Nerve Root Compression

Nerve root compression is the condition where one of the nerve roots exiting the spine becomes constricted, or pinched, causing back pain at that level of the spine as well as referred pain.

There are several medical terms to describe the condition where the nerve roots of the spine, or the branches off of them, become constricted because of disease, injury, or degenerative changes to the soft tissues around them. The terms used to describe the squeezing of the nerves, and the pain and associated symptoms related to this condition, include pinched nerves, nerve root compression, and nerve root impingement. There are 31 pairs of nerve roots that emanate from each level of the spine, through the intervertebral foramina of the spine. The nerves of the spinal cord are part of the central nervous system, and when they exit the spine, they become part of the peripheral nervous system. Shortly after exiting the spine, these nerve roots branch again, and continue to branch until near every cell in our body is close to a nerve fiber. These nerves are the most vulnerable to being squeezed or constricted at an near the spine, where the soft tissues such as the facet joints, intervertebral discs, and spinal ligaments are. These nerve roots are also the most vulnerable to being compressed in the cervical vertebra in the neck, and the lumbar vertebra in the lower back, due to our unique posture and anatomy.



When these nerve roots do become constricted, we may experience pain at that level of the spine, as well as some difficulty with movement or motor control in the structures supplied by that nerve. When the results of the nerve root compression cause pain and related symptoms in the arms or legs, the condition may be described as referred pain, or radiculopathy. Radiculopathy is a much different condition than neuropathy, which involves the destruction of nerves and nerve tissue to disease.

Sciatica is a term used to describe a form of radiculopathy caused by compression of one of the two sciatic nerves, which travel down each leg. The lumbar nerve roots, as well as nerve branches from the sacrum and coccyx (tail bone) combine to form the sciatic nerve, which is one of the largest nerves in our body, and travels the length of our leg. If any of these nerve roots or branches that feed into the larger sciatic nerve become compressed, we may pay experience symptoms of sciatica. Symptoms associated with sciatic include radiculopathy in the hip, buttocks, thigh, and lower leg. Sciatic may also involve changes in sensation or motor control, with weakness, numbness, or burning pain in the legs, feet, and toes. Sciatica is caused by either constriction or inflammation of the main sciatic nerve, or one of the spinal nerves that give rise to this main nerve. Degenerative spine condition such as bulging discs or herniated discs are usually the cause of sciatic pain, though other musculoskeletal or inflammatory conditions may be involved. Other possible cause sciatica include piriformis syndrome, lumbar spinal stenosis, and spondylolisthesis.

Degenerative disc disease, which often results in disc bulges and disc herniations, are the two most common causes of nerve root compression. The walls of the disc often become thin or cracked as we get older. When these walls become thin enough, they may bulge outwards. When the walls become completely torn, the material in the disc's nucleus oozes out through this wall. When the bulging wall or expelled nucleus, press into one of the nerve roots, the result is nerve root compression. Nerve root compression to one of the lumbar nerve roots may cause lower back pain as well as radiculopathy in the leg or foot.