Lumbar Impingement: What is it? Causes, Symptoms, Diagnosis and Treatment

One of the essential functions of the spine is to house and protect the spinal cord.

This is defined as a bundle of nerves that connects to the trunk of the brain and is part of the central nervous system; nerve roots are branched from the spinal cord.

This branching allows brain messages to travel to all the body’s peripheral regions, such as the arms and legs.

Occasionally, the roots of the nerves may become blocked or inhibited, which can cause a wide variety of symptoms.

The term ” nerve root shock ” refers to this phenomenon.

The many nerves that move away from the spine can be affected, as can the spinal cord.

Nerve root impingement can become a disabling or life-threatening condition if not treated properly and proactively.

 

Causes

In general, a nerve is affected due to the natural aging process.

As it ages, the thorns lose water content and begin to reflect many years of wear.

Because of this, the spine becomes vulnerable to several degenerative changes, which include:

  • Protrusion or herniation of the intervertebral discs: between the majority of the spine’s vertebrae, cartilage-based discs absorb the impacts. Sometimes, the disc’s inner core, similar to a gel, can come out of the hard outer shell of the disc; this displaced disc material can exert pressure on the nearby nerves, pressing and preventing the nerve from functioning correctly, which can cause acute pain.
  • Spinal stenosis: Age-related spinal complications can cause the spinal canal to narrow. If the spinal canal becomes small enough, it can begin to compress the spinal cord. These spinal cord injuries are severe conditions that can quickly become a life-threatening emergency.
  • Foraminal stenosis: the foraminal channels through which the secondary nerves branch from the spinal column to various body regions can narrow the nerves that generally protect it.

In addition to age, many factors have the potential to increase the chances of developing a lumbar clamp, such as:

  • The presence of bony spurs.
  • Participate in high-impact sports such as gymnastics or soccer, which can often cause injuries.
  • The presence of benign or cancerous tumors near the spine.
  • Excess weight or obesity.
  • The lack of exercise.
  • Smoking
  • The inflammations around the spine.
  • Osteoarthritis or disintegration of the facet joint.
  • Adhesions (scar tissue) from previous surgery.
  • The abuse of alcohol.
  • Experience a sudden trauma, such as a car accident or a fall.
  • Lifting heavy objects incorrectly
  • Twist or bend the torso quickly.
  • Do repetitive movements, perform work that requires physical effort, or drive vehicles for long distances.

symptom

The symptoms of a lumbar clamp can vary widely, depending on the affected nerve’s location and the obstruction’s severity.

In general, the following changes may be evidence of a lumbar clamp:

  • The acute pain, burning, and discomfort can occur in episodes or be constantly present.
  • The sensations of numbness, tingling, or pricking, can happen in the lower back or radiate to the arms and legs.
  • Muscle weakness all along the path of the compressed nerve.
  • The feeling that the extremities or the back are suffering electric shocks or being insensitive.
  • A decrease in motor function can be noticed when performing daily activities.
  • A reduction in sensitivity in the affected areas.

Pinching symptoms of the nerve root may get worse during certain activities. Without proper treatment, the effects of a lumbar clamp may intensify over time.

The nerves that are most commonly pinched are:

  • The pinched nerve in the L5:  the nerve located in the L5 supplies impulses to the muscles responsible for lifting the foot and the big toe. As a result, the compression in this nerve can cause numbness in these muscles and hinder movement.
  • A pinched nerve in S1: nerve S1 innervates for ankle pull in the Achilles tendon and foot. When the impingement occurs in nerve S1, this can cause weakness in the large gastrocnemius muscle located in the back of the calf, which causes difficulty with the thrust of the foot.
  • The pinched nerve in C5: when pinching occurs in C 5, this can cause shoulder pain, weakness in the deltoid, and possibly numbness in the shoulder, as well as the biceps reflex, which may be diminished in the exam physical.
  • The pinched nerve in C6: this pinching can cause pain and numbness that extends from the arm to the thumb and weakness in the biceps and wrist extensors. The brachioradialis reflex (middle forearm) may be diminished on physical examination.
  • The pinched nerve in C7: the pinching of this nerve can produce pain and numbness that go from the arm and extend to the middle finger. In the physical examination, the triceps reflex may be diminished.
  • The nerve pinched at C8 can cause hand dysfunction since this nerve innervates the small muscles of the hand. Pain and numbness may appear outside the hand, including the little finger, and affect the reflex.

Diagnosis

The doctor will carefully and compassionately evaluate the medical history, symptoms, and physical condition during the initial consultation.

To confirm a lumbar pinch and identify its underlying cause, tests such as:

  1. X- rays:  used to evaluate the spine (tumors and fractures).
  2. Computed tomography: images of cross-sections of the vertebrae and discs (herniated discs or spinal stenosis).
  3. Myelography: identifies the problems of the spinal cord and nerve roots.
  4. Magnetic resonance imaging: images of cross-sections to detail the spine (problems with the lumbar discs, nerve roots, spinal infections, or tumors).

After obtaining a complete and accurate diagnosis, a treatment plan is designed to suit your unique needs and objectives.

The nerves go from the neck to the lower back or lower back, which tend to heal slowly.

The nerves take weeks or months to heal completely, depending on the amount of damage when the nerve is embedded or pinched.

Treatment

The lumbar impingement treatment is aimed at pain relief allowing the nerve to heal over time by itself.

Pinched nerves are painful conditions because they are inflamed and pressured, so relieving the inflammation or pressure of the nerve relieves the pain.

In lumbar impingement treatments, there is a conservative approach.

A combination of the following conservative treatment options can be used for at least the first six weeks of discomfort and pain:

  • Physiotherapy, exercise, and gentle stretching help relieve pressure on the nerve root.
  • Ice and heat therapy to relieve pain.
  • Manipulation is like chiropractic.
  • Nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen, or COX-2 inhibitors for pain relief.
  • Narcotic medications to relieve pain.
  • Oral steroids to decrease inflammation and relieve pain.
  • Epidural injections to reduce inflammation and relieve pain.

The components of the treatment for a nerve root shock will depend on the location and severity of your condition.

It is recommended to explore conservative care methods before opting for surgery.

However, when compression of a nerve or spinal cord is significant and quality of life becomes difficult, then surgical intervention may be necessary.

The performance of laparoscopic procedures is recommended for being minimally invasive compared to traditional open surgeries.

This procedure usually produces benefits that include:

  • Recovery time is reduced, allowing patients to return to their daily activities more quickly.
  • Less postoperative pain
  • Reduced risk of scarring.
  • Reduction of blood loss.
  • Very little trauma to surrounding muscles and soft tissues.