Pinched nerve or not?
Dr. Daniel Klerer D.C.
I would like to take a moment to address a very common misuse of the term “pinched nerve” that I hear very often in my office when seeing a new patient or seeing a patient with a new complaint.
Often, a patient will walk into the office with lots of pain, limited movement and they say, “I think I have a pinched nerve”, which of course, sounds very sinister and uncomfortable! This is a perfect time to educate patients on terminology and as always, run them through a proper history and physical exam to determine the cause of their pain, get a diagnosis and create a tailor made treatment plan for their specific issue.
The thing is, almost 95% of the time when I hear the words “pinched nerve” it does not coincide with symptoms of a pinched nerve!
What is a pinched nerve?
A pinched nerve by definition, is when too much pressure is being applied to the nerve by surrounding tissue such as bones, muscles, ligaments, tendons or discs. This will disrupt the nerve’s normal function, which usually causes pain, numbness, tingling and even weakness in the areas that the nerve supplies. A pinched nerve creates a bigger roadblock to recovery as well as treatment, compared to an injury that does not involve the nerve.
One of the first questions any practitioner should ask, in any history taking, but especially when a nerve is suspected to be involved, is are you experiencing any numbness/tingling? Most often, the answer is no, but that doesn’t mean the nerve is in the clear. A physical exam, testing the nerve function like reflexes, nerve root tension, sensation and strength testing will help rule in or out any nerve related issue.
So, if it isn’t the nerve, then why are you in so much pain and why can’t you move your neck to one side or the other?
What I notice is that the more restricted patients are with their movements, the more worried they get with what exactly is happening to them. It makes sense, if you cannot bend forward to pick something up off the floor without immense pain, the first thought goes to the worst possible outcomes! Again, this is where a proper physical exam comes in.
Most of the time, in my experience, that painful range of motion or extremely restricted range of motion with pain is caused by muscle or joint pain. When our joints in our spine get injured or inflamed, they no longer want to move for us. The problem gets worse when the muscles hear the joint’s cry for help and begin to tighten up to stop us from moving. For such a small change in our body’s functionality, it can cause such a massive pain stimulus and causes a lot of us to think the worst. In reality, with the right advice and treatment, it will be resolved quicker than you think!
Given that many of us are home at this time, if you are in this sort of pain, what can you do to get relief?
Most often when dealing with a new injury, ice is the answer, applying it for 10 minutes at a time. This will help with the pain but also help bring down the inflammation associated with the new injury.
As well, rest and light stretching may be a good idea to help get the joints moving better. Using a trigger ball or other self massage tools can be helpful as well to settle the tight and tender muscles around the area.
As always though, if you are in too much pain to try these tips or you are worried about what is going on with your new injury, it is best to consult us through virtual sessions. This way, we can ask the right questions, assess the area, and give tailor made advice for each individual case in order to help with this painful time!
So, the next time you have a lot of pain, limited range of motion, stop and think.
Do I have any numbness or tingling anywhere? If not, ditch the term pinched nerve, remember that if you take care of the issue, it will resolve and be better than ever!