The motions of the lumbar spine (in order of greatest to least) include flexion (bending forward), extension (bending backward), side bending, and rotation right and left (turning).
The two lowest levels (L4-L5) and (L5-S1) have the most flexion and extension motion stress, and the highest rate of injury. The most common lumbar nerves that get pinched or entrapped are the L4, L5, S1 levels. Entrapment of these nerves may lead to a condition called Sciatica.
In the spine, there are areas where the intervertebral disc and facet joints join two lumbar vertebral bodies. Where this occurs, it forms two canals on either side of the spine. These canals are called intervertebral foramina. The nerves leave the spinal cord, and travel through the foramina, exiting the spinal column, where they travel out to the rest of body.
The size or diameter of the spinal foramina can vary from person to person. If anything compromises or encroaches on the canal, it may put pressure on the exiting nerve. This produces symptoms that may include pain, tingling, numbness or even weakness. Degenerative disc disease, degenerative joint disease, disc herniation, and bony spurs or osteophyte formation are conditions that can narrow the intervetebral foramen and compress the exiting nerves. This may produce symptoms in the back, buttocks and legs.
The most common nerve irritation originating from the lumbar spine is Sciatica. This is an irritation of the sciatic nerve, which can produce pain, numbness, and weakness down the leg along the areas innervated by the sciatic nerve.
Symptoms can include:
- Pain in the back or radicular to the buttock, into the leg and extending down behind the knee, to the foot depending on the nerve involved and the severity of the encroachment.
- Impairment of normal reflexes in the lower extremity.
- Numbness or paraesthesia (tingling) may be experienced from the low back to the foot depending on the distribution of the affected nerve.
- Muscle weakness may occur on any muscle that is innervated by the pinched nerve. Long-term pressure on the nerve can produce atrophy or wasting of that particular muscle.
- Pain and tenderness localized at the level of the involved nerve.
- Muscle spasm and changes in posture in response to the injury.
- Pain and tenderness localized at the level of the involved nerve.
- Loss of motion like the inability to bend backward, move sideways to the effected side, or stand erect for extended periods of time.
- Sitting, standing and walking can be difficult if the irritation is severe.
- Stiffness in the joints following a period of rest.
Physiotherapy & Chiropractic Treatments of a pinched nerve or injury will depend on the severity of the condition. When treating acute back problems:
- Rest
- Medication to reduce inflammation
- Ice in acute cases
- An exercise regiment designed specifically to address joint mobility, spinal alignment, posture, and range of motion.
- A lumbar support
- Spinal decompression, acupuncture, the McKenzie technique, hands on therapy, dry needling and other modalities.
Most pinched nerves or entrapment problems can be managed conservatively without surgery and return to normal function. Duration of treatment can range from 4 to 12 weeks depending on the severity of the symptoms. We ensure that you continue with a regiment of postural, stretching, strengthening and stabilization exercises.
PhysioMAX Wellness offers physiotherapy, chiropractic, acupuncture, massage therapy and other health care services to many patients in the Burlington area including Hamilton, Oakville, Stoney Creek, Waterdown, and Milton.