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Damage or interference with the conduction (transfer of information) of these nerves can cause neurological problems such as pain, weakness, abnormal sensations, numbness and changes in spinal reflexes. Early treatment is important to the prognosis of lumbar spinal cord damage. Perform co-contraction of the two muscles while sitting on a balance board. Although improvements are possible, embracing your current abilities and engaging in activities you value is important at all stages of recovery. Clinical Examination Videos. The horsetail shaped area, which extends past the conus medullaris, is called the cauda equina. This content does not have an Arabic version. http://orthoinfo.aaos.org/topic.cfm?topic=a00332. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). https://www.physio-pedia.com/index.php?title=Lumbar_Radiculopathy&oldid=314485, Hallux extension and ankle plantar flexors. Pain radiating into one or both thighs and legs, similar to the lay term "sciatica". Youll also receive our popular recovery emails with SCI survivor stories and other useful tips you can opt out anytime. Numbness and Tingling As such, all fractures should be handled with extreme caution to prevent worsening a lumbar SCI. Iliac crest and groin. Medical professionals often use theInternational Standards for Neurological Classificationto determine thelevel of spinal cord injury. If the annular fissure or annular tear is significant enough, disc material can herniate to irritate or compress traversing nerves or spinal cord. Injury to the L5 spinal nerve bundle can cause numbness and weakness in the legs, but the extent of these symptoms can vary from case to case. As you get older, the bones and tissues that make up the spine can become worn down, which can lead to a narrowing of the spinal column. 3. If you have carpal tunnel syndrome, your doctor may . Overview and evaluation of hand disorders. This is called lumbarization. causing nerve root impingement, this maneuver may elicit a positive response. This pressure can cause pain, tingling, numbness or weakness. Pinched nerve information page. 1. Surgical treatments include removing bone spurs and widening the space between vertebrae. Injuries below this level (at the L3, L4, and L5 vertebrae) affect the hips and legs and may cause numbness extending to the feet (sciatica). Reported prevalence is 83 people per 100,000 people [8]. These sections are labelled as the L1-L5 vertebrae. Thickening (ossification) of the spinal ligaments may also lead to narrowing of the space around the nerve roots and subsequent nerve compression. Some other treatments that may be helpful for some people include acupuncture and chiropractic care. Other causes of nerve root impingement often present with a unique constellation of symptoms ( Table 3). Early treatment is important to the prognosis. Severe foraminal narrowing typically develops gradually but can be worsened by injury or lifestyle factors. The ability to lift the foot upwards (ankle dorsiflexion) is primarily tested to determine whether this level of the spinal cord has been injured. If nerve root compression is present, this test causes severe pain in the back of the affected leg and can reveal a disorder of the L5 or S1 nerve root. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Other studies. L1. Weakness is the main issue with patients who experience lumbar nerve injuries, so physical therapy is a must in the recovery phase. We are vaccinating all eligible patients. Lumbosacral radiculopathy. 2. mild disc bulging at L4-5 3. Tests that help with your diagnosis may include: X-rays of your spine. Pain is usually just on one leg. Babinski's test. Radiculopathy symptoms can often be managed with nonsurgical treatments, but minimally invasive surgery can also help some patients. other information we have about you. When the L3 spinal nerve is involved, the following symptoms may occur: A lumbar spinal cord injury can cause varying degrees of paralysis in the lower body, also known asparaplegia. Our experts have collected everything in one place to help you learn more about your injury, locate doctors and treatment centers, find financial support, and get assistance navigating your next move. Find more COVID-19 testing locations on Maryland.gov. Sometimes the MPPT is positive at the popliteal fossa, other times only at . Disease onset is usually insidious; early symptoms may. TStraight leg raise test - Lasegues sign. This section of the spine contains a portion of the spinal cord. All six patients with L1-L2 disc herniation showed severe thigh pain and sensory disturbance at the anterior aspect or lateral aspect of the thigh. Vertebrae are bones in your spine that are stacked one upon the other. Thanks to the Americans with Disabilities Act, most restaurants, stores, and other public places are wheelchair accessible. Click here to get instant access. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Top Contributors - Admin, Liena Lamonte, Clay McCollum, Bo Hellinckx, Kim Jackson, Lucinda hampton, David De Meyer, Eric Robertson, Liesbeth De Feyter, Khloud Shreif, Rachael Lowe, Bram Van Laer, Lynse Brichau, Simisola Ajeyalemi, WikiSysop, Adam James, Rewan Elsayed Elkanafany, Kai A. Sigel, Candace Goh, Mariam Hashem, Barb Clemes and Vidya Acharya, Lumbosacral radiculopathy is a disorder that causes pain in the lower back and hip which radiates down the back of the thigh into the leg. L5 Nerve Root - Everything You Need To Know - Dr. Nabil Ebraheim nabil ebraheim 1.08M subscribers Subscribe 2.8K 198K views 3 years ago Dr. Ebraheim's educational animated video describes the. Your doctor may take several steps to diagnose radiculopathy: A physical exam and physical tests may be used to check your muscle strength and reflexes. [6] Spinal fusion is another option. Pinched nerves in your neck can cause a sharp or burning pain that starts in the neck and travels down your shoulder and arm. When the vertebrae protecting the spinal cord and spinal nerves are fractured or dislocated, bone shards can damage or pinch the spinal nerves/cord. You may opt-out of email communications at any time by clicking on The level of spinal cord injury refers to the lowest level of the spinal cord in which sensory and motor functions remain intact. Physical therapy may include exercises to strengthen your back, abdominal, and leg muscles. Pain. In a complete spinal cord injury, the spinal cord is completely severed, leaving no spared neural pathways. Sustain this pose for 10 seconds and then return to the starting position with ten repetitions.Train the muscle co-contraction in a standing position with ankle movement. To help you understand what to expect after a lumbar spinal cord injury, this article will discuss: The lumbar region of the spinal cord consists of 5 segments, based on the five lumbar vertebrae. The pinched nerve can occur at different areas along the thoracic spine Symptoms of radiculopathy vary by location but frequently include pain, weakness, numbness and tingling. A frequently overlooked cause of testicular and buttock pain is irritation of the T10-L1 sensory nerve roots, the genitofemoral nerve, and the ilioinguinal nerve. In refractory cases, surgical decompression and spinal fusion can be performed. L5spinal nerves affect sensation at the outer areas of the lower legs down to the big, second, and middle toes. One common cause of foraminal stenosis and radiculopathy is a bulging or herniated disc. 1994 Jun 1;41(6):480-5. Depending on the cause of the compression, symptoms may develop suddenly or gradually, and they may require anything from supportive care to emergency surgery. The second exercise this week required 10-second holds with ten repetitions. In most cases, the symptoms ease off gradually over several weeks. You can help prevent symptoms of spinal cord compression caused by gradual wear and tear by keeping your back as strong and healthy as possible. As is the case with other spinal cord injuries, the completeness of the spinal cord damage will determine how severe the injury and symptoms will be for the patient. As highlighted above, the neck and lower back are the two regions with the highest likelihood of developing nerve root impingement. Sneezing, coughing or laughing may also increase your pain. Symptoms may also include neurogenic claudication, a nerve-related pain that increases with walking and improves with rest. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Spinal discs act as cushions between your vertebrae. Ilioinguinal neuralgia is a frequent cause of pain in the lower abdomen and the upper thigh. Clinical presentation depends on the cause of the radiculopathy and which nerve roots are being affected. Rutkove SB. [10]. All of this comes together for a motivating home therapy program. Physical therapy can include mild stretching and pain relief modalities, conditioning exercise, and ergonomic program. However, if the pressure continues, chronic pain and permanent nerve damage can occur. To diagnose L5 radiculopathy, the clinician focused on the straight leg raise test, sensory loss in the L5 dermatome, and the muscle power for the hip abduction, ankle dorsiflexion, ankle eversion, and the big toe extension. Injuries only sometimes occur in isolation, so trauma to the surrounding lumbar and sacral spinal nerves may accompany an injury to the L4 nerves. These fluid-filled sacs can put pressure on spinal nervescausing pain, loss of sensation, or loss of function at the injury site. Using best practices for good posture while sitting, playing sports, exercising or lifting heavy objects is also important for preventing injuries. Lesions of the intervertebral discs and degenerative disease of the spine, most common causes of lumbosacral radiculopathy. Pain is a common symptom associated with L5-S1 pinched nerves 3. Make a donation. The emotional effects of a lumbar spinal cord injury can be as challenging as the physical effects. Common types of medical equipment for lumbar spinal cord injury include: Talk with your doctor or therapist about what equipment may be beneficial for you. Perform co-contraction of the two muscles in a standing position while a mini ball is behind your upper back and against the wall. As a result, the compression in this nerve can cause numbness in these muscles and hinder movement. The disc often presses on a nerve root which can cause pain and other symptoms in a leg. Your doctor will ask you to stop any activities that cause or aggravate the compression. Call your healthcare provider or go to the emergency room if you have: Severe or increasing numbness between your legs, inner thighs, or back of your legs. Tumors or infections may cause symptoms that develop over days or weeks. Cauda Equina Syndrome (CES), which is often difficult to distinguish from the similarly-located conus medullaris syndrome, affects the lumbar spine and is considered a medical emergency. Overview of upper extremity peripheral nerve syndromes. If you have a follow-up appointment, write down the date, time, and purpose for that visit. Incorporate strength and flexibility exercises into your regular exercise program. Such symptoms may include: Pain, weakness or numbness in the legs, calves or buttocks. Next to simple discectomy and spinal fusion, there are 3 other surgical treatments which can be applied in patients with disc herniation: 1) chemonucleolysis 2) percutaneous discectomy 3) microdiscectomy. The types of spinal cord injury corresponding to these regions of the spine . The lumbar nerve roots and spinal cord. Nerve root pain symptoms may include: Tingling or numbness Weakness of muscles Increased sensitivity Pain in the back, neck, and limbs Causes of Nerve Root Pain Nerve root pain is often caused by other underlying conditions that have caused compression or damage to the nerve root. Typically, a dull ache or sharp pain may be felt in the lower back. The pinched nerve in the L5: the nerve located in the L5 supplies impulses to the muscles responsible for lifting the foot and the big toe. Integrated transversus abdominis and lumbar multifidus training light activities2. How many vertebrae are in the spine? It is important to understand that the spinal cord does not extend beyond the lumbar spine. ; Clinically oriented anatomy seventh edition; Wolters Kluwer; p 556-632; 2014, Valentyn Serdyuk; Scoliosis and spinal pain sydrome: new understanding of their origin and ways of successful treatment;Byword books; p47; 2014. 1173185. Radicular pain and nerve root pain can be defined as a single symptom (pain) that can arise from one or more spinal nerve roots. Spinal nerve impingement can cause great discomfort, causing weakness in muscles innervated by the impacted spinal nerve as well as pain and numbness in the associated dermatome. Peripheral neuropathy is the damage of the peripheral nervous system, such as carpal tunnel syndrome that involves trapped nerves in the wrist. Foraminal stenosis occurs when the openings between the spinal vertebrae begin to compress and narrow. A comprehensive rehabilitation program includes postural training, muscle reactivation, correction of flexibility and strength deficits, and subsequent progression to functional exercises. 91 (95% CI 0.82-0.94), a pooled specificity 0.26 (95% CI 0.16-0.38)[7]. For the cross straight leg raising test a pooled sensitivity was 0.29 (95% CI 0.24-0.34), pooled specificity was 0.88 (95% CI 0.86-0.90)[7](LOE 1A). information and will only use or disclose that information as set forth in our notice of 2009 Dec 1;147(1):17-9. Occupational therapists may encourage using adaptive techniques as necessary. The second to last section of the lumbar spinal column. However, because lumbar SCIs do not affect upper body functions, individuals generally learn to adapt and live independent, fulfilling lives. Asymmetric right sided facet degeneration is seen at this level. [4]5-10% of patients with low back pain have sciatica. 2007 May 1;25(2):387-405. Numbness, cramping, or weakness in the arms, hands, or legs Loss of sensation in the feet Trouble with hand coordination "Foot drop," weakness in a foot that causes a limp Loss of sexual ability Pressure on nerves in the lumbar region (lower back) can also cause more serious symptoms known as cauda equina syndrome. Then you abduct one leg to 45 degrees of hip abduction and hold it for 10 seconds.Train co-contraction of these muscles in a crooked lying position with both hips at 45 degrees and both knees at 90 degrees. Depending on the nerve root(s) affected, patients can present with these symptoms in predictable patternsaffecting the corresponding dermatome or myotome[2]. https://www.uptodate.com/contents/search. Entrapment refers to the compression or irritation of the nerve, in this case at the nerve root. Get regular exercise. Patients with lumbar spinal cord injuries may experience: The most common causes spinal cord injuries at the lumbar level are: There are several types of spinal cord injury that can affect the lumbar spine: Where lumbarization is the presence of an extra bone in the lumbar spinal column due to the failure of the first and second sacral spine to fuse, sacralization is the fusing of the L5 vertebra with the sacral spine. Perform co-contraction of transversus abdominis and lumbar multifidus muscles while sitting on a chair. In patients under 50 years, a herniated disc is the most frequent cause. Symptoms include numbness, pain, and weakness. Common symptoms of an L3 lumbar spinal injury include weakness, numbness, and loss of flexibility in the legs, hips, and/or groin. Radiculopathy can be defined as the whole complex of symptoms that can arise from nerve root pathology, including anesthesia, paresthesia, hypoesthesia, motor loss and pain. Pain, which can start in the lower neck and travel to the posterior shoulder, back and chest. In most cases Physiopedia articles are a secondary source and so should not be used as references. Herniated disc with nerve root compression causes 90% of radiculopathy, underlying diseases like infections such as, Strenuous physical activity (frequent lifting), Unilateral leg pain greater than low back pain, leg pain follows a dermatomal pattern, Pain traveling below the knee to foot or toes, Numbness and paraesthesia in the same area, Straight leg raise positive, induces more pain, X-rays: to identify the presence of trauma or, EMG: useful in detecting radiculopathies but they have limited utility in the diagnosis. In addition, choose two aggravating activities or tasks that you anticipate would cause pain or instability and perform muscle co-contraction while doing these activities or tasks without having pain. Other good body mechanics include sleeping on a firm mattress and sitting in a chair that supports the natural curves of your back. This pain can range from mild to severe and may be constant or intermittent. Sign up to receive a free PDF ebook with recovery exercises for stroke, traumatic brain injury, or spinal cord injury below: Government Contract Vehicles | Terms of Service | Return Policy | Privacy Policy | My Account, Copyright 2023 All rights Reserved. Numbness and tingling in the extremities. Joining a SCI support groupcan help you connect with others who understand what youre going through. Initially I wasnt sure if it would work because of the various treatments I tried and also many physiotherapists who tried their level best, but didnt achieve any positive results. While individuals withcomplete spinal cord injurieslose all motor control and feeling below their level of injury, those withincomplete spinal cord injurieswill retain partial motor control and/or sensation below the level of injury. Since mostdisc herniationsoccur posterolaterally, the root that gets compressed is actually the root that exits the foramenbelowtheherniated disc. Vanti C, Turone L, Panizzolo A, Guccione AA, Bertozzi L, Pillastrini P. Kennedy DJ et al. Potential right L5 nerve root impingement within the neural foramen secondary to facet degeneration and foraminal bulging disc. Maintain good posture and learn how to safely lift heavy objects. Excess weight puts more stress on your back and can contribute to developing symptoms of spinal compression. It is suggested that impingement of the higher lumbar spinal nerve roots (L1-L3) can cause pain in the dermatomal distribution surrounding the hip. Know what to expect if you do not take the medicine or have the test or procedure. When a patient complains about instability, core stability is really important. It can also help to look for SCI support groups. Medicationsmay be prescribed to help manage secondary complications such as pain, constipation, and spasticity. They also hold your body upright. After that point, nerve roots exit each of the remaining lumbar levels beyond the spinal cord. The lumbar vertebrae function to contain and protect the end of the spinal cord, as well as support the weight of the torso. Some people may need more advanced treatments, such as surgery. One to two times per month, Virtual Advisors receive a link to short, interactive surveys. 30 c. 33 d. 35, What is the space where the spinal nerve roots exit the vertebral column called? When a nerve root in the neck is irriated or compressed, a patient will show certain signs and symptoms. Besides relieving the pain the patient also needs muscle training, more specific stabilisation. Keith L. Moore et al. All responses are confidential. L3/4 central disc herniation with impingement on the bilateral descending nerve roots. Pain and stiffness in the neck, back, or lower back, Burning pain that spreads to the arms, buttocks, or down into the legs (sciatica), Numbness, cramping, or weakness in the arms, hands, or legs, "Foot drop," weakness in a foot that causes a limp. With an L5-S1 degenerative disc, these sensations are generally felt on the outside of the ankle, heel or foot. Pressure on nerve roots may produce numbness, tingling or pins and needles sensations in the areas supplied by the nerve. Radiculopathy is typically caused by changes in the tissues surrounding the nerve roots. https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/hand-disorders/overview-and-evaluation-of-hand-disorders?qt=&sc=&alt. A common cause of radiculopathy is narrowing of the space where nerve roots exit the spine, which can be a result of stenosis, bone spurs, disc herniation or other conditions. Patients symptoms may come on slowly, but once it is diagnosed, it requires immediate surgery. L2, L3, and L4 spinal nerves provide sensation to the front part of the thigh and inner side of the lower leg. These cysts are most often caused by repetitive motion stress injuries (i.e. A CT or MRI scan will give a more detailed look at the spinal cord and the structures surrounding it. The locations of C6 and C7 vertebrae are both in the lowest levels of the cervical spine, near the base of the neck. Systemic steroids are often prescribed for acute low back pain, although there is limited evidence to support its use. Thus, individuals with an L2 spinal cord injury will be able to feel their upper thighs and move their hips, but may be unable to move or feel their lower legs. Consult a spine specialist for an accurate diagnosis. Hip functions affected by the L4 spinal nerves include the ability to bring the leg back (hip extension), pull the leg outward (hip abduction), and rotate the hip inward (internal rotation). Click here to download our free SCI Rehab Exercise ebook now (link opens a pop up for uninterrupted reading). Keep respiration normal. A pinched nerve in S1: nerve S1 innervates for ankle pull in the Achilles tendon and foot. In other cases, muscle or tendons may cause the condition. Tarulli AW, Raynor EM. These nerves also control movements of the hip and knee muscles. [6], Lumbar radiculopathy is a disorder that commonly arises with significant socio-economical consequences. The L5 vertebra is the final section of the lumbar spine (at least, it is for most people). The pinched nerve can occur at different areas along the spine (cervical, thoracic or lumbar). Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. The lower back is the area most frequently affected by radiculopathy. Review/update the Oswestry Low Back Pain Disability Questionnaire - considered as the golden standard to measure the permanent functional disability of the lower back. In the case of carpal tunnel syndrome, a variety of tissues may be responsible for compression of the carpal tunnel's median nerve, including swollen tendon sheaths within the tunnel, enlarged bone that narrows the tunnel, or a thickened and degenerated ligament. 3% (188/5895) 3. Numbness or decreased sensation in the area supplied by the nerve, Sharp, aching or burning pain, which may radiate outward, Tingling, pins and needles sensations (paresthesia), Frequent feeling that a foot or hand has "fallen asleep". With Piriformis Syndrome, there is pain and paresthesia in the posterior thigh, (sometimes calf, foot). What is the L4 Vertebra? Also important is the nature (sharp, dull, piercing, throbbing, stabbing, shooting, burning) and localisation of the pain[10]. Once the pressure is relieved, nerve function returns to normal. Neuroplasticity allows spared neural pathways in the spinal cord to compensate for the pathways that were damaged. These vertebrae are located near the base of the spine and naturally form a slight outward curve in the back, just below the inward curve of the thoracic spine. Nerve root impingement is a diagnostic conclusion often found on the MRI reports of back, neck and sciatica pain sufferers. Nerve compression syndrome . Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. This is the American ICD-10-CM version of G54.4 - other international versions of ICD-10 G54.4 may differ. The spinal cord ends around the L1 or L2 vertebrae in adults, forming the conus medullaris. Your spinal cord is the bundle of nerves that carries messages back and forth from your brain to your muscles and other soft tissues. Spinal cord compression can cause cauda equina syndrome, which needs medical attention right away. Medical conditions such as rheumatoid arthritis, diabetes, or hypothyroidism can also play a role. By research the majority of radiculopathy patients respond well to this conservative treatment, and symptoms often improve within six weeks to three months. (79% versus 56% Global PerceivedEffect, respectively). You use the index and middle fingers to palpate the contraction of the transversus abdominis muscle and the opposite two fingers to palpate the contraction of lumbar multifidus muscle. These may show bone growths called spurs that pushagainst spinal nerves. Traveling pain. I feel more at ease in flexing.. Accessed Sept. 21, 2021. Know why a test or procedure is recommended and what the results could mean. This site complies with the HONcode standard for trustworthy health information: verify here. Consistent at-home therapy is key to making this happen. In turn, this allows individuals to relearn functions after an incomplete spinal cord injury. The back may also be stabilized by fusing some of the vertebrae together. In some instances, spinal nerve impingement can result in a radiating burning sensation. Exercise therapy is often the first line treatment. Sometimes, radiculopathy can be accompanied by myelopathy compression of the spinal cord itself. Generally speaking, sacralization is very mild. Treatment depends on the cause and your symptoms and may involve medication, physical therapy, injections, and surgery. You flex the hip and knee of one leg to 90 degrees. Hopefully this article helped you understand what to expect following a lumbar spinal cord injury and how to promote recovery. Sustain this pose for 10 seconds and then return to the starting position with ten repetitions. The pain extends from the surgical incision laterally into the inguinal and suprapubic regions. Some potential complications following a lumbar spinal cord injury include: In the following section, well discuss how to manage complications and promote recovery after a lumbar spinal cord injury. The pain will be concentrated in the neck, upper arm, shoulders . Following an L4 spinal cord injury, hip, knee and some ankle functions are intact, while sensation and motor control of the foot may be affected. Radiculopathy describes a range of symptoms produced by the pinching of a nerve root in the spinal column. Studies on the effect of acupuncture in people with acute lumbar radicular pain found a positive effect on the pain intensity and pain threshold. Check out our bestselling tool by clicking the button below: Acute Spinal Cord Injury: Understanding the Early Phases of Recovery, Spinal Cord Injury and Bradycardia: Why Youre Feeling Weak and Tired, Can a Spinal Cord Injury Cause Memory Loss? Most cases of spinal stenosis occur in older people. This may involve removing all or parts of a disc and/or vertebrae. While injuries to the L4 vertebra tend to be less severe than injuries to the spinal cord proper, symptoms include an inability to bend the feet in a particular direction. Spinal cord compression is caused by a condition that puts pressure on your spinal cord. Conclusions: L3 radiculopathy was characterized by various lower limb pain and neurologic deficit. The vast majority of cases are benign and will resolve spontaneously, and thus, conservative management is the most appropriate first step in the absence of clinical red flag symptoms. If you have any of these symptoms, you need to get medical attention right away, typically in the emergency room: Severe or increasing numbness between the legs, inner thighs, and back of the legs, Severe pain and weakness that spreads into one or both legs, making it hard to walk or get out of a chair. On average, survivors complete hundreds of repetitions per half hour session. If you have pain with certain movements, this may help your doctor identify the affected nerve root. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Traumatic and Non-traumatic Spinal Cord Injury. Clinical presentation for radiculopathy from each lumbar nerve root: Radicular syndrome/ Sciatica:a disorder with radiating pain in one or more lumbar or sacral dermatomes, and can be accompanied by phenomena associated with nerve root tension or neurological deficits. This exercise progresses from 10- to 60-second holds of co-contraction for ten repetitions. One of the most common causes of spinal cord compression is the gradual wear and tear on the bones of the spine, known as osteoarthritis. Herniated or bulging discs can sometimes press on the spinal cord and on the nerve roots. Lumbosacral radiculopathy is the clinical term used to describe a predictable constellation of symptoms occurring secondary to mechanicaland/or inflammatory cycles compromising at least one of the lumbosacral nerve roots. Symptoms of nerve root impingement vary depending on the location and severity of the condition. A herniated disk in your lower spine may "pinch" a nerve root, causing pain that radiates down the back of your leg (sciatica).