If you suspect having a pinched nerve, chances are you have one of these questions?
- What is a pinched nerve?
- What is pinching your nerves?
- What causes a pinched nerve?
- What does a pinched nerve feel like?
But do you really have a pinched nerve or is it something else? Let’s find out!
What is a Pinched Nerve?
To fully understand what a pinched nerve is, let’s start with a little anatomy, and we’ll get to the pinched part later. According to BYJU’s, “A nerve is a cable-like structure within the body designed to conduct nerve impulses that relay information from one part of the body to another.” As you can see in the image below, all the nerves in your body stem from your spinal cord, exit through the spine (vertebrae) and distribute to your many body parts.
Nerves are how the brain sends and receives information when communicating with any part of the body since the brain is in charge of every function in your body. Simply put, the brain sends the command based on your needs (some you are aware of but most you have no clue about) and the body parts do as they are told and report back to the brain.
For example, you decide you want to get up to grab something, every muscle you use to go from a seated position to standing is doing so because your brain sent the signal for those muscles to work to produce the movement you have requested. Now, let’s talk about pinched nerves.
When we say pinched nerve this means there is pressure (which typically starts as irritation) on one of the trillion nerves in your body. This pressure can be produced at the site of the nerve exiting the spine (shown below) or along the pathway that the nerve distributes to whatever body part it goes to.
The confusion typically happens because not every pain shooting to somewhere is necessarily a pinched nerve. We have the ‘imposters’ to think about.
The ‘imposters’ are different for different areas of the body but to generalize them, they are trigger points, lactic acid build-up, that trigger pain as if it is the nerve that is irritated or pinched. Pinched nerve, just as imposters can be anywhere in the body, the neck, the back, pelvis, along the arms, and legs.
There are different reasons why a nerve may be pinched. They can be structural, meaning the anatomy of the area contributes to it due to genetic deviations (such as an extra set of ribs on the 7th neck vertebra), could be soft tissue such as disc material, cyst, or tumor, or it can be functional meaning in the process of movement or holding the posture, the joints, muscles, and movement patterns are dysfunctional leading to irritation of the main nerve or the nerve nearby. Let’s explore this further.
What is Pinching Your Nerve?
The first step to figuring out what is irritating your nerve is to figure out if it’s happening at the spine or elsewhere. Clinical findings are the first clue as to if you are having a pinched nerve and this may or may not be confirmed by an MRI. Often people think it is a disc issue if they are having back pain, ‘catching’ of the back, or if they have pain going down their arm or legs.
This video explains the main imposter in the neck that may lead to pain down the arm.
When a nerve is pinched as it exits the spine, we are talking about potential stenosis or narrowing of the exit hole due to multiple factors that you can read about in my blog “Basic Understanding of Stenosis, Its Pain and Non-Surgical Treatment”.
Disc material in the forms of protrusion or herniation can put pressure on the nerve at the spinal exit of a nerve leading to the pinching of the nerve. Disc bulge, by the way, is hardly ever grounds for pressure on the nerve unlike what most people may think.
If there’s no reason to suspect the nerve is being pinched at the spinal exit, then we look elsewhere for the cause. A nerve can become “pinched” between a variety of different structures including bones, tight muscles, and tendons. For example, there are many structures passing through the shoulder complex, which is a common location for pinched nerve occurrence which will be discussed in a separate blog about pinched nerve at the shoulder and shoulder blade.
Dysfunction in movement can lead to over firing or under firing of the muscles involved which can lead to the trigger points that mimic nerve pinch. In many instances, a patient has seen a PCP, neurologist, sometimes orthopedists, massage therapists, and physical therapists having gone through tests such as NCV or EMG. Once examined, I go right to the area where I think the imposter is and sure enough, that resolves the issue.
What Causes Pinched Nerves?
I am going to go on a limb and say that with the exception of a traumatic incident leading to a disc herniation, and genetic anomalies such as a cervical rib (neck) almost all cases of a pinched nerve are due to dysfunctional movement. Dysfunctional movement is when you can get from point A to B, but not based on the ‘factory design’. You see, if you think about it, every baby regardless of where they are born or their gender or so on, moves the same way. That is what I refer to as ‘factory design’. They don’t know what they are doing and yet they go from being fully helpless to fully mobile. Then at around age 4-5 years when we start playing one-sided sports, go to school and sit for long hours using digital devices, the dysfunction begins.
All of these are discussed in detail at my website under Functional Movement. As adults the most common causes of dysfunction are:
- Sitting behind a desk and typing every day
- Sleeping in the wrong position
- Too much use of handheld devices = Tech neck
- Bad form when exercising
If these kinds of dysfunctional activities are done minimally, then it’s not so bad, but if these things persist over long periods of time, it’s only a matter of time before you have issues such as a pinched nerve or degeneration. To see if you are moving functionally or dysfunctionally, read my blog, What Functional Movement Is and How to Tell if You Are Moving Functionally or Dysfunctionally.
What Does a Pinched Nerve Feel Like?
Pinched nerve symptoms will vary depending on the location but generally, when it comes to a pinched nerve involving nerves exiting the spine in the neck or lower back, the common presented signs and symptoms are:
- Weakness in the muscles of the arms or legs (depending on the location where the compressed nerve),
- Pain traveling down the hands or feet and
- Perhaps some numbness and/or tingling down the arms or legs
Pinched Nerve Treatment
Once it is established if you have a true pinched nerve or being tricked by the imposter, the treatment varies. Surgery is at the bottom of the list and only applicable when there is a cyst or herniation that is large enough or at a location where the slightest bit of movement, the wrong way, leads to pain shooting down the leg or arm.
Typically people take medication for pain which actually does matters worse because it postpones effective treatment. The longer a condition lasts, the harder it is to get rid of it.
If you try physical therapy or massage, you will see some improvement and that is because they are both partial answers to the solution. They, therefore, provide partial relief to your complaint.
The only true solution to a pinched nerve is to remove the very reason why the nerve is pinched to begin with. Since almost all pinched nerves are a result of dysfunctional movements, first you need to learn what you are doing that is adding to the dysfunction. Next is to see how the dysfunction has changed the ‘blueprint’ of movement in your brain. That is when Postural Neurology becomes an effective tool. Along with the correct exercises to bring back the correct ‘map of movement’ to the equation are the functional movement exercises that I mentioned above. If you did not look that up, here is a video that explains it.
Bottom line is that it is easy to get distracted from the correct and most effective solution to a pinched nerve and you don’t need to become a specialist doctor to get your issue resolved. If you think you may have a pinched nerve or want to confirm you have a pinched nerve if you are looking for the right solution to get rid of your pinched nerve and for it to never return, make sure to contact my clinic to see how you can be helped.