Low back pain affects everyone. Is my pain a pinched nerve or just muscular? What is a pinched nerve? How can a Chiropractor help?
There are many types of low back pain, but what I often hear in our office is, “Is this a pinched nerve or just muscle?”
About 80% of adults will deal with episodes of low back pain in their life. Of those, roughly 3-5% will have a “pinched nerve”, also known as a lumbar radiculopathy or sciatica. Chiropractors have been shown to be incredibly effective with low back pain due to their detailed analysis and unique corrective treatment.
The first thing we do in our clinic is a detailed history, since typically 80% of the diagnosis is formed here.
For a pinched nerve diagnosis, common questions we would ask is if there is any:
Numbness, tingling, electric, hot or cold sensation running down the body
Radiating or travelling pain into the legs
Perceived or actual weakness in muscles
Sharpness on certain positions (like bending forwards to put on your shoes).
Large or small areas of tightness
Stiffness or pulling down to the butt, legs, and feet
For more of a muscular pain, we would ask about:
When and how the pain first occurred
Is it more of an ache, sharp, heaviness, pulling, tightness?
Does the pain travel past any joints, or just in-line with a muscle body
Is there any pain when resting or with certain exercises
Stiffness or pulling into the butt, legs, or feet
What is a Pinched Nerve?
Your Nervous System (Nerve system) controls and regulates every aspect of your body, from your movement, muscle tension, blood pressure, etc. When we injure our low back or compress it for hours at a time with long hours at work, those nerves can be irritated and inflamed.
First there is a Structural Shift, also known as a Subluxation. This uneven compression can cause the disc to physically push against the exiting nerve. The pinched nerve can also be chemically irritated with a build up of inflammation as the body tries to heal the injury.
Given time, these joints start to degenerate and can be harder to resolve the longer they linger.
Pinched Nerve Symptoms
A low back pinched nerve often creates:
Shooting pain down the back of the leg
Numbness or tingling
Electric, cold, or hot sensation down back or leg
Deep ache of low back, butt, and legs
Weakness and cramping of leg muscles
“Often the ‘leg pain’ can be more intense than the low back pain. This is a big indicator the Sciatic nerve has been irritated.”
What Causes a Pinched Nerve?
Most cases of pinched nerve occur because of a slipped disc, degenerated disc, or acute injury.
Acute sports injuries, slip and falls, motor vehicle accident, improper lifting and bending mechanics, can often be the trigger that sets off a pinched nerve.
In some cases, the pinched nerve can become irritated by your gluteal nerves, which can create a Piriformis Syndrome.
What is Piriformis Syndrome?
While most pinched nerves in the low back come from the spine, occasionally the gluteal (one of your butt muscles) can become too tight and restrict the Sciatic nerve exiting out. These patients often feel increased numbness on their back or legs that becomes worse with sitting or running.
As the problem in the case comes from an overly tight muscle, these cases are typically much easier and quicker to resolve in our clinic with Chiropractic Adjustments and simple home exercises for strengthening and stretches the dysfunctional areas.
Now remember, even though the piriformis muscle is tight, you need to find out WHY the muscle it tight. It can be:
Overstrained from daily activities
Weak due to inactivity
Weak due to neurological inhibition
Weak due to muscular compensation
All of these require different interventions (treatments) in order to make an effective change.
There is no one test to determine all of these different factors. Make sure to get your spine (and butt muscles) checked by one of our highly trained Chiropractors for a specific diagnosis and corrective treatment.
I Didn’t Have an Injury, but I still have Pain!
Pain is typically one of the last symptoms to occur with our body. Your spine is very adaptable, but due to our 2019 lifestyle of chronic sitting, poor posture, limited exercise, and often poor nutrition, problems with our spinal health tend to build for years.
Think about this, the first signs of heart disease is often a heart attack! It takes a long time for the body to get to that stage, but for most people you can’t feel it.
The same thing occurs with your spine. Slow continued compression of your joints and discs over time will start to create degeneration and inflammation, and eventually low back pain.
The Physical Exam
After listening intently and asking detailed questions, we follow up with specific physical examination including orthopaedic and neurological testing to determine where specifically and how severe the problem is.
At Aligned Chiropractic, we would specifically tailor the exam towards your problem, including:
Deep tendon reflexes
Physical palpation (touching)
Joint mechanics loading and testing
Range of motion
Not recognizing the signs
The occasional ache and stiffness in our low back can be just a one-off pain, but most patients who come in with pinched nerves have had a history of on/off ache for years! Chiropractic works incredibly well for BOTH pinched nerve and muscle pain.
It’s important to get yourself checked if you are having any of these symptoms, or if you suspect something doesn’t “feel right” in your body.
For more information, or a free consult to see if your case is right for us, email us at