Nerve Root Impingement

Nerve root impingement is one of the most common causes of referred pain, which is a condition where pain in one area of the body is caused by an injury in another area. With back conditions, patients may feel referred pain in their head, neck, shoulders and arms because of nerve root impingement in their cervical spine. Patients may experience pain, discomfort, and weakness in their hips, buttocks, and legs because of nerve root impingement in their lumbar spine (lower back). Nerve root impingement, or nerve root compression, occurs when the nerve roots that exit the spine through the intervertebral foramina are squeezed or constructed. Typically, the nerve roots become constricted when the intervertebral discs between the vertebral bones either deflate due to a loss of material in it's center, or leak their inner materials our of the disc, as a result of a herniated disc. This material projects out of the herniated disc because of cracks or holes that develop in its outer wall as a result of wear and tear (the aging process). Often people with herniated discs may continue to go on with their lives as if nothing ever happened to them. In other cases, the herniated disc material projects out of the back of the disc and presses into the nerve roots. When this occurs, the person is more likely to have back pain at that level of the spine, and to suffer from radiculopathy. Radiculopathy is a condition when a person's referred pain is cause by a compression of one or more of the nerve roots of the spine.



Symptoms of nerve root impingement are pain at that level of the spine, as well as pain in the extremities (arms and legs). Patients with referred pain, associated with nerve root impingement, experience pain in their upper or lower limbs, and around the attachments to the trunk, such as the shoulders, hips, and buttocks. Along with the pain that occurs in their arms or legs, people may also experience associated neurologic symptoms, such as numbness, burning, tingling, or even the loss of motor control.

Pain that is associated with nerve root impingement may have similar symptoms to neuropathy, but the cause of the symptoms are much different. Neuropathy is nerve pain that is caused by destruction of the nerves due to a metabolic disease (e.g. diabetes) or other disease. Electromyography (EMG) tests may help doctors diagnose one of the two conditions from the other when the cause of the nerve pain has not yet been determined.

Why would the compression of the nerve near the spinal cord affect the nerve endings in the arms, legs, hands and feet? For us to be able to feel, sense, tough, and move, the electrical signals in our nerves must be able to travel throughout the entire circuit. If the nerve is constructed at any point along the path of the nerve, any structures distal (further away) from that point of impingement may be affected. An impingement of one of the nerves in the lower back or lumbar-sacral spine may result of the loss of sensation, or difficulty using the foot. A nerve impingement in the neck may cause headaches, jaw pain, or neck pain.