Lower Back Pain and Leg Numbness: Causes and Solutions

Lower back pain with leg numbness?

Hello, doctor.
I originally had pain on the left side of my lower back near the iliac bone, but it was only occasional.
Today, when my back hurt, I experienced numbness above my left knee and in my thigh.
Although the numbness in my thigh has become less pronounced, my entire leg still feels slightly numb.
I would like to know why this is happening.

Niming, 10~19 year old female. Ask Date: 2023/07/14

Dr. Jiang Junyi reply Neurology

Hello,
You mentioned that "when experiencing lower back pain, there is numbness in the upper side of the left knee and thigh." Your symptoms may suggest compression of the lumbar nerve roots.
Typical discomfort associated with lumbar nerve root pathology includes pain radiating from the buttocks down the leg, as well as numbness, tingling, and weakness in the toes.
However, if the numbness is rapidly extending upwards, it may indicate acute demyelinating polyneuropathy, which is considered a neurological emergency.
You should seek immediate medical attention.
Diagnosis of lumbar nerve injury requires laboratory assistance to determine the location and severity of the nerve damage, which will help in assessing prognosis and deciding on treatment principles.
The tools that can confirm a diagnosis of sacral nerve injury include nerve conduction studies and electromyography.
I recommend consulting with a neurologist or a rehabilitation physician to discuss further evaluation and treatment options.
Thank you for your inquiry.
If you have any related questions, feel free to discuss them.
Wishing you good health and peace.
Dr.
Jiang Junyi, Neurology Department, Taoyuan Hospital

Reply Date: 2023/07/14

More Info

Lower back pain accompanied by leg numbness can be a concerning symptom, and understanding its potential causes is crucial for effective management. The symptoms you describe—pain in the lower back near the iliac crest and numbness or tingling in the thigh and leg—may suggest a few underlying issues that are worth exploring.

Potential Causes
1. Nerve Compression: One of the most common causes of lower back pain that radiates into the leg is nerve compression, often due to a herniated disc or spinal stenosis. When a disc in the lumbar spine bulges or herniates, it can press on nearby nerves, leading to pain, numbness, or tingling sensations in the legs. This is particularly true if the pain is localized to one side, as you described.

2. Sciatica: This term refers to pain that radiates along the path of the sciatic nerve, which runs from the lower back through the hips and buttocks and down each leg. Sciatica can occur when the sciatic nerve is compressed, often due to a herniated disc or bone spur. Symptoms may include lower back pain, as well as numbness, tingling, or weakness in the leg.

3. Muscle Strain: Sometimes, lower back pain can be attributed to muscle strain or ligament sprain, especially if there has been recent physical activity or heavy lifting. While muscle strain typically does not cause numbness, it can lead to discomfort that may be perceived as pain radiating into the leg.

4. Sacroiliac Joint Dysfunction: The sacroiliac joint connects the lower spine to the pelvis. Dysfunction in this joint can lead to pain in the lower back and may also cause referred pain or numbness in the legs.

5. Other Conditions: Conditions such as arthritis, fibromyalgia, or even infections can lead to lower back pain and associated leg symptoms. It’s essential to consider these possibilities, especially if the symptoms persist or worsen.

Recommended Actions
1. Medical Evaluation: Given the symptoms you are experiencing, it is advisable to consult a healthcare professional, such as a primary care physician or a specialist in orthopedics or neurology. They may recommend imaging studies, such as an MRI or CT scan, to assess the condition of your spine and identify any potential nerve compression or structural issues.

2. Physical Therapy: If a diagnosis such as a herniated disc or sciatica is confirmed, physical therapy can be beneficial. A physical therapist can design a program that includes exercises to strengthen the core and back muscles, improve flexibility, and alleviate pressure on the nerves.

3. Pain Management: Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen or naproxen), can help manage pain and inflammation. In some cases, a physician may prescribe stronger medications or recommend corticosteroid injections to reduce inflammation around the affected nerves.

4. Lifestyle Modifications: Maintaining a healthy weight, practicing good posture, and avoiding prolonged sitting or standing can help reduce strain on the lower back. Incorporating regular low-impact exercises, such as walking or swimming, can also promote spinal health.

5. Alternative Therapies: Some individuals find relief through alternative therapies such as chiropractic care, acupuncture, or massage therapy. While these treatments may not address the underlying cause, they can provide symptomatic relief.

Conclusion
In summary, your symptoms of lower back pain and leg numbness warrant a thorough evaluation to determine the underlying cause. Early diagnosis and intervention can significantly improve outcomes and prevent further complications. It’s essential to listen to your body and seek professional guidance to address these symptoms effectively.

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