1. Nerve Root Pain (Radicular Pain)
Typical nerve pain is a shooting, electric shock-like pain that runs down to your lower leg or foot. Usually the leg pain is much more severe than the local back or buttock pain. Squashing or compressing a nerve initially is not painful at all, until inflammation sets in.
Radicular pain is often associated with pins and needles, numbness and weakness. The pain comes from a chemical inflammation of the nerve and does not cause local back pain.
Somatic referred pain is characteristically a deep, vague, diffuse pain, but it can be sharper in a well-defined area, usually in the back or hip area. The pain is usually worse in your back, closer to its point of origin, and less severe in the leg.
Somatic referred pain is the most common form of pain that traces back to your spinal structures. It can arise from any structure that contains a nerve supply, such as from inside the disc, the facet joint or the muscles. It does not come from pressure on a spinal nerve.
You know where the pain hurts most but our job is to find its source, which may be:
- One of the discs between your vertebrae – the source of about 40% of all chronic low back pain problems.
- Your sacroiliac joint in your pelvis – the source of about 15% of chronic low back and buttock pain
- The facet joints in your spine – responsible for about 15-40% of lower back pain (rising with age).
Your discs and other structures sit deep within your back, meaning we can’t diagnose the problem by palpating (feeling) the disc. Nor can this diagnosis be purely based on your symptoms and movement patterns.
It was previously thought that pain on bending forwards was most likely due to disc pain and that pain on bending backwards and twisting was more likely to be due to facet joint pain. However, this generalisation has been disproved.