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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 nerve?

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 motion sensors.

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.
Fuller Chiropractic
576 Main Street
Woburn, MA 01801

(781) 933-3332

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