Many people experience low back pain that is accompanied by tingling in their legs. If you also experience back and pelvic pain with spreading to the legs and numbness of the feet and numbness and tingling of the feet, and you are looking for the cause of this disorder and how to treat it, we recommend that you read more.
In the following, we are going to talk about shooting pains in the lower back and explain to you the way of treatment and the ways to prevent them.
We first need to familiarize you with the term that doctors use in these cases.
What is radiculopathy?
Conditions during which the nerve root that is leaving the spinal cord (spinal nerve root) is pressed in a way and following this pressure, inflammation and nerve damage occur. From the connection of the roots of the spinal nerve
The main trunk of large nerves that are responsible for innervating the pelvis and the muscles of the buttocks, pelvis and lower pelvis is formed. These nerves move from the lower back and pelvis down and will be responsible for nourishing the muscles and… in the course of their movement.
They have both sensory and motor parts, so their inflammation causes pain and stiffness in the muscles, as well as numbness and tingling.
The above clinical symptoms are caused in the pathway of the injured nerve.
The nerve root is actually described in such a way that from the right and left distances of the two vertebrae at the bottom of the spine, a pair of delicate nerves emerges, that is, a pair on the left and a pair on the right. And we said that from the connection of these nerve roots, important nerve trunks and neural networks are formed.
Now any pressure on these spinal roots and nerves is called radiculopathy, And the pain caused by them, which is diffuse and shooting down, is called radicular pain.
Signs and symptoms in radiculopathies
Signs and symptoms of radiculopathy include:
- Stabbing pains
- Downward spreading pain
- feeling Paresthesia
- Decreased sensation or numbness in a part of the skin that has been nourished by damaged nerves
- A tingling sensation in the damaged nerve pathway
- Feeling lethargic
- Muscle weakness in the nerve pathway
- Decreased muscle strength in the nerve pathway
- and in prolonged cases, muscle wasting
What people mistakenly call sciatica is actually radiculopathy.
- Intervertebral disc herniation:
There is a cartilaginous disc between the two bony surfaces of the adjacent vertebrae, which is responsible for regulating the pressure on the vertebrae. In young people, the center of this cartilage is juicy, soft and flexible, and it is like jelly, and there is a strong ring around the disc ring.
If, for any reason, the pressure on the vertebrae is greater than the disc bearing or moderate pressure is applied chronically on the spine, this soft and jelly core puts pressure on the peripheral ring of the disc and the disc protrudes from its place. Doctors call this displacement from its normal location a hernia. Sometimes the pressure is so great that the protruding disc ruptures. In any case, a protruding or ruptured disc will put pressure on the nerve root and start the radiculopathy process.
This procedure is common among young people.
- Spinal osteoarthritis and degenerative processes:
As you age, the soft core of the disc hardens. The flexibility of the disc will decrease and the cartilage will decay. The height of the disc will decrease and the distance between the bony surfaces of the adjacent vertebrae will decrease and the wear will increase. Gradually, cysts form at the bones adjacent to the disc, ectopic bone growths also form, in general, this procedure is called degenerative procedure and the above-mentioned process is called osteoarthritis or osteoarthritis of the vertebrae.
These abnormal bone growths start the process of radiculopathy by putting pressure on the root of the spinal nerve. This procedure is common in the elderly.
- Slipping the vertebrae on top of each other
- Spinal fractures due to:
- Muscle spasms and cramps
- Due to electrolyte disturbances
- Improper and long sitting and …
- Tumors and masses located in the spinal cord, spine bones, and…
Alcohol and diabetes both damage nerves outside the spinal cord. Nerve damage is called neuropathy and nerve damage outside the spinal cord is called peripheral neuropathy.
You must be familiar with narrowing of the arteries of the heart. The same process that causes narrowing and blockage of the arteries of the heart may involve the arteries of the pelvis or legs. This disorder is characterized by severe pain in the pelvis and legs when walking. This disorder is known as peripheral arterial disease or PAD.
We remind you that the most common radicular pain that the general public is familiar with is sciatica, but in fact it is the inflammation and damage to the sciatic nerve or spinal cord that forms the trunk of the sciatic nerve that leads to the following picture.
Low back pain spreading to the buttocks behind the thighs behind the knees, a feeling of tightness and heaviness in the muscles of the back of the legs, numbness and tingling of the skin of the feet and sometimes inability to bend the toes up, usually involves unilateral pain.
- Piriformis syndrome:
Piriformis is a pear-shaped muscle, that is located behind and deep in the pelvis. The trunk of the sciatic nerve passes right behind and sometimes through the middle of this muscle. When you move your thighs away from the pelvis, this muscle contracts. Spasm and cramping of this muscle is associated with inflammation and swelling of the muscle and eventually pressure on the sciatic nerve.
Sciatica Injury, inflammation of the nerve causes symptoms that are often confused with sciatic radiculopathy.
In Piriformis syndrome, there is pain in the buttocks and sometimes pain in the upper back.
Special rest and exercises are needed to improve this syndrome to relieve the discomfort.
What do doctors use to diagnose the cause of diffuse pain with tingling in the toes?
History, questions about medications and underlying diseases, alcohol and smoking, along with general examination are helpful.
Nerve conduction velocity or ncv tests are used to determine the damaged nerve or the root of the involved spinal nerve.
The condition of the muscles involved will be assessed with EMG.
Radiological studies are sometimes used to evaluate tumors, fractures, and spinal canal stenosis.
Simple radiological photo
Sometimes the evaluation of special laboratory tests is necessary in some cases.
Rest: 48 hours of rest is enough and doctors do not believe in more rest because inactivity will make the condition worse.
Cold compress on the painful muscles in the first two to three days of the acute phase.
Warm compress after the second day to accelerate recovery.
OTC drugs such as painkillers and anti-inflammatory drugs such as ibuprofen and naproxen.
Antispasmodics such as baclofen and methocarbamol (baclofen is extremely hypnotic. Avoid driving and other things that require alertness while taking this drug)
After the acute phase of pain subsides, stretching exercises should be started as long as it is tolerable.
If the pain persists, your doctor will prescribe more specific medications and stronger painkillers.
Nowadays, in cases resistant to past treatments, in addition to specific physiotherapy, steroid injections into the epidural space also receive acceptable results. This injection should be performed by a specialist and experienced physician.