Pinched Nerves can be extremely painful, and interfere with most aspects of your daily life, from simple things like lying in bed, bending over to dress yourself, sitting at your computer or couch, to more stressful physical activities like exercising. This article will help you understand what may have caused the pain, how to diagnose the problem, as well as your treatment options and how to get pinched nerve pain relief.
What Causes Sciatica and other Pinched Nerves
There are the obvious traumatic causes of pinched nerves like motor vehicle accidents and falls which cause a violent movement that often bends your spine into an abnormal position. This spinal trauma can create bony structural abnormalities leading to bony pressure on the nerves, and intervertebral disc compression, which can lead to a bulging disc (slipped disc) which gives you neurological symptoms like pain, burning, tingling, numbness or weakness down the arms/hands or the legs/feet, depending on which portion of your spine was harmed in the accident. Nerve pressure in the neck produces symptoms down the arms and lower back nerve pressure causes symptoms down the legs. This type of traumatic injury might only cause pain in your neck or lower back, so if there are no symptoms down your arms or legs, it is very unlikley that a pinched nerve has occurred.
By far the most common cause of pinched nerve visits to a Chiropractor is from the stress and strain of daily life. The factors leading to this type of pain mainly include the following:
- Sitting: Adults have never been more sedentary in any part of human history than we are now. Most people sit behind a computer all day and/or sit in a car for many hours to fetch kids, driving to meetings etc. We eat all our meals seated, and tend to sit on the couch or bed in the evening to read or watch TV. Sitting tilts your pelvis backward (posteriorly) which flattens out the normal lumbar spinal curvature, diminishing the lower backās ability to bear weight. This is completley unnatural for our spine and pelvis and therefore there is some truth to the saying: āSitting Is The New Smokingā.
- Excessive use of technology/reading: Forward bending (flexion) of your neck for hours each day to look down at laptops, cell phones, tablets or books is literally bending your spine in the opposite direction to how the cervical (neck) portion of your spine is naturally bent. Over time, the spine can lose its natural curved shape, a condition know as Loss of the Cervical Lordosis (Curvature).
- Poor Bending Technique: Forward bending (flexion) of your lower back (lumbar spine) is always a bad idea. Whether it be to lift a heavy weight, or no weight at all like when dressing yourself or picking up kids toys or dirty washing off the floor etc. When these movements are performed in this way, you are again bending your spine in the opposite direction to how the lumbar (lower back) portion of your spine is naturally bent. Besides being detrimental for you lumbar intervetrebral discs, over time, the spine can lose its natural curved shape, a condition know as Loss of the Lumbar Lordosis (Curvature).
There is a common misconception that every ache or pain in the body is muscular in origin. This couldnāt be further from the truth. The soft tissues could definitley be involved in your problem (muscles, tendons or ligaments), but there are other tissues in the neck and lower back which could easily be the source of your pain, like the lumbar spinal joints, sacroiliac (pelvic) joints, intevertebral discs and spinal/pelvic nerves.
As a general rule of thumb, soft tissue problems in the neck or lower back cause short term pain, hours to days. When a problem has been going on for weeks, months or years itās generaly spinal or pelvic in origin. Quite simply, muscles donāt usually cause pain for prolonged periods of time, but spinal and pelvic problems nearly always do. Muscular neck and lower back problems donāt directly cause internal lumbar spinal or pelvic problems, but if you have a spinal or pelvic problem you will almost certainly have an associated muscle spasm, your bodyās natural muscular response to the lower back condition.
When neck or lower back pain has been around for weeks or longer, especially when accompanied by symptoms down your arms/hands or legs/feet, be sure to to shift your focus away from the muscles and get your spine and/or pelvis assessed by a Chiropractor or Neurosurgeon, the spinal focused practitioners.
How to Diagnose Sciatica and other Pinched Nerves
There are 4 pillars to making the correct pinched nerve diagnosis:
- A Thorough Patient History: having an in depth discussion with a health care practitioner is the first step in understanding which neck or lower back nerves / discs are involved in your problem. As mentioned in the ācausesā section above, there are many potential tissues involved in neck and lower back pain, but based on a simple conversation, your practitioner can already get an idea of the problem based on how the pain is is traveling from your neck and down into your arms, or from your lower back and down into your legs. Each nerve has a specific path that it runs down your arms/hands and legs/feet, and by verbalizing the path accuratley, the practitioner can know which nerve is being pinched before seeing any diagnostic imaging. The neurological symptoms down the arms or legs can include pain, burning, tingling, pins & needles, numbness or weakness.
- A Physical Examination: your neck and lower back are moving structures and specific movement / orthopedic tests need to be performed in order to see how the different tissues function under movement stress. Discomfort during certain tests helps the practitioner understand which tissues are injured, either the soft tissues or the spinal/pelvic structures. Muscle spasm / knots / triggerpoints can be felt with the practitioners hands, and joint stiffness and inflammation can be elicited through lumbar and pelvic (joint) tests.
- X-Ray Scan:Ā when a patient history and physical examination does not help the practitioner to make an initial diagnosis, or if the results donāt add up, especially when the spine or pelvis is the cause of your problem, visualizing the tissues internally is required. The bony structure of the spine is investigated through an X-ray, which can help diagnose joint degeneration (Osteoarthritis), fractures, dislocations, vertebral instability, and structural abnormalities like vertebral misalignments and loss of the lumbar curvature (lordosis), all of which could create bony pressure on your nerves.
- MRI Scan: when a X-ray of the neck or lower back bony structure fails to bring you closer to the diagnosis, an MRI is the best way to understand the health of your other spinal tissues, namely the intervertrebral discs and spinal nerves. Conditions like disc bulges (slipped disc), disc ruptures, and the extent of the disc pressure on your spinal nerves are well visualized on a MRI scan.
There are lots of different soft tissue (muscle) practitioners in health care, but not many spinal (pinched nerve) focused practitioners. If you have neck pain or lower back pain, as well as neurological symptoms running down your arms/hands or legs/feet, make sure you get help from a Chiropractor and/or Neurosurgeon.
Sciatica and Pinched Nerve Treatment in Umhlanga
The treatment you receive for your pinched nerve pain should be 100% dependant on the diagnosis that was made. There could be bony or disc pressure on your nerves, or a combination of both, and the treatment will then differ accordingly. There are various treatments worldwide for pain associated with a pinched nerve, but the procedures mentioned below are the most used, have the highest success rate, and are backed by the most science.
Pinched nerve pain responds well to the following treatments:
- Electrotherapy (T.E.N.S / Interferential): blocks pain signals, therefore reducing your perception of the pain.
- Heat: increases blood flow to the area, and the warmth has a relaxing effect on tight muscles and helps loosen stiff joints.
- Spinal Facet Joint and Sacroiliac (hip) Joint Mobilization: gently moving your spinal and pelvic joints through their natural range of motion, in order to restore the normal fuction and motion to the problematic joints.
- Spinal Traction: helps reduce pressure on any bulging intervertebral discs, which in turn reduces pressure on your nerves.
- Spinal / Pelvic Manipulation: most effective way to restore misaligned vertebral and pelvic bones back to their normal position, and restores the movement back to a āseized upā / tight / stiff joints that have lost their ability to move naturally. This helps remove bony pressure on your nerves. (see Manipulation video)
- Curvature Restoration: a specialized home based exercise and stretching protocol to restore the normal curvature to the cervical or Lumbar spine. The spinal curvatures act like a biomechanical spring that helps distribute weight. Restoring these curvatures helps unload the intervertebral discs, which in turn reduces nerve pressure.
- Surgery: When all conservative (non-invasive) treatments have been exhausted, it is time to consider surgical intervention. Sometimes no matter how much pressure you try to take off the nerves from the outside, there is no reduction in nerve pressure and pain, and this is when a Neurosurgeon will need to operate internally. If the disc is bulging onto the nerves or if there is bony pressure, a Laminectomy or Discectomy procedure can be performed. These are minimally invasive decompression surgeries, relatively speaking, and are the best surgical option if these procedures are possible. If the intervertebral disc has ruptured, and is damaged beyond repair, then the entire disc will need to be removed and the two vertebra on either side of the disc must be bonded together with screws, a procedure called a Spinal Fusion.