One of the more common questions we get online, in the clinic and over the phone – “Can you help with a pinched nerve?” It’s a very, very broad and non-specific type question but just to answer it right off the bat, most of the time, “Yes.”
First, we need a proper diagnosis to figure out what is the putting pressure on the nerve. Our spinal cord runs up our back and throughout the spinal column and what comes off the spinal cord are nerves that obviously innervate everything in our body.
We could have a problem with a disc. Herniated or bulging discs put pressure on a nerve. Misalignment or rotation of vertebrae could irritate a nerve, as well. With disc problems, we take a different approach. We don’t want to move a disc because it’s unstable. There’s too much pressure on the disc already so we want to try and figure out how to stabilize it. We want to figure out how to get some of that pressure off that disc and onto some of the surrounding structures like the spinal stabilizers and the core.
Misalignment and restriction in the spine itself are mechanical dysfunction. Manipulation is a good option for that. We can reestablish motion and get some things moving properly in hopes that that will reduce some of the irritation into that nerve root.
Typically, you’re going to have some type of referred pain. It could be sciatica or sciatic type pain down into one of your butt cheeks or down into your lower extremity or your leg. That’s just secondary to the problem in the back. We don’t want to chase the leg pain. We will take you through different tests and determine what the issue is. And if we make a determination that there is a disc problem or some type of nerve irritation in the low back we want to address the source of the pain in the low back.
You don’t want to rely on “Dr. Google.” At Tulsa Spine and Rehab our office, we take an extensive history, conduct an examination that includes orthopedic and neurological tests. If needed, we take an MRI or an x-ray. Once these are done we’ll know exactly what’s going on and we can make sure you have a good understanding of the treatment needed.
We’ll explain through just how are we going to get pressure off the nerve itself. It may be an entrapment or pinching or nerve irritation in the extremities such as carpal tunnel syndrome. It may be an ulnar entrapment, which is entrapment of the nerve at your elbow even down into the foot so in different joints where nerves pass through we have irritation of the nerve. Sometime surgery is indicated for that. Other times conservative care such as physical therapy, different treatment modalities, stretching some other things can be effective for those types of cases as well.
You may be prone to relapses if you have a job or hobby where you use your hands a lot to type or maybe play a guitar. If we’re able to manage a low back disc problem that’s putting some pressure on the nerve, we can educate the patient on what they can do moving forward. A lot of times its about education, empowering yourself as a patient. If this does come back, what are the steps that I go through, what should I do, what should I not do?
If you’d like to ask Dr. Riley a question, you’ll find a submission form on the right hand side of the web page or you can contact Sean using the comment section below.
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