Just like the roots of a tree come together to form the trunk, nerve roots in the spine come together to form nerves in the back which run down through your pelvis then down into your legs. Nerve roots are like cables. Each root contains millions of fibers. Some of the fibers in the nerve root cable are for movement, some are for sensation, others make you sweat. Any time there is pressure on a nerve, it hurts!
What does a pinched nerve feel like?
The pain of a pinched nerve is sharp, stabbing, and runs down your leg like electricity. Over time, compression can cause damage to the nerve root and result in a patch of numbness of the painful leg. It will also cause weakness. The numbness can be felt in different places, depending on which nerve root is pinched and what that pinched root normally does. Doctors can predict which nerve root is pinched based on your symptoms and examination. The pain could be temporary or last longer depending on the severity of the pinched nerve.
For example, the L5 nerve root has fibers which signal the tibialis anterior muscle to lift the toes when walking and other fibers which allow you to feel your big toe. Pinching the L5 nerve root causes a sharp, stabbing, electrical pain to shoot from your back down your leg into your big toe and causes a foot drop when walking. On examination, your doctor will find a weakness of the tibialis anterior muscle and the extensor halluces muscle, as well as numbness to your big toe, and normal reflexes. If the weakness is severe or the pain has gone on for more than 12 weeks, your doctor will confirm the pinched nerve root by MRI.
What could cause a pinched nerve?
Lots of bad injuries pinch nerve roots, and you can see them all on MRI. The most famous one is the herniated disc. Disc material is very irritating to nerve roots; the disc doesn’t have to pinch the root much to damage it by irritation. Over time, old herniations calcify, and the joints of the spine develop bone spurs, which can pinch nerve roots as well. If one spinal bone moves forward on another, nerve roots can become trapped and cause severe pinching. MRI shows all of these villains in high definition. If you can’t have an MRI, we can still see them in black and white on CT.
How is a pinched nerve treated?
There are different treatment options available depending on severity. In some cases, simply resting the area and avoiding aggravation will help the nerve heal on its own. In other cases, treatment options could include taking anti-inflammatory drugs, physical therapy, steroid injections, and in worse cases, surgery. Speaking with your doctor if you suspect you have a pinched nerve is the best way to determine which treatment is right for you.