Why do lower back pain and leg numbness occur together?

If leg numbness accompanies lower back pain, irritation of a nerve in the lower back is one possibility to consider first.

However, leg numbness can also occur not only due to lumbar disc herniation or spinal stenosis but also from peripheral nerve compression around the knee or ankle, diabetic neuropathy, circulatory problems, and other conditions.

It is necessary to check together where the tingling sensation appears, whether it is on one side or both sides, and if there are changes in muscle strength and gait.

Patients express numbness differently depending on the individual.

• It feels like electricity is flowing.
• It feels like an insect is crawling.
• burning sensation or coldness
• Skin sensation is dull.
• It feels like wearing thick socks on the soles of the feet.
• I feel a sensation of weakness in my legs.

Tingling may differ from actual muscle weakness, so objective examination is necessary.

If one buttock and the back of the leg feel numb

It may be related to irritation of the lumbar nerve. We check whether the sensation extends to the calf and foot, and whether there are changes in the strength of the ankle and toes.

If the front or inner side of your thigh feels numb

We can also examine other nerves in the lower back, as well as nerve issues around the hip and groin.

If both feet and toes are numb in a similar manner

We can identify systemic causes such as diabetic neuropathy and peripheral nerve problems.

If your legs feel numb when walking or standing

We check whether symptoms improve when sitting or bending the waist to examine symptoms related to spinal stenosis. If your feet feel cold or your skin color has changed, you should also check for circulation problems.

If numbness persists even at night or during rest

If symptoms persist regardless of posture or if the area of numbness gradually expands, we can evaluate not only the lower back but also peripheral nerves and systemic conditions.

Confirm the location of numbness/tingling

Compare which area of the thigh, calf, top of foot, or sole of foot feels numb on the left versus the right.

Muscle strength examination

We examine the strength of the legs by extending the knee, lifting the ankle and toes, and standing on the tips of the toes.

Sensory examination

Checks whether the sensation to light touch differs from left to right.

Reflex examination

We can check for changes in lumbar nerve function by examining knee and ankle reflexes.

Gait examination

We check whether the foot drags or strength decreases during normal walking, heel walking, and toe walking.

Examination of the lumbar spine and peripheral nerves

We also check whether numbness changes with lower-back movement and whether nerves around the knee, calf or ankle are irritated.

With such examinations, you can determine the initial direction for many common lower back and nerve-related symptoms. However, if there is progressive muscle weakness or any warning signs, an MRI and evaluation at another medical institution may be necessary first.

• If leg strength suddenly drops or gradually weakens
• If it is difficult to lift the ankle or toes and the foot drags.
• If numbness in both legs suddenly worsens
• Changes in bowel and bladder control
• Reduced sensation in the perineum
• If walking suddenly becomes unstable
• In cases where numbness occurs after a severe trauma
• If the foot becomes pale or cold and severe pain is present

Such symptoms should not be judged as simple muscle tension or fatigue.

In the following cases, imaging tests or other examinations may be considered.

• If muscle weakness progresses
• If there are changes in urination and defecation, or sensation in the perineum.
• If numbness and pain continue to worsen
• When a decision must be made regarding whether to perform surgery or a procedure.
• If diabetes or other systemic causes are suspected
• Cases where vascular problems need to be confirmed

Even if the lumbar MRI is normal, tingling may occur due to peripheral nerves or systemic diseases. Conversely, even if a disc is visible on an MRI, it may be unrelated to the current numbness; therefore, both symptom distribution and examination findings must be considered together.

Chuna manual therapy

If movement restriction in the lumbar spine and pelvis, along with musculoskeletal dysfunction, is determined to be present, this may be considered as part of the treatment plan.

The fact that there is numbness alone does not mean that Chuna manual therapy can immediately resolve nerve compression. Before and after treatment, you must check not only the range of tingling but also changes in muscle strength, sensation, and gait.

Acupuncture treatment and pharmacopuncture treatment

Depending on the symptoms and the medical team's judgment, it may be selected to manage pain and discomfort in the lower back, buttocks, and legs.

Exercise and lifestyle management

After confirming nerve function first, we gradually restore movement of the lumbar spine and hip joint, lower limb strength, and balance.

Medication and injection therapy

If muscle strength and sensation are stable, treatment can be provided with the Chuna manual therapy, acupuncture, pharmacopuncture, and exercise described above. In periods when pain and numbness are severe, neuropathic pain medications or injections are sometimes used alongside them; however, neuropathic pain medications can increase fall risk through dizziness and drowsiness, and systemic burdens accumulate the more injections are repeated.

The fact that symptoms have decreased does not necessarily mean actual muscle strength and sensation have fully returned to normal. In particular, if pain has decreased but the foot drags or strength weakens further, immediate re-evaluation is necessary.

Collaborative consultation

If peripheral neuropathy, vascular issues, or systemic diseases are suspected, or if muscle weakness progresses, you may consult with relevant medical institutions for collaborative care.

• Do not test sensation by pricking the skin with a needle or using a hot object.
• Do not apply a hot compress pack to numb feet for a prolonged period.
• If you experience dragging of the foot or weakness, exercise caution when driving and using stairs.
• Record the range of numbness and changes in muscle strength by date.
• If symptoms progress, we receive a re-evaluation rather than repeating the same treatment.