This week I will discuss achy Lower back pain with tingling pain referring into the Big toe, Calf muscle and into the small toe region. Listed below are the symptoms of a typical Lower back case that I come across in my clinic.
Signs & Symptoms that he experiences:
Awakens in the morning time with achy lower back pain & stiffness
Lower back pain became severe when bending down with pain radiating down the leg
Standing upright immediately eases this severe lower back and leg pain
However standing for long durations causes the pain to recommence in the lower spine and leg
Unable to bend backwards because of increased back pain
May suffer a tingling pain into the big toe that spread into the outer area of the foot.
Moving to a standing from a seated position aggravated lower back pain
So what is causing the sharp lower back & leg pain?
Pain into the big toe and into the outside area of the foot can indicate that 2 discs of the Lumbar spine are bulging out of position and compressing the L5 and SI nerve roots. The nerve roots exit each of the Lumbar vertebrae and extend downwards like a wire where it branches off to supply movement control and sensation to each muscle. In the case above we can assume that there is a bulging disc between the L4 and L5 Lumbar vertebrae of the lower spine that is impinging on its nearby L5 nerve root that supplies muscle control and sensation to the Big toe. Compression of this nerve root causes tingling pain into the Big toe. In addition there is a bulging disc between L5 and SI vertebrae of the Lower spine which is impinging of the S1 nerve root that supplies feeling and sensation to the outside of the foot. Hence compression of the S1 nerve is causing pain into the outside area of the foot.
Treatment & Management
Treatment of these symptoms is based on the findings in the examination of the Patient. For example when the Patient gently bent his Spine backwards and twisted to the left, his leg pain sharply increased. In the same position twisting to the right side helped ease his lower leg symptoms. In this situation mobilisation treatment would directed to the pain relieving right side.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
Contact Number: 0504 26672
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Injury Solutions Clinic
Physiotherapy & Injury Rehabilitation Clinic in Tipperary