The term “pinched nerve” is somewhat of a catch-all phrase that is commonly used to describe the pain associated with a variety of conditions from subluxations, to tunnel syndromes to the referred pain from trigger points.
Most of the time, what is called a pinched nerve is actually an irritated, or inflamed nerve where the nerve itself is not actually pinched. In most cases, nerves become irritated and inflamed when the bones, joints or muscles of the spine are not in their proper position, or are not moving properly. This condition is called a “subluxation”, the treatment of which is the specialty of the doctor of chiropractic.
There are instances when nerves do become ‘pinched’, such as in Carpal Tunnel Syndrome, Sciatica and Thoracic Outlet Syndrome. In each of these cases, injury, spasm or inflammation of the surrounding muscles and connective tissue causes the nerve to become compressed, resulting in pain. These conditions are referred to as “tunnel syndromes.” Treating tunnel syndromes is more complex than treating a simple spinal subluxation, but they usually respond very well to chiropractic care; especially when combined with other therapies, such as exercises and stretches.
Trigger points are very tight “knots” of muscle that form when muscles are either chronically overworked or injured, and are often experienced as a pinching or burning pain. Trigger points will commonly cause pain that radiates to other parts of the body, which is also known as referred pain. The successful treatment of trigger points usually requires a combination of chiropractic care, stretching and a form of deep tissue massage called ‘trigger point therapy.’ It is very important that the cause of any form of pain be properly diagnosed. This is especially important when nerves are affected as severe or long term irritation, or compression, of a nerve can lead to permanent nerve damage. If you have been told that you have a “pinched nerve” it is very important that you seek professional care from a doctor of chiropractic as soon as possible.
You may have heard the term “slipped disc” used to describe a low back injury. Discs do not actually “slip”. Rather, they may herniate or bulge out from between the bones. A herniation is a displaced fragment of the center part or nucleus of the disc that is pushed through a tear in the outer layer or annulus of the disc. Pain results when irritating substances are released from this tear and also if the fragment touches or compresses a nearby nerve. Disc herniation has some similarities to degenerative disc disease and discs that herniate are often in an early stage of degeneration. Herniated discs are common in the low back or lumbar spine.
What causes discs to herniate?
Many factors decrease the strength and resiliency of the disc and increase the risk of disc herniation. Life style choices such as smoking, lack of regular exercise, and inadequate nutrition contribute to poor disc health. Poor posture, daily wear and tear, injury or trauma, and incorrect lifting or twisting further stress the disc. If the disc is already weakened, it may herniate with a single movement or strain such as coughing or bending to pick up a pencil.
How do I know if I have a disc herniation?
Herniated discs are most likely to affect people between the ages of 30 and 40. Disc herniations may be present without causing pain. The most common symptom will be pain in the area of the herniation that may radiate across the hips or into the buttocks. You may also experience numbness or pain radiating down your leg to the ankle or foot. If the herniation is large enough, you may notice weakness with extension of your big toe and you may be unable to walk on your toes or heels. In severe cases of lumbar disc herniation, you may experience changes in your bowel or bladder function and may have difficulty with sexual function.
How is a disc herniation treated?
Mild to moderate disc herniations can usually be treated conservatively with stretching, exercise therapy and chiropractic care. More advanced cases will often require some form of spinal decompression, such as traction or mechanical decompression, in conjuction with chiropractic care.
Occasionally, a herniation may be severe enough to warrant surgical intervention. These cases are usually reserved as a last resort when other forms of therapy have failed to relieve pain, or if there is significant compression of the spinal cord or nerves.