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Have I Pinched a Nerve?
Dr. Scott Fuller, D.C., C.C.S.T.
For many years, the public has equated back pain with a pinched nerve.
Although there are some instances of back and neck pain that result from a pinched nerve,
these cases are very rare.
Some sources have reported that as little as 4% of back pain cases are due
to a pinched nerve. This means that nearly 96% of back pain sufferers have a different
cause to their discomfort. How would one know if he or she was suffering from a pinched
First of all, it is imperative that pain sufferers seek consultation with a physician who
is qualified to diagnose and treat such neurological disorders. There are some specific
signs that a physician must investigate to properly diagnose a pinched nerve. A spinal
nerve is an aggregation of smaller nerves that carry information to and from the spinal
cord. The spinal nerve is analogous to a telephone cable in that it houses many fibers
that transmit various types of information to multiple areas. Some of these nerve fibers
carry information towards the brain (sensory nerves) and others carry information out to
the muscles and organs (motor nerves). When a nerve is pinched some of the nerve fibers
are compromised. These fibers either become dysfunctional or in the worst case they die.
The fibers that are the largest in diameter are the first to be compromised. These nerves
are sensory and they inform the brain about vibration. When a nerve in the neck or low
back is pinched, the patients? ability to sense vibration is diminished. Because these
nerves extend into the arms and legs, vibration would be diminished in the corresponding
extremity. This is easily tested by the examiner with a tuning fork. Sometimes patients
will experience sensations of pins and needles or numbing to their skin as a result of a
pinched nerve. Sensory tests are helpful but they are not the best way to make a
definitive diagnosis of a pinched nerve. This is because uncompromised sensory nerves from
other areas tend to help damaged nerves carry information to the brain. This is called
sensory overlap. The most important criteria in the diagnosis of a pinched nerve is motor
testing. Testing the strength of a specific muscle or group of muscles will allow a
physician to know whether or not a nerve is pinched. If the motor fibers in the nerve are
compromised, they will lose the ability to control the strength of the muscles they
innervate. Patients who rupture discs and compress nerves (again, direct nerve compression
is rare) are highly likely to have weakness to one or more groups of muscles. The
integrity of these motor nerves can be evaluated by the utilization of electromyography,
also known as EMG. An EMG can actually test the amount of electrical activity in a
specific muscle in relationship to the motor nerve that innervates it. These are some very
simple ways of diagnosing a pinched nerve. If a pinched nerve is rarely the cause of neck
and low back pain, then what is the most common cause?
Most current research cites the soft tissues of the spinal column as the source of back
and neck pain. These tissues include the intervertebral discs, the joint ligaments, and
the muscles/tendons. These tissues allow for support and flexibility of the spinal column.
They are saturated with many small nerve receptors that inform the brain about position,
alignment, motion, pressure, and damage. With proper biomechanics and spinal motion, the
nerve receptors in these tissues function to transmit important neurological information
to the brain. It is this information that allows the brain to accommodate to the
never-ending changes in our environment. Spinal joint dysfunction due to chronic postural
strain and/or trauma results in diminished frequency of firing of these nerve receptors.
This dysfunction also results in degradation of the joints and supporting soft tissues
exciting pain receptors. When joint integrity is lost, not only does pain result but there
is also a loss of pain inhibition that depends on the firing of the joint motion sensors.
These sensors specifically inhibit pain when they are stimulated by healthy joint motion.
Dysfunctional joints not only stimulate pain sensors but they diminish the effects of the
pain inhibitory joint motion receptors. Individuals experience the effects of these pain
inhibitory receptors by rubbing an injured area and gaining relief. For example, if you
hit your head and then rub it, pain is diminished by the excitation of inhibitory
receptors in the skin. These receptors block the transmission of the pain nerves, at least
temporarily. Regarding neck and back pain, chiropractic treatment is focused on improving
joint dysfunction. Improved function of the joints and supporting soft tissues not only
diminishes the source of pain but also increases the pain inhibitory effects of the joint
Dr. Fuller is currently enrolled in a Neurology Diplomate Program. He continues to attend
seminars for postgraduate education concerning the diagnosis and conservative management
of intricate neurological syndromes.
How can pain be treated properly when the source is never identified?
Are you unhappy with the results of your present care?
Maybe the source of YOUR pain has yet to be identified!
For more information call Fuller Chiropractic at (781) 933-3332
Created by: Dr. Scott Fuller, D.C., C.C.S.T.
576 Main Street
Woburn, MA 01801
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