Is it a pinched nerve? My neck is killing me!

Have you been told your neck or back pain was caused by a pinched nerve?  Have you heard a friend describe this issue or concerned you may be at risk?  Fear not--this description is often not accurate and not likely.

A "pinched nerve" refers to the space just next to the spine, where spinal nerves exit from the spinal cord and travel towards fingers, toes, and all the organs of the body.  If you've had pain anywhere from your neck to your fingertips, or low back down to your toes--you may have worried it could be a pinched nerve.  The space provided in the low back is more than enough for the nerves to fit through.  In fact, the space can often degenerate more than 50% and still have no symptoms!  The space in the neck is sufficient for the nerves to travel through even with inflammation.

In the chiropractic world, a pinched nerve is often described as the "garden hose theory", similar to a hose losing water pressure when it is kinked or someone is stepping on it.  This theory has no proper scientific evidence and should be disregarded as an explanation for treatment.

So if it's not likely a pinched nerve, what causes such pain?

The evidence points to irritation, adhesion, and perception.  Yes, just as the brain is powerful enough to let a grandmother lift a car to save her child or a football star finish a game on a broken ankle--your brain is powerful enough to misinterpret irritating signals as significant pain.  That means something can hurt really badly but not be very dangerous.  Our brains have an imperfect ability to perceive the level of danger.  As I remind my wife, the drive to skydiving is far more dangerous than actually jumping out of the plane.  Yet our brains have decided that the skydiving is more intense than anything else, just as irritation to a nerve--not a pinched nerve--can be more intense than other insults.

Adhesions are like cob webbing around tissue and can create tension instead of smooth, easy gliding.  Improper growth of connective tissue can create these stubborn changes, specific manual therapy can quickly eliminate these problems.  This leads to a more fluid tissue motion, whether it's muscle, nerve, tendon, ligament, or fascia.  Treating a "pinched nerve" should be focused on direct manual therapy and exercises that calm, release, and gently move the area.  This is the best way to avoid surgery, speed healing, and return to feeling normal.  Find a chiropractor, physical therapist, massage therapist, or physician who is focused on helping you move again, without relying on drugs to numb it or surgery to cut it.

Why does my back hurt so much?

Why back pain and neck pain are different than arm or leg pain.

I hear from patients frequently: "I didn't do anything that I remember", "I lifted some things this weekend but nothing out of the ordinary", or "I'm worried that I'm about to break!"

Intense back or neck pain can be very startling--even scary.  When pain appears without a specific incident or accident, it's hard to understand.  Neck, upper back, and lower back pain can feel like you're headed towards paralysis and not able to return to the activities you want to do or even need to do.  But why does neck pain or low back pain seem so much more challenging that wrist or ankle pain?

I suggest we remember that our neck and back muscles are most often controlled by the sub-conscious while our arms & legs are more often controlled by conscious decisions.  You actively choose to move your arm to reach in the fridge, but you probably put little thought into all the back muscles you need to hold your body in front of the fridge.  In that same way, our brains are able to discriminate more clearly what is happening to our elbow, while we have a greater challenge sensing where the pain is coming from in the back.  I am often told: "it hurts everywhere in my neck".  Which is another way of saying: "I can't tell where it's located." 

If you're experiencing neck or back pain, visit a chiropractor or physical therapist whom you trust.  Once a thorough exam has ruled out scary things (which would suggest more immediate or aggressive intervention), you can proceed toward conservative treatments knowing they are likely to help the most and have the least risk.  Conservative manual therapy (including manipulation, soft-tissue treatments, Active Release Techniques, and exercise) works so well because it treats the source of the problem, which is often that muscles, nerves, and ligaments are irritated.  The best way to calm them down is by providing calm, soothing input.  The kind of input that is gentle on the body, feels good, and helps you return to the activities you want to accomplish.

Attitude for Success: Making long term body changes

Last week, Jim came into my office finding it near impossible to walk.  He was supposed to be golfing with family in three days.  He had low back pain that had gotten worse over the past 2 months, a sharpness like a knife that prevented finding any comfortable position.  Fortunately, we were able to show him the exercises that would help his back calm down, and he was able to play 72 holes within 72 hours.  This is not the most amazing part...

...he came back from the trip and asked to learn what he could do to prevent that pain from ever returning.

Eliminating pain is exciting, and patients are--of course--glad to be out of pain.  Preventing future incidents is additionally rewarding.  Because I take much more time per patient than most physicians, I enjoy a unique opportunity to calm fears and educate for the future.  There is often exercises in rehab or activity that will prevent pain from returning in the same way.  I want to highlight the best start towards prevention which is a healthy mental attitude.  In three steps:

1) Loving Curiosity:  An attitude of curiosity and acceptance is crucial for lasting changes.  You must view your problem as a experience you are having, not a fault or failure.  Instead of thinking, "I have horrible posture" or "I am lazy and never exercise", you might ponder, "what get's in the way of me exercising?" or "what type of activity would I like to do?"  Too often we close the door on change by attacking the one we're trying to help: ourselves.

2) Seeking a plan:  Steps toward prevention most often include (a) optimal movement, (b) increased sleep, and (c) healthful diet.  Is there an area you would like more information on?  Do you think you could use an expert opinion on how to move, what to eat, or how to attain more rest?  Ask your physician or friends if they know an expert in that area.  Browse a few blogs and get some simple tips.  You could even comment on this blog and we'll continue the dialogue.  Be encouraged to take small steps, but keep stepping forward.

3) Following through: This is not about willpower.  Repeat that to yourself.  You will not continue activity which you do not truly enjoy.  You cannot force yourself to participate in something you find miserable or undesirable.  Dream of activity you would like to do, imagine how you might feel with appropriate rest, and how delicious healthful food might taste.  By all means, if you find yourself slowing momentum or worse yet, quitting--stop and return to step 1) Loving Curiosity.

You can best help someone you love, equipped with fresh ideas, and continuing to take small steps forward.  Best wishes on seeking the changes you desire!