One of the more common complaints that patients present with at our physiotherapy clinic is back pain with a “pinched nerve pain”.
Patients will often present to us, saying that they have back pain that extends past their bottom and travels into their thigh or lower leg. Sometimes patients will only have the lower leg pain without back pain.
What is a pinched nerve?
“I’ve pinched my nerve!”
“I have sciatica!”
You may have heard people say this or you may have even said it yourself to describe your condition, but what does it actually mean?
What is a nerve?
We have hundreds of nerves throughout our body and there are different types of nerves that play different roles.
Some are responsible for feeling sensation, hot or cold temperatures, others are responsible for helping us with our balance or co-ordinating our movements – for example finding the light switch in a dark room and some nerves are responsible for providing us with muscle power.
Think of nerves as electrical wires in our body, delivering messages from our brain to different parts of our body so that it can function properly.
A “pinched” nerve in the back as it’s often referred to, means that there is an interruption to one of the lumbar nerves.
Your doctor may have sent you for an MRI or CT scan that reported an “L4 or L5/S1 nerve root impingement caused by a disc or degenerative joint. This just means that a structure in your lower back spine (lumbar spine) is gently pressing on one or two of the nerves that pass through the spine with certain movements or even at rest.
How do I know I have it?
Many patients with nerve related back pain report of pain in their back extending into their buttock and leg. Sometimes there is also weakness in the affected leg.
The best way to find out if you have a nerve impingement or nerve related back pain, is to make an appointment with an experienced physiotherapist.
A physiotherapist will do a thorough examination, which may include some or all of the following tests:
-
Thorough history taking of how the pain started or how you sustained the injury
-
Posture assessment
-
Looking at your movement restrictions e.g. bending forward, backward, sideways, twisting
-
Neurological tests to see if there is a nerve impingement and if so, where it is
-
Neural tension tests
-
Reflexes
-
Hamstring length testing
-
Assessing core strength
Sometimes your doctor will also request an MRI or CT scan to check if they suspect a nerve related back pain.
Will I need surgery?
Not necessarily.
Most nerve related back pain can be treated conservatively.
Most times if a patient sees a neurosurgeon or spinal surgeon, they will recommend the patient to trial physiotherapy for three months before reviewing them again.
Physiotherapy treatment for back pain with nerve impingement typically consists of reducing your symptoms, restoring pain-free movement, strengthening your core muscles and then finally prescribing you with a functional strength program so that you can get back to normal life without re-injuring your back again.
If any of this resonates with you, you can make an appointment to see one of our experienced physiotherapists. We will be more than happy to help you with eliminating your low back pain.
