One common cause of foraminal stenosis and radiculopathy is a bulging or herniated disc. On occasion, these discs slip out of place or become damaged and press on nerves. This problem is most likely to occur in your lower back, but it can also affect your neck. At Penn, physicians begin with conservative, non-surgical approaches to treat nerve root pain. When non-surgical treatments do not work and an individual’s condition does not improve, surgery may be the next best step to treat underlying conditions causing nerve root pain. Medications designed for epilepsy or depression often reduce the symptoms, and topical medications are sometimes helpful.
Often, the discomfort temporarily eases when bending forward and is relieved by sitting down. Spinal stenosis is most commonly due to degeneration of the discs between the vertebrae. The result is compression of the nerve roots or spinal cord by bony spurs or soft tissues, such as discs. Symptoms of nerve or spinal cord compression include pain, aching, stiffness, numbness, tingling sensations, and weakness. Low back pain that gets worse with sitting may indicate a herniated lumbar disc . A pinched nerve in the lower back occurs when the nerve becomes compressed by surrounding tissue or bone.
That is one reason why imaging tests are performed to confirm a diagnosis, which is supported by results from the physical/ neurological exam, medical history, and symptoms. Many people who have undergone an x-ray or other imaging test for a non-spine-related matter have discovered they have spondylosis, osteophytes, and/or a bulging disc. The most common symptom of spinal stenosis is low back, buttock and back of the thigh pain that worsens with standing and walking. Many people with lumbar spinal stenosis experience symptoms only when they are standing or active.
Symptoms may inhibit your ability to move without discomfort, pain and/or neurological signs, such as tingling sensations and numbness that may radiate into another part of your body. If low back pain worsens or does not improve after two to three weeks of home treatment, contact the primary care physician. The physician neurologist expert witness can evaluate and perform an in-office neurologic exam to determine which nerve root is being irritated and to rule out other serious medical conditions. If the physician notes clear signs that the nerve root is being compressed, he/she can prescribe medications to relieve the pain, swelling and irritation.
Surgery is typically used to reduce the pressure on the nerve root by widening the space where the nerve roots exit the spine. Cervical posterior foraminotomy is one of the minimally invasive spine surgery options available. Radiculopathy is typically caused by changes in the tissues surrounding the nerve roots. These tissues include bones of the spinal vertebrae, tendons and intervertebral discs. When these tissues shift or change in size, they may narrow the spaces where the nerve roots travel inside the spine or exit the spine; these openings are called foramina.
There are cases of low back pain, however, that take much longer to improve, and some that need evaluation for a possible cause other than muscle strain or arthritis. 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. Sometimes, radiculopathy can be accompanied by myelopathy — compression of the spinal cord itself.
Keeping fit with a strong core helps protect your precious spine, spinal cord and nerves that innervate your extremities. A pinched nerve occurs when too much pressure is applied to a nerve by surrounding tissues, such as bones, cartilage, muscles or tendons. This pressure disrupts the nerve’s function, causing pain, tingling, numbness or weakness.
Routine use of lumbar corsets may weaken core strength and delay recovery. Spinal manipulation can be effective for some patients with acute low back pain. Treatment for inflammatory back pain includes stretching and strengthening exercises.
For example, the patient may be asked to hyperextend her back, bending backwards for 20 to 30 seconds, to see if that movement causes pain. If it does, spinal stenosis, a narrowing of the canal that runs through the vertebrae and houses the spinal nerves, may be the cause. Back pain is the No. 2 reason adults visit a doctor and the No. 1 reason for orthopedic visits. It keeps people home from work and interferes with routine daily activities, recreation, and exercise. The good news is that for 9 out of 10 patients with low back pain, the pain is acute, meaning it is short-term and goes away within a few days or weeks.