The pain from pinched nerves differs to that from soft-tissue damage. Unpleasant sensations may also radiate into the arms (if the neck nerves are being pinched) or into the buttocks or legs (if the lower back nerves are being compressed).
The sources are numerous, but they all do the exact same thing: push on a nerve and cause pain. Nerves can be pinched in the spinal canal or where they leave the spine. The pain can come in waves or be constant.
Here’s what a pinched nerve can feel like:
Short-term compression of nerves doesn’t usually cause permanent damage, but the tingling and numbness which result from it may require several months to go away. If it’s a recurrent or chronic problem, surgery to free the trapped nerve may be needed.
Vertebral discs are tissues which possess a solid outer layer (annulus fibrosus) with a softer gel-like inner layer (nucleus pulposus). The discs act as a cushion between the vertebral bones and therefore are subject to wear and tear from the normal pressures of life, disease, trauma, or repetitive stress from physical actions. If a disc becomes herniated, it bulges out and can push on nerves and cause pain. Depending on how compressed the nerve is, pain can be mild or severe with a sharp or dull feeling. It is possible, for a disc bulge to not cause any pain as it may not compress the nerve. This is why it’s very important not to rely only on imaging tests to analyze back pain.
Equally, some discs bulge more when you bear weight on them. It’s like changing a tire, the tire will not bulge if the car is on a jack, as it is not bearing any weight. Should you remove the jack and the tire will bulge slightly.
If you have a bulge pushing on a nerve, treatments are usually nonsurgical and can include pain medications, physical therapy, and sometimes steroids and nerve blocks. Time, again, is usually the best healer.
Intervertebral discs do not have their own blood supply. They are actually the largest organ in the body without a blood supply. In its place, they take in their nutrients from the surrounding bony cartilage, above and below. This is a slow process, meaning that a herniated disc may require a long time to heal.
The sciatic nerve extends from the lumbar region (lower spine) down through the back of your leg to your foot. If this nerve is pinched, the pain can radiate from hip to ankle or just somewhat down that path. Typically, sciatica just affects only one side at a time. However, it can be extremely painful and hard to find a comfortable position if you’re suffering from sciatica. The pain is commonly a shooting pain and again can be mild or severe. It can become worse if you bend forward or lift up your knee.
Herniated discs are often the source of the problem but sciatica can also be a result of other factors including the narrowing of the spinal canal (see the following section on stenosis) or a tumour (this is rare). The majority of people suffering from this condition find relief using nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Although acetaminophen (Tylenol) can also be an excellent painkiller, it does nothing to lower the inflammation, which is the source of the pain. Physical therapy and therapeutic exercises can aid in realigning body structures and lower pressure on the nerve.
This is a tightening of the spinal canal or vertebral foramen (the areas where nerves leave). The narrowing is often a result of bone spurs or inflammation. As the spaces narrow, the nerves can get squashed. Some patients have a narrow spinal canal at birth and therefore are more at risk of developing this disease. Doctors refer to this as short pedicle syndrome or congenital stenosis.
The majority of stenosis cases are caused by arthritis. Arthritis is most common in people over 60 and is also more prevalent in females. Stenosis can also, however, result from a birth defect.
Bone spurs are referred to in the medical world as osteophytes. It is extra bone growth as a result of the body attempting to repair itself. This can happen if there is prolonged pressure, rubbing, or stress on bones. For instance, if cartilage wears away, a spur can develop. If no other structure is affected, it’s not a problem, but in the spine bone spurs can often narrow the areas where spinal nerves are, and pinch them.
Spinal stenosis usually affects the lower back (lumbar) or neck area (cervical spine). It’s not usually found in the middle back (thoracic). But it can become worse if you bend backward but better if you lean forward and lie down. When you lean forwards, you are pulling apart the facet joints in the vertebra, which eases pressure on the underlying nerve and opens the bony canal. Exercise, medication, steroids, or surgery may be advised to alleviate pressure from stenosis.