Understanding Your Lower‑Back “Pinched Nerve” – What Is Lumbar Radicular Pain?
- Jessica Rioufrays Osteopath Hamilton Nz
- 12 minutes ago
- 4 min read
If you've ever had a sharp pain shoot down your leg from your lower back, you may have heard terms like sciatica or nerve root compression. What you’re likely experiencing is lumbar radicular pain — a common and treatable condition that can feel scary but often improves with the right approach.
This article breaks it down simply and gives you evidence-based treatment options.
🧠 What Is Lumbar Radicular Pain?
Your spine is made up of vertebrae (bones), discs (shock absorbers), and nerve roots that exit the spine and run down into your legs. If one of those nerves gets compressed or irritated — often by a disc bulge or inflammation — it can cause:
Pain that shoots down the leg
Numbness or tingling
Weakness in muscles like your calf or foot
Difficulty walking, climbing stairs, or pushing off the toes
This is different from a simple back strain. It means a nerve is involved — not just the muscles or joints.
What We Test Clinically — and Why It Matters
As osteopaths and clinicians, we use several tests to check your nerve health:
Light touch: Can you feel soft brushing on your skin?
Sharp-dull: Can you tell the difference between a pin and a blunt object?
Motor strength: Can you raise your heel (calf strength), push your foot down, or lift your toes?
If you lose strength or sensation, or can't tell sharp from dull, it may mean the nerve root is under significant pressure.
💡 But here’s the nuance:These tests don’t tell us exactly how big the disc bulge is, or whether surgery is needed — but they help guide the plan and track your recovery.
🔍 One 2016 review found that no single nerve test is perfect on its own, but when combined, they help paint a more reliable picture of radiculopathy.BMC Musculoskeletal Disorders, 2016
What Causes It?
Disc herniation (“slipped disc”)
Degenerative changes in the spine
Spinal stenosis (narrowing around the nerve)
Inflammation or trauma
Most cases get better with time and the right support — but there are red flags to watch for (more on that below).
How Is It Treated?
Here’s where evidence and clinical experience meet.
✅ First-line treatments (Conservative Care)
Most people do not need surgery. Instead, a personalised approach with:
Education: Knowing what’s going on helps reduce fear and improve movement.
Movement: Staying active (walking, gentle stretching) is often better than bed rest.
Exercise therapy:
Core stabilisation and lumbar extension-based exercises show good results.
One RCT found better outcomes from stabilisation plus thoracic mobilisation.
Manipulation or mobilisation can help, especially when paired with exercise.
Manual therapy: Hands-on work like traction, massage, or joint mobilisation can ease symptoms.
Traction therapy: Supine mechanical traction may reduce pain and disability short-term — but it’s more effective when added to other treatments.
🪡 What About Needling?
Many people ask about acupuncture or dry needling — and for good reason.
🔹 Acupuncture
Acupuncture has shown superior pain relief compared to standard care in many studies.
A 2022 meta-analysis found acupuncture improved pain and mobility in lumbar disc herniation with radicular pain.
📚 Wang et al., 2022 – Systematic Review & Meta-analysis
🔹 Electroacupuncture
A mild current is added to acupuncture needles. It may help reduce nerve pain and improve outcomes when combined with exercise.
🔹 Dry Needling
Targets tight or irritated deep tissues, often used by osteopaths and physios.
A 2022 RCT found that adding dry needling to exercise improved outcomes in patients with disc-related pain.
💬 Needling isn’t magic — but when used properly alongside movement-based care, it can accelerate pain relief and help you engage more in rehab.
💊 Supplements for Nerve Pain — PEA
A promising supplement for nerve pain is Palmitoylethanolamide (PEA) — a naturally occurring fatty acid that supports the body’s inflammation response.
Studies show it may reduce sciatic-type pain, improve function, and be well tolerated.
It’s often combined with Alpha-Lipoic Acid (ALA) for stronger effects.
📚 PubMed – PEA in chronic pain management📚 Systematic review – PEA and sciatica
While not a cure, it can be a helpful tool in chronic nerve pain, especially when other meds aren't well tolerated.
🚨 When to Refer or Escalate Care
Sometimes, conservative care is not enough, and further investigation is needed.
Referral is recommended when:
Progressive symptoms — worsening pain, numbness, or weakness over time
Significant motor loss — e.g., foot drop or severe calf weakness
Multiple nerve roots involved (e.g., symptoms affecting both S1 and L5)
Failure to improve after 6–8 weeks of good conservative care
Bladder, bowel, or saddle numbness symptoms (these require urgent referral)
Monitoring Your Progress — Why Follow-Up Matters
Your first assessment gives a baseline. But what happens over time tells the real story.
Improving = stay the course
Plateau = adjust the approach
Worsening = escalate or refer
👉 That's why we often re-check things like calf strength, light touch, or sharp-dull testing at your follow-up visits. It’s how we know if the nerve is healing — or needs more help.
Takeaways
Lumbar radicular pain (aka "sciatica") is common and treatable.
It's a nerve root problem — not just muscle strain.
Most cases improve with good conservative care: education, exercise, and time.
Techniques like needling, PEA, and hands-on treatment can help — but work best as part of a bigger plan.
If you notice worsening or serious symptoms, further tests or referral may be needed.
Need Support?
If you're dealing with leg pain, weakness, or numbness, reach out. At TLC Osteopaths, we are osteopaths in Hamilton and can assess the root cause and guide you through evidence-informed care to get you back on your feet — literally.
Darryl Jenkins TLC osteopaths
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