A pinched nerve refers to compression of the nerve anywhere along its course. Typically folks refer to “piching” when the nerve is compressed within the spinal canal or as it exits the neuroforamen of the spine.
A nerve becomes pinched by surrounding tissues — such as bones, cartilage, muscles or tendons. Muscular dysfunction, poor posture, boney abnormalities and certain systemic diseases can all serve to make a nerve more likely to be “pinched”.
There are five (5) lumbar nerve roots that exit the lumbar spine on each side. Each nerve root imparts sensory and motor information to a specific area of the lower extremities/torso and specific groups of muscles. Numbness or decreased sensation in the area supplied by the nerve can result from a nerve being pinched. The pain is often sharp or burning and may radiate outward. Coughing and sneezing increase spinal canal pressure and can worsen symptoms of a pinched nerve.
Procedural treatment for lumbar pinched nerves can include cortisone injections under imaging guidance via a transforaminal or interlaminar approach to target the area of nerve compression. The location of the injection is decided by the distribution of symptoms and imaging findings. Regenerative injections including platelet-rich plasma (PRP) injections are also being used experimentally to provide a healthier environment to promote healing in the lumbar region. Some physicians will inject material into the disc itself if a disc herniation is causing nerve irritation.