A pinched nerve in the lower back happens when a nerve in the lower part of the spine becomes compressed by nearby tissue or bone. The pressure may cause pain, numbness, burning, or tingling in the lower back, legs, or feet.
In this article, we discuss pinched nerves in more detail, including their causes, diagnosis, and treatment. We also explain exercises that people can try at home to relieve the symptoms.
The spine contains many nerves, which carry signals to the brain. If bones or tissues in the spine press on a nerve, this disrupts the signals. This disruption causes the symptoms of a pinched nerve. In the lower back, a pinched nerve may cause symptoms that extend into the pelvis, legs, and feet.
Pinched nerves can occur suddenly, due to injury, or gradually, as the result of aging.
When a pinched nerve occurs in the lower back, a person may experience symptoms that radiate to the lower extremities, such as the legs, buttocks, and feet. Some people also call this condition sciatica or radiculopathy. Symptoms
- sharp or burning pain in the lower back or buttocks
- pain that extends down one leg
- numbness or tingling
Pinched nerves can also occur in the upper spine and neck, which causes different symptoms. According to Cedars Sinai, if the pinch occurs in the neck, a person may experience symptoms such as:
- shoulder pain
- sharp pain in one arm
- weakness or tingling in one arm
- an increase in pain when moving the shoulder or neck
Nerve pain often feels different than other types of back pain. Nerve pain tends to be sharp and include burning, tingling, and numbness. In contrast, muscular pain typically causes muscles and joints to feel stiff, achy, or tender.
If a person has lower back pain that does not affect their legs or feet or does not involve numbness, tingling, or burning sensations, they may have a different type of condition.
There are many possible causes of pinched nerves in the lower back. These
- injury or inflammation, which may put pressure on the nerves
- spinal stenosis, which is a narrowing of the spinal column
- spondylolisthesis, which occurs when a vertebra slips out of place
- herniated disk, which occurs when the disks between vertebrae become compressed
- an infection in the spinal disks, joints, or bones
- osteoporosis, which can cause painful fractures
Certain risk factors make it more likely that someone will develop nerve pain or a pinched nerve in the lower back. These factors include:
- physical inactivity
- uneven posture
Aging and inactivity may weaken the muscles around the spine and make someone more likely to develop age-related conditions, such as spinal stenosis. Obesity and uneven posture put additional pressure on the spine, which increases the chance of a nerve becoming compressed.
To diagnose a pinched nerve, doctors typically perform a thorough physical exam to test a person’s range of movement and reflexes, and to determine the site of the pain. In some cases, a doctor may need to carry out further testing to discover the cause of chronic or reoccurring back pain.
The Columbia University Department of Neurological Surgery note that doctors may use the following tests:
- an X-ray, which shows doctors the bones and structure of the spine
- an MRI, to look at the soft tissues of the spine, including the disks and nerves
- CT scans, which create a digital image of the back
- a myelo-CT, which is a CT scan involving an injectable dye that allows doctors to test a person’s nerve function
The treatments that a doctor prescribes will depend on the nature of a person’s back pain.
- avoiding strenuous activities temporarily
- applying hot or cold packs to help ease pain
- using over-the-counter (OTC) pain medication, such as ibuprofen (Advil) or acetaminophen (Tylenol), to reduce swelling
For severe or chronic pain that does not resolve in a few weeks, a person may need more in-depth testing to determine the underlying cause. At this point, a doctor may recommend:
- physical therapy
- oral or injected corticosteroids
- muscle relaxants, if the pain is severe
- surgical procedures, such as a diskectomy, to reduce pressure on the nerve
In addition to rest and pain medication, a person can take other steps to help their recovery and prevent a pinched nerve from occurring again.
Maintaining a neutral posture while sitting or standing may benefit overall back health. A neutral posture places the head and spine in alignment, with the ears directly over the shoulders.
Other ways to reduce strain on the back include:
- lifting heavy objects by bending the knees, rather than the back
- avoiding sitting for extended periods, especially at work
- maintaining a moderate weight
- stopping smoking, if applicable
At-home exercises may also help a person regain strength and range of motion after their back pain has lessened. A physical therapist will be able to provide a person with specific exercises and stretches for their individual needs.
However, a person can also try the following exercises when they are no longer experiencing pain, tingling, or numbness.
It is important to note that a person should not try at-home exercises if they are still in pain or if exercises make their symptoms worse.
Single knee to chest
Lying flat on the back with the legs straight, bring one knee to the chest, hold it there for 15 seconds, and then place it back down. Repeat 5–10 times on each leg.
Lying on the back with the knees bent and the feet flat on the floor, slowly rock the knees from side to side, allowing the back to twist slightly. Repeat 10–15 times.
Start on all fours with the hands and knees shoulder-width apart. Arch the back upward and hold the position briefly before slowly lowering the back into a concave position and holding it there for a moment. Repeat 10–15 times.
On all fours, hold the spine straight and then bend it to one side, drawing the hips toward the ribs. Hold the bend briefly, and then repeat the exercise on the other side. Repeat the whole exercise 10–15 times.
People should seek emergency medical attention if they experience:
- sudden and severe numbness or paralysis in the legs
- loss of control of bladder or bowel function
- severe pain in the legs, making it difficult to move
These symptoms may indicate a spinal cord injury, which is a serious condition that requires immediate treatment.
In addition, a person should see their doctor for lower back pain if they also have numbness or tingling in the legs or feet that does not improve with rest and OTC medications. If the pain gets worse or does not resolve within a few weeks, the doctor will be able to recommend further tests or treatments.
A pinched nerve in the lower back occurs when the nerve becomes compressed by surrounding tissue or bone. This type of nerve pain can radiate through the lower back, buttocks, legs, or feet. Sometimes, it also causes burning or tingling.
Treatment usually involves resting, taking OTC medications to reduce pain and swelling, and doing gentle physical therapy. In some cases, doctors may recommend steroids or surgery.