Determining the causes of a pinched nerve in the lower back (lumbar region of the spine) can be difficult, as there are usually several contributing factors that have led to the occurrence. One of the main causes, however, is the natural process of spinal degeneration that takes place as we grow older.

The spinal components – vertebrae, facet joints, intervertebral discs, ligaments, and muscles – work together to provide support the body, but years of wear and tear can take its toll on these components. Discs become weak and may bulge or herniate; facet joints can become arthritic; a vertebra may slip out of place in relation to an adjacent vertebra. Any of these occurrences can lead to the compression of the spinal cord or a nerve root, which usually causes symptoms of radiating pain, numbness, weakness, and tingling to affect the extremities.

A pinched nerve can occur in any area of the body, including the spinal column. The individual vertebrae that form the spinal column are stacked on top of each other, and provide protection to the spinal cord, which runs from the base of the brain into the lower back. Along the way, nerve roots extend off the spinal cord, exit the spinal column through passageways called intervertebral foramina, and branch off into various areas of the body. These delicate nerve structures are particularly susceptible to compression as they travel through the foramina, as these openings are already narrow and can be easily constricted by bulging or herniated disc material, a displaced vertebra, or other anatomical abnormalities. While neuropathic symptoms usually occur as a result of a pinched spinal nerve root, where those symptoms arise will depend on whether the affected nerve root is located in the neck or lower back.

The decision to undergo a spinal pinched nerve procedure is not something that should be taken lightly. Only after having attempted a wide variety of conservative (non-surgical) treatments over the course of several months should surgery be considered, and even then not all patients will be viable candidates for a spine procedure.

Once you and your doctor have decided that a surgical procedure offers you the best chance for pain relief and an improved quality of life, you will need to determine what type of procedure will be best for your specific condition. In general, spine surgeries will fall under two categories: endoscopic surgery and open spine surgery. Gathering information about the risks and benefits of both will be an important part of your decision-making process, and you should always feel free to get opinions from more than one specialist before consenting to any spinal pinched nerve procedure

Whether or not you are a candidate for pinched nerve surgery will depend on a variety of factors. Your doctor will need to consider your age, your general state of health, the severity of your pinched nerve, which conservative treatments have been tried, and whether you have undergone any previous surgeries for spine conditions, among other variables. If you prove to be a good candidate for surgery – spine surgery is almost always considered an elective procedure – you will then need to consider the different types of procedures that are available to you.

While the idea of getting a pinched nerve diagnosis can be scary, just remember that the sooner you know what exactly is causing your pain, the sooner you can relieve your symptoms with an appropriate treatment plan. If you have been experiencing pain, weakness, tingling, numbness, or a pins-and-needles sensation in your back, neck, and/or extremities and think a pinched spinal nerve may be to blame, make an appointment with your primary care physician.

Pinched nerve treatment can take a variety of forms, but in nearly all cases, conservative treatments will be attempted first. After confirming a pinched nerve diagnosis, your doctor may prescribe a regimen of non-steroidal anti-inflammatory drugs, physical therapy, hot and cold compresses, gentle stretching, and low-impact exercise. Other non-surgical options for pain management include analgesic pain patches, ultrasound therapy, corticosteroid injections, and transcutaneous electrical nerve stimulation (TENS).

Pinched nerve symptoms will vary based on which specific nerve or nerves are compressed, as well as their location in the body. Nerve impingement in the spine can be especially debilitating because this is where the spinal nerve roots (nerves that branch off the spinal cord) reside – if a root is pinched, all of the peripheral neural pathways branching off that root throughout the body will be affected, a condition referred to as radiculopathy. A variety of conditions can cause a pinched nerve root in the upper back and neck (cervical spine), or the lower back (lumbar spine), including herniated discs, bulging discs, spondylolisthesis, and bone spurs.

Pinched nerve causes can vary and may depend on where in the body the pinched nerve is located. For instance, if the median nerve in the wrist becomes compressed (carpal tunnel syndrome), one of the main causes is overexertion due to repetitive motions like typing for long periods of time. In the spine, however, the main cause of a pinched nerve is degeneration caused by the aging process. As we grow older, the elements of the tightly compact spinal column can begin to change. Intervertebral discs can bulge or herniate, bone spurs can develop in arthritic joints, and unstable vertebrae can shift out of alignment. Any of these degenerative changes can lead to spinal nerve compression.

There are a variety of ways that a pinched nerve can develop in the spine. For instance, age-related degeneration may cause an intervertebral disc to bulge or herniate. A portion of the disc may then press on a nearby spinal nerve or nerve root. The same can occur if bone spurs develop or if a ligament, muscle, or tendon becomes inflamed.

A pinched nerve, which may also be referred to as a compressed or impinged nerve, occurs when some sort of anatomical abnormality presses on a nerve. It can occur anywhere in the body, though the spine is a common site of nerve compression because spinal nerves, nerve roots, vertebrae, intervertebral discs, and spinal ligaments are in such close proximity to each other.

There are a variety of ways that a pinched nerve can develop in the spine. For instance, age-related degeneration may cause an intervertebral disc to bulge or herniate. A portion of the disc may then press on a nearby spinal nerve or nerve root. The same can occur if bone spurs develop or if a ligament, muscle, or tendon becomes inflamed.

While there are dozens of specific back problems that come with their own unique symptoms and specific causes, most are variations on nerve compression. Simply stated, this condition occurs when any type of tissue—bone, spinal discs, cartilage, etc.—presses on the spinal cord or a nearby nerve, causing inflammation and irritation. Depending on the location of the nerve and the severity of the pressure, pain from nerve compression can travel down the limbs and into the fingers and toes, making even the simplest tasks, like standing in line or reaching for the remote, painful. That’s the case with sciatica, a common back problem that’s caused by compression of the sciatic nerve where it leaves the spinal canal.

Nerve compression is also the cause of the pain associated with these other common back problems: