Pinched Nerve In Lower Back

A pinched nerve in lower back is one of the more common complaints heard in a chiropractic office.

It seems that most lower back pain is automatically blamed on a pinched nerve. When in fact, most lower back pain is not caused by a pinched nerve at all.

However, it is not an uncommon condition nonetheless.

When a pinched nerve in lower back is present it can cause varying degrees of pain, numbness, weakness, burning, tingling, and pins and needles sensations.

There are other conditions that can cause these very same symptoms. These conditions may not all be related to a pinched nerve. Some of the more common conditions associated with similar symptoms of a pinched nerve are:

  • Nutrient deficiencies (vitamin B12).
  • Contusions of the nerve (blunt force trauma).
  • Hormone disease (hypothyroidism).
  • Neurological disease (multiple sclerosis).

All of the above conditions are rather uncommon causes of symptoms similar to a pinched nerve with the exception of myofascial pain syndrome.

Usually a lumbar pinched nerve is caused by compression from a herniated disc or stenosis.

When the pinched nerve in the lower back is at the disc level there most often is found a bulging disc or a true disc herniation.

A bulging or herniated disc presses against one or more lumbar nerves and causes symptoms due to the actual pressure and/or inflammation.

herniated disc on mri

Herniated Disc Pinching Nerve

It is most often found at one or more disc levels or at the neuro-foramen. The neuro-foramen is the area or space between adjacent vertebrae located between the facet joints where the nerve roots exit the spine.

If the nerve is pinched at the foramen the most likely cause is narrowing of the foramen (stenosis) due to bony thickening, bone spurs or an abnormal alignment or approximation of the joints surfaces of adjacent vertebrae. This approximation or glide reduces the size of the opening. Therefore, it is more likely to create compressive forces on the nerve.

In many cases a pinched nerve can occur at more than one place. An example of this would be when a bulging disc presses the nerve and at the same time the nerve is being compressed by bony spurring from the facet joint or perhaps from a tight piriformis muscle.

You may also have multiple lumbar nerve roots being pinched due to multiple levels of disc herniation, stenosis or foraminal occlusion.

There may also be little correlation with the number of nerves pinched and the amount of signs and symptoms. Most often it is the amount of pressure that determines the severity of the symptoms.

The majority of cases when a lower back pinched nerve is found even though the pain intensity may be severe it is usually of minor urgency.

However, pressure that does not cause a lot of pain may in reality be a major concern and require immediate surgical intervention. Symptoms, aside from the pain, that would require immediate medical care would be saddle or perineum numbness, and/or loss of bladder or bowel control.

Other conditions that may cause pinched nerve in lower back are:

  • cysts
  • tumors (cancer)
  • foreign bodies (bullets-shrapnel)
  • muscle compression (piriformis syndrome)

  • scar tissue (previous surgery)
  • hematoma (blood clot-bleeding)
  • swelling (trauma)

Pain or other symptoms that may be related to a pinched back nerve needs to be evaluated by a healthcare provider to rule out the need for urgent surgical care or surgery.

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