Nerve root pain is used to describe symptoms that are associated with an irritation or compression to one (normally) or more nerves coming out of the spinal cord, i.e. a nerve root. The diagram opposite clearly shows that depending on which nerve is involved, a specific referral pattern of pain is experienced.
Many people call this a 'trapped nerve' or ‘Sciatica’.
To understand the cause and how symptoms behave, it is of benefit to first understand that anatomy of your spine.
When correctly aligned the back has 3 curves; these curves help to distribute the pressure evenly throughout the vertebrae and discs.
It curves forwards (lordosis) at your neck (cervical) It curves backwards (kyphosis) in the mid region (thoracic) It curves forward again in the lower back (lumbar)
Nerve root pain can occur for a number reasons;
Annular tear (the elastic and fibrous outer casing of the disc)
Disc Prolapse (see our Disc Prolpase sub-section)
Spinal Stenosis – narrowing of the internal diameter of the spinal canal
Spondylolythesis – spinal slip often seen in the lumbar spine
Piriformis Syndrome – sciatic nerve compression caused by piriformis spasm in the buttock
Somatic referred pain arising from joints, ligaments, tendons and muscles
People will feel the pain along the course of the nerve, typically down one leg as far as the calf or foot.
The irritation or pressure on the nerve may also cause pins and needles, numbness or weakness in part of a buttock, leg or foot.
It is important to note that this presentation of symptoms occurs in less than 1 in 20 cases of acute low back pain. People can experience leg symptoms with or without back pain.
Stay Active. It is important to keep moving and avoid bed rest from the initial onset of back pain.
Pain control is important to ensure that you continue to stay active and can carry on with daily activities. Medication in the form of pain killers and anti-inflammatories are the most common form of pain control used; antiflammatories can be particularly useful for nerve root pain as the condition is inflammatory in nature. Other forms of pain relief include TENs, heat and ice.
Physiotherapy in the form of;
Structured Exercise Program – our resource section has a sheet of basic active range of movement exercises for the back which may be appropriate for you to ensure that your back stays active and importantly your back symptoms stay under control.
Manual Therapy, including Manipulation
Soft Tissue mobilisations
Education for prevention of future episodes
Further intervention may be indicated if conservative management does not help. This may include;
Assessment from a Consultant who may decide that injections (facet joint or nerve root) may be appropriate. Failing this surgical intervention may be considered.