A disc herniation in the back is a common cause of lower back pain and pinched nerves. The pain often shoots down the leg and into the toes. The pain is from both nerve compression and inflammation. The symptoms are commonly described as painful numbness and tingling, as well as burning shooting down the leg. A pinched nerve can cause weakness but sensation changes are more common because the sensory fibers of the nerve are more sensitive to irritation. In many cases, lumbar radiculopathy improves in three to six months. There is a large variation among people, however, and some have symptoms for much longer (years or even chronically).
Lower Back Pain Relief
The burning and tingling are from nerve pain. Nerve pain feels different than muscle and joint pain and it is treated differently. With a new disc herniation, it is important to get control of the nerve pain to reduce the chance of it becoming chronic. Specific types of medications are used to treat nerve pain. It is important to titrate nerve pain medication to the therapeutic dose specific to that individual since people have a large variation in what dose works for them. Under-treatment of nerve pain with sub-optimal dosing is the most common issue I see with those recovering from radiculopathy. Examples, of common medications used to treat nerve pain are gabapentin, amitriptyline, duloxetine, and cannabidiol. In addition, there are more aggressive ways to treat newly pinched nerves including various types of injections and procedures.
Lower Back Exercises
Since nerve pain comes from a nerve, exercise won’t make nerve pain go away. What exercise can do is improve motor control, movement patterns, and range of motion that reduces stress and improves support for the back. Key exercise therapy for the back includes:
1) stretching all the muscles so there is an adequate range of motion
2) core strengthening (strengthening the abdomen and back muscles)
Lower back stretches
When muscles don’t have enough range of motion they can pull the back out of optimal position. The suboptimal position then puts abnormal forces on the back, increasing the risk of irritation and injury. Stretching restores the range of motion. Key muscles to stretch for the low back are the back of the legs (hamstrings), hips (front and side muscles), and low back. A great active stretch for the front of the hip is a lunge. Gentle low back stretches include the “cat” and “cow” yoga postures.
Lunge- stretch for the front of the hip
Core strengthening
The core is the muscles in the abdomen and back. The core muscles support and protect the spine. A key core muscle to strengthen is the transverse abdominis. It works reflexively to protect the spine when moving. To activate it, simply pull the belly button towards the spine. Practice doing this laying down, then while walking. A great core exercise is a plank.
Planks- core strengthening exercise
Summary
In summary, a disc herniation in the back is a common cause of lower back pain and pinched nerves. Pinched nerves cause nerve pain and it is treated differently than muscle and joint pain. Lower back exercises to help recover from a pinched nerve include stretching and core strengthening.
