occur in the following areas:
- lower back
- feet and ankles
Symptoms of sciatica tend to worsen when you make sudden movements, such as sneezing. The pain may also be significant enough to interfere with everyday movements, such as walking.
Additionally, you may experience tingling sensations between your lower back and ankles that feels like “pins and needles.”
As a rule of thumb, if you have pain in the lower back only, you likely don’t have sciatica.
A pinched nerve in your back may seemingly appear out of nowhere, or it could be the result of a traumatic injury, such as a fall.
You’re more likely to experience symptoms if you’re between ages 30 and 50. This is because your vertebrae compress with age, and the discs in your vertebrae degenerate over time.
Another 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. Men ages 20 to 50 are at a higher risk of developing a herniated disc.
Other possible causes of a pinched nerve in the lower back include:
- bulging disc
- spinal stenosis
- bone spur formation (osteophytosis)
- foraminal stenosis
- rheumatoid arthritis
Risk factors for a pinched nerve
Aside from normal wear-and-tear with age, other risk factors could contribute to pinched nerve in the lower back, such as:
- poor posture, especially from computer work
- not getting enough regular exercise
- improper lifting
- repetitive movements
- overweight or obesity
Your doctor will first ask you about your symptoms. It’s important to provide as many details as you can, such as how long you’ve been experiencing pain and discomfort, how it’s affecting your quality of life, and whether you’ve recently experienced any recent injuries.
Next, your doctor will look for physical signs of trauma or other issues in your low back by checking for possible:
- 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.
They may order 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 can be used to evaluate bony structures and muscles
Such imaging tests are typically ordered in the case of long-term symptoms only. For example, doctors may not order imaging tests for sciatica unless symptoms last for
Once your doctor diagnoses the pinched nerve in your lower back, you can begin to consider treatment. Options may include a combination of:
Sometimes your doctor will need to treat the pinched nerve with more invasive measures, such as spinal injections or surgery.
Your doctor will likely recommend noninvasive, baseline treatments for your pinched nerve first. Inmost cases, nonsurgical measures will relieve your symptoms.
Keep in mind that it can take several weeks for treatment to take effect before your doctor may consider more invasive treatment options.
If your doctor gives you the go-ahead, you may try OTC 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.
- Activity modification. 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 you avoid these 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. If you’ve recently experienced a low back injury, however, avoid applying heat for 48 hours.
- Frequent movement. Exercising regularly may help avoid the onset of nerve pain or relive symptoms. You may also try light yoga or tai chi as forms of light exercise that still help build strength and flexibility.
- 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.
Higher level treatments
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, a herniated disc in your lower back may be treated with 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.
Always discuss any stretches and exercises you may be considering with your doctor before you try them. You want to 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. Knees to chest
- Lie on the floor.
- Bend both knees and point them up toward the ceiling. Your feet should be on the floor.
- Bring your knees up to your chest and hold them there for 10 to 20 seconds.
- Release your legs and return your feet to the floor in the knees bent position.
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.
Any chronic (ongoing) low back pain ought to be checked by a doctor, especially if your symptoms interfere with your daily activities. By properly identifying a pinched nerve and the possible underlying cause, your doctor can then direct you to treatments that can help.
If you’re currently undergoing treatment for a pinched nerve in your lower back, it’s also important to see your doctor if symptoms worsen or don’t improve within 4 to 6 weeks.
There are many possible treatments for a pinched nerve in your lower back. You’ll 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.
Make an appointment with a doctor if your pain is persistent or severe.