Low back pain typically presents in one of two primary patterns: localized pain, which stays in one specific area and often feels sharp, pinching, or “stuck,” and shooting or pinched-nerve pain, which begins in the low back and travels down the leg, causing burning, electric, or numbing sensations. These two patterns have different root causes and are treated differently to achieve the best results. Scroll down to find the pattern that matches your symptoms so you can better understand what’s happening and how we can help.
PATTERN 1: LOCALIZED LOW BACK PAIN (Facet-Type Pain)
Overview of Symptoms
- Pain in one specific area of the low back
- Pain on either left or right side (or across both sides)
- Sharp, stabbing, “pinched,” or deep aching sensation
- Pain worsens with bending backward, twisting, or standing up
- Tightness or “guarding” in nearby muscles
- Reduced flexibility or difficulty bending
- Pain does NOT travel down the leg
How Chiropractic Can Help
Localized low back pain often originates from irritated or compressed facet joints. Chiropractic adjustments restore joint spacing, correct misalignments, reduce guarding, and normalize lumbar biomechanics to prevent recurrence and reduce long-term degenerative stress.
Recommended Therapies for Low Back Pain
Our therapies help reduce inflammation, stimulate cellular repair, improve circulation, and support healthy tissue recovery. Your doctor will choose the therapies most appropriate for your condition after evaluating your X-rays and exam findings.
Therapies We Offer
- Chiropractic Adjustments
- Spinal Decompression
- Laser Therapy (Class II & IV)
- Shockwave Therapy
- Pulsation Electromagnetic Field Therapy (PEMF — pelvic-floor stabilization)*
- Ovation ULT Red-Light Therapy Bed
- Stabilization & Posture Coaching
*Some patients have contraindications for PEMF.
PATTERN 2: PINCHED NERVE / SHOOTING PAIN (Sciatic-Type Pain)
Overview of Symptoms
- Pain that starts in the low back and travels into the leg
- Two main nerve patterns:
- L1–L3 → groin, front of thigh, side of thigh
- L4–S1 (true sciatica) → back of thigh, calf, ankle, foot, toes
- Burning, numbing, or tingling sensations
- Weakness or heaviness in the leg or foot
- Worsened by sitting, driving, bending, or coughing
- Often described as “shooting,” “electric,” or “lightning bolt” pain
How Chiropractic Can Help
Chiropractic identifies the irritated nerve root, corrects misalignments that compress or tension the nerve, improves disc hydration and motion through decompression, reduces inflammation around the nerve, and stabilizes the pelvis to prevent recurring nerve irritation.
Recommended Therapies for Low Back Pain
These therapies reduce inflammation, encourage nerve healing, increase blood flow, and support tissue recovery. Your doctor will determine which therapies are most appropriate for your specific nerve pattern.
Therapies We Offer
- Chiropractic Adjustments
- Spinal Decompression
- Laser Therapy (Class II & IV)
- Shockwave Therapy
- Pulsation Electromagnetic Field Therapy (PEMF — pelvic-floor stabilization)*
- Ovation ULT Red-Light Therapy Bed
- Stabilization & Posture Training
*Some patients have contraindications for PEMF.
A Note for Patients With Prior Spinal Surgery
We frequently and safely treat post-surgical low back patients using modified, gentle techniques. Decompression (when appropriate), laser therapy, shockwave, and PEMF stabilization are all effective options that do not compromise surgical sites.
NERDS ONLY — The Deep Dive Into Localized vs. Shooting Low Back Pain
Low back pain can feel similar from the outside, but under the surface, two very different mechanical problems are usually at play: facet-joint driven localized pain or nerve compression–driven radiating pain. Understanding the difference between the two is the key to getting long-term relief — and it’s where things get interesting.
PART 1: WHY LOCALIZED LOW BACK PAIN HAPPENS (Facet Syndrome)
Localized low-back pain most often comes from a condition called facet syndrome, which originates in the small stabilizing joints on the backside of each vertebra. Each vertebra has two superior and two inferior articular facets — essentially tiny bony ramps that interlock like puzzle pieces to guide motion.
When the spine is aligned properly, these joints glide smoothly.
But when a vertebra rotates, tilts, or shifts forward or backward, the facet joints become compressed. Instead of gliding, they begin grinding.
Every time you bend, twist, stand, or walk, those irritated joints rub together, wearing down cartilage, irritating the joint capsule, and triggering inflammation. This is why localized low-back pain often feels sharp, pinchy, stuck, or locked.
When inflammation builds, the surrounding muscles tighten defensively — a protective mechanism called muscle guarding. This is why patients suddenly feel unable to bend forward to tie their shoes or roll out of bed without sharp pain. In severe cases, the facet can become so irritated that it “locks,” producing a sudden pain that can drop someone to their knees.
Facet pain typically stays localized — either on one side of the spine or across both sides like a belt. It rarely travels into the leg unless swelling encroaches on a nearby nerve root.
Misalignments, mild scoliosis, pelvic imbalance, and degenerative changes can all increase the compressive load on facet joints. Over time, this accelerates the grinding effect and worsens inflammation.
This is why full spinal X-rays are essential. They tell us:
- Whether the vertebra is rotated
- If the spine is leaning or tilted
- Whether disc height is reduced
- If arthritic changes are narrowing the facet space
- Whether the pelvis is level or contributing to the imbalance
Once the exact mechanical cause is identified, chiropractic adjustments are applied in the precise direction needed to restore joint spacing, reduce grinding, and allow inflamed tissue to heal.
Facet syndrome is painful — but extremely treatable.
Correcting alignment reduces mechanical stress, inflammation subsides, muscles relax, and mobility returns.
PART 2: WHY SHOOTING OR RADIATING PAIN HAPPENS (Pinched Nerves & Sciatica)
“Shooting” low back pain — the kind that travels into the leg — almost always comes from nerve compression, but there are two very different nerve patterns:
Pattern A: Upper Lumbar Nerve Pain (L1–L3)
Pain travels into:
- The front of the thigh
- The groin
- The side of the thigh
This is not sciatica — it’s irritation of the upper lumbar nerve roots that supply the anterior thigh and groin.
Pattern B: True Sciatica (L4–S1)
Pain travels down:
- The back of the thigh
- Into the hamstring
- Down the calf
- Into the ankle, foot, or even the toes
This classic radiating pattern happens when the sciatic nerve or its contributing nerve roots are compressed or inflamed.
The Mechanics Behind Nerve Pain
Nerves can be compressed in three major ways:
1. Disc Bulge or Herniation
When the disc weakens or shifts due to misalignment or uneven pressure, the nucleus pulposus bulges toward the nerve root and compresses it between the disc and the vertebra.
2. Vertebrae Approximating (Bones Moving Too Close Together)
When the spine rotates or tilts, the space between vertebrae narrows on one side.
This squeezes the nerve root inside the intervertebral foramen.
3. Arthritic Overgrowth / Calcification
Years of misalignment can cause the body to grow stabilizing bone spurs.
These spurs grow into the nerve tunnel and physically narrow the space.
Why Updated X-rays Are Critical
Without imaging, you cannot know whether the nerve is being compressed:
- Between a disc and a bone
- Between two vertebrae crunching closer together
- By arthritic changes and bony encroachment
You also can’t know which direction the spine needs to be adjusted to create more room for the nerve.
Sciatica (L4–S1) always travels down the back of the leg and may reach the toes.
Upper lumbar nerve irritation (L1–L3) rarely goes below the knee and follows a front-of-thigh pattern.
Knowing the difference is everything — and treating the right pattern is the difference between temporary relief and long-term resolution.
The Bottom Line for Nerds
Localized low-back pain = facet joint compression
Radiating pinched-nerve pain = nerve root compression
Different causes → different mechanisms → different treatments.
If you’re still reading this, welcome to the “nerds only” club — the top 1% of patients who want to understand their body at a deeper level. And the more you understand, the better your long-term outcomes will be
Get Neuropathy Treatment Today
If you suffer from neuropathy, contact Doyle Chiropractic at (864) 881-4221 to schedule an appointment. Our dedicated team is here to help you achieve lasting pain relief and better health. Visit our clinic in Simpsonville, SC, and experience the difference our specialized care can make.