Since you’re reading this blog I’m guessing you’ve either been told you have a pinched nerve or you’re attempting to self-diagnose. If you have done your research on what a pinched nerve is and what causes pinched nerves then this blog will tell you what your treatment should consist of, if not I suggest you read my previous blog, “ What is a Pinched Nerve?”
Whether you have a pinched nerve in your lower back, shoulder, wrist, or between the shoulder blades, your symptoms may vary, but the treatment plan is very similar so let’s get into it.
Who Treats Pinched Nerves?
First things first, who do you go see to get treatment for a pinched nerve? For musculoskeletal injuries, which a pinched nerve falls under, you end up either seeing a Physical Therapist (PT) or a Chiropractor.
Depending on your insurance situation you may need a referral from your primary physician to see a PT while you can directly see a Chiropractor if you have a PPO. While you can call your insurance plan to see about your coverage, it is best to call the office as well, as the specific coverage plans are asked when verifying coverage. My staff, for instance, is trained to ask the details specific to our treatments so when a potential patient calls, we let them know exactly what to expect.
The question then is if you should see a PT or a chiropractor. I have written a blog on the Difference Between a Chiropractor and Physical Therapist that I encourage you to see. Typically your PCP refers to a PT only because that’s what they are used to but that does not necessarily mean you are better off going through that route; frankly, a large number of my patients come from PT offices because either the treatment did not work or did not last long. Not all PTs and Chiropractors are created equal in terms of the care they provide, for example, I specialize in what is called Postural Neurology, which we will discuss more in the sections below. When choosing an office for your treatment, do your research to make sure you are getting the treatment you actually need to feel better and stay healthier.
Pinched Nerve Pain Relief
If you walk into my office in pain (believe it or not I actually see many people who are not in pain that just want to improve their posture and correct their movement), then the first step is to get you out of pain.
There are several research studies supporting the efficacy of chiropractic adjustment for pain with the last by Chiropractic and Manual Therapy published on Jan. 8, 2021. If you’ve never been adjusted and you’re curious, you can watch the video below to see what it’s like; with the recent popularity of chiropractic adjustments on YouTube, not every chiropractic adjustment requires the so-called ‘cracking’ of the spine and there are so many alternatives that your chiropractor may choose based on your findings and condition.
Chiropractic adjustment certainly has its benefits, but alone will not fix your problem. It stimulates the nervous system similar to the teacher walking in and announcing she has something exciting to tell the class. What happens after that is the key.
With a pinched nerve, it’s common to have muscle tightness, decreased range of motion, and movement dysfunction that contribute to your symptoms. What muscles and joints specifically need to be worked on will depend on where the pinched nerve is and can vary from case to case. I find the best method of getting rid of the trigger points to be Active Release Technique (ART).
This first stage of treatment is all about getting you out of pain so that we can move on to the most important part of any treatment, to not only get rid of the cause but also the ‘feeders’ of the cause.
How to Fix a Pinched Nerve?
If your goal is to stay out of pain, then you’re going to want to pay extra attention to this section. What good is a treatment if you never address what caused your pinched nerve to begin with? As we discussed in our blog on pinched nerve, the cause is typically due to postural decline and most commonly seen in people who sit behind a desk for work every day. Why is that?
When you sit behind a computer all day, you force your body to function in a way it was not designed to function- this is dysfunction. If you are staring down at a screen, this guarantees neck pain and down the road, shoulder pain, tightness in the arm, pain between shoulder blades, headaches, and even pain down the arm. All of these things are looked at as separate problems but in reality, they are different parts of the same ‘story’. This is just one example of a small simple thing you do often enough to cause a problem. So one of the most important steps in treating and preventing musculoskeletal injuries is Ergonomic Correction. If that rings a tune with you, make sure to read my Ergonomic Checklist to self-evaluate your work setting. You don’t have to be experiencing pain to make the changes on the list and prevention is the smartest way to live life.
Now unfortunately the neurology behind your pain takes more time and very specific work to change, but trust me you don’t want to skip this step!
In your brain, there is a map for movement of all your body parts called homunculus. When due to an injury, lifestyle, or partial treatment of a previous injury, this map gets compromised. That is the beauty of the human body; it is highly adaptable but every time there is an adaptation and ‘tweaking’ of the ‘factory design’, you are working closer to dysfunction and any dysfunction over time becomes a problem.
Next thing you know, the map of movement which btw you are born with but especially during the first 3-4 years of life it gets really complete with details- ends up resembling its original design. This map is like the musical notes to a concert conductor. If the note does not spell the music we are expecting to hear, what you expect and what you get won’t be the same.
This is called Postural Neurology and is the most ignored part of all musculoskeletal conditions. We are too busy treating the area as if the area of problem lives by itself and in isolation. That is why our healthcare system is a failing system. Watch this video to understand what Postural Neurology is and why you should never ignore exercising your brain just like your muscles to bring back the lost functions.
Through a postural neurology exam, we are able to identify your specific dysfunctions in terms of posture and movement. This information is then used to bring back the function into the dysfunctional patterns of movement that were created as a result of necessity.
Everyone thinks their recommended exercises are the best and the most effective ones but what better evidence as to what is the most suitable exercise than us knowing how every baby on this planet goes through the same developmental stages of movement. If these step-by-step developments in muscles, joints, nerves, tendons, and soft tissue is universal, then why do we keep creating yet another “best and most effective” exercise, and how come they go out of popularity over time?
Developmental Kinesiology or Dynamic Neuromuscular Stabilization exercises to correct your movement and treat the neurology behind your pain is how, at our clinic, we address all issues. Everyone’s ‘story’ is unique, their weaknesses and strengths are different but the solution is always the same.
Now What?
Now that you know ART, Postural Neurology and Developmental Kinesiology are at the root of any musculoskeletal problems, start looking for practitioners that provide these all and read their reviews. Check out my Youtube Channel for videos with more information on these treatments and plenty of exercises that are a great resource for you. Don’t hesitate to contact us with any questions you may have.
Dr. Shakib
