The vertebrae, which protect the spinal cord and spinal nerves, through daily activities experience normal wear-and-tear. Sometimes this causes slight impingement of nerves, in turn causing spinal nerve inflammation and shooting pain down to the feet.
Radiating back pain
Back pain that shoots down the leg into some (not all) toes can be due to lumbar radiculopathy, which comes from impingement of the lumbar spinal nerves by otherwise normal day-to-day wear-and-tear of the vertebrae. Impingement causes pain not as much by mechanical compression as by inflammation and irritation of the nerves.
Irritation of a lumbar spinal nerve causes pain, spasm, and inflammation in body parts served by the nerve.
Nerve irritation can also cause neurogenic inflammation in involved peripheral tissue. This is mediated by interactions between nerve endings and the immune system.
Chronic pain cycle
- Shooting pain down to some of the toes on one side
- Spasms of buttock, thigh, leg, and foot muscles
- Back & buttock pain
- Physical examination
- X-ray, CT, and/or MRI of the lumbar spine
- Other musculoskeletal conditions often co-exist
- Rule out other “red flag” medical conditions
- Physical therapy strengthening the back and pelvic girdle muscles, improving posture
- Epidural steroid injection under fluoroscopy guidance reduces inflammation around the spinal nerves.
- Co-existing musculoskeletal conditions should also be treated.
- Spinal cord stimulation (SCS) is sometimes an option for non-drug, convenient therapy.
- Comprehensive pain management including pain psychology, physical therapy, and complementary & alternative medicine (CAM)