Nerve Impingement (Pinched Nerve)
Understanding Nerve Irritation in the Spine
The term “nerve impingement” (often called a pinched nerve) describes a situation where a spinal nerve becomes irritated or compressed as it exits the spine.
​
This commonly occurs in the lower back and may cause symptoms travelling into the buttock or leg rather than pain only in the back.
​
The cause is usually not the nerve itself, but pressure from surrounding structures such as a disc bulge, herniation, or narrowing around the nerve opening.
Common Causes Of Nerve Impingement
Nerve impingement or a nerve irritation most often occurs due to:
​
-
reduced disc height
-
narrowing of the nerve exit opening (foraminal narrowing)
​​
​
In many cases the nerve is inflamed rather than severely compressed.
Typical Pinched Nerve Symptoms
Symptoms depend on which nerve is affected and may include:
​
• leg pain- sciatica (often worse than back pain)
• tingling
• burning sensation
• numbness
• altered sensation
• weakness in the leg or foot
​
Pain often increases with sitting and improves with gentle walking.
Why Back Pain and Leg Pain Behave Differently
Back pain usually comes from muscles or joints.
Nerve pain behaves differently and often:
​
• travels down the leg
• feels sharp, burning or electric
• worsens with sitting
• may cause numbness
​
This distinction helps guide management.
Pinched Nerve Assessment
Assessment aims to determine:
​
• whether symptoms are nerve-related
• which nerve may be involved
• whether neurological function is stable
• whether conservative care is appropriate
​
Neurological screening is important to ensure serious compression is not present.
​
Patients should always have had a CT or MRI of the area they want treated before booking an appointment.
Conservative Management
​
Where appropriate, conservative care may be considered.
​
In selected cases, structured spinal decompression therapy may be used to reduce mechanical stress on sensitised discs and improve tolerance to activity.
​
Suitability depends on the clinical presentation rather than imaging wording alone.
​
→ Spinal Decompression Therapy
→ Am I a Candidate for Spinal Decompression
Non Surgical Treatment Options for Nerve Impingement
Management depends on the cause, severity, and duration of symptoms.
​
Where clinically appropriate, care may include:
​
• Structured spinal decompression therapy
• Guidance on movement and activity modification
• Strategies to reduce nerve irritation
• Progressive rehabilitation planning
• Ongoing monitoring of neurological symptoms
Spinal decompression therapy aims to reduce pressure within affected spinal segments and may assist in reducing mechanical irritation of nerve structures in suitable patients.​
​
The aim of care is to improve comfort, tolerance to activity and quality of life.
​
Treatment plans are tailored and adjusted based on clinical response.
Who May Not Be Suitable for Spinal Decompression
Spinal decompression is not appropriate for every presentation of degenerative disc disease.
​
Alternative pathways may be recommended in cases involving:
-
Significant neurological deficit
-
Osteoporotic patients
-
Patients with advanced degenerative instabilities
-
Certain advanced spinal conditions
-
Some post surgical cases- If surgery has any hardware such as a fusion surgery spinal decompression therapy is not appropriate
-
Abdominal aortic calcifications or aneurysms
-
Conditions requiring medical or surgical management
-
Pars defects with a Grade 3 or 4 Spondylolisthesis
​​
Where this is identified, referral to the appropriate provider is discussed.
When Urgent Medical Review Is Needed
Immediate medical assessment is recommended if there is:
​
• progressive weakness
• foot drop
• loss of sensation in the groin region
• bowel or bladder changes
​
These findings are uncommon but require prompt medical care.
​​
Frequently Asked Questions About Pinched Nerve
What is a pinched nerve?
​
A pinched nerve (nerve impingement) occurs when a spinal nerve becomes irritated as it exits the spine. The nerve itself is not usually damaged — it is reacting to reduced space or inflammation around it, most commonly from a disc bulge or herniation.
​
What does a pinched nerve feel like?
​
Symptoms often travel away from the back and into the buttock or leg. People commonly describe:
• sharp or shooting pain
• burning sensation
• tingling or pins and needles
• numbness
• sensitivity to sitting
This pattern is often referred to as sciatica.
​
Is a pinched nerve serious?
​
Most cases are not dangerous, but certain symptoms require urgent medical assessment, including:
• progressive weakness
• foot drop
• loss of bowel or bladder control
• numbness in the groin area
These findings are uncommon but important to recognise.
​Why is the pain worse when I sit?
​
Sitting increases pressure inside the lumbar discs. If a disc is irritating a nerve, this added pressure can aggravate leg symptoms more than standing or walking.
​
How long does a pinched nerve take to recover?
​
Recovery varies between individuals. Many patients notice improvement over several weeks to a few months. Fluctuations are common and do not necessarily mean worsening.
The nerve often settles before the imaging appearance changes.
​
Should I rest or stay active?
​
In most cases, gentle and progressive movement is encouraged. Long periods of inactivity can actually increase stiffness and sensitivity. Activity should be guided by symptom response and professional advice.
Avoid movements that significantly increase leg pain or neurological symptoms
​
Can spinal decompression help a pinched nerve?
​
In selected patients, structured spinal decompression therapy may be considered to reduce pressure on the irritated nerve and improve tolerance to activity. Suitability depends on the clinical presentation.
​