Pinched nerves are common problems in the neck and low back. In the neck and low back there is a lot of movement, which tends to wear out the discs faster than in the middle back region such as between the shoulder blades. When discs wear out, over time, they can bulge or herniate, putting pressure on the nerves that exit on the right or left side of the neck or low back. When nerves are pinched, the pain will typically be felt down the arm or leg. Early in the process a mildly pinched nerve may only refer pain from the neck to the shoulder blade area, but as the process progresses and gets worse, it will radiate further down the arm or leg.
Pinched nerves will typically result in weakness of the muscles innervated by the nerve or with reflex changes of the muscles and, most commonly, and firstly, with sensory changes such as the perception of pain in the arm or leg, or tingling or numbness.
In the low back, when a nerve is pinched, early in the process you may feel pain only in the buttock or thigh. When the pain or symptoms radiate beyond the thigh, into the leg and foot we infer that this is definitely a pinched nerve. Once again signs and symptoms associated with a pinched nerve in the low back can result in loss of motor function, which is least common, and more commonly will result in pain, tingling and numbness down the buttock, thigh, leg and foot. Reflex changes may also be present. When the pain from a pinched nerve in the low back goes down the buttock, back of the thigh, and back or side of the leg we call this sciatica. The reason is that the sciatic nerve is a nerve in the buttocks and leg, which is comprised of five nerve roots in the lowermost low back and sacral regions. Sciatica is pain in the sciatic distribution of your leg. This is a very common phenomenon, typically resulting from a bulging or herniated disc. On rare occasions, it can be from some other “space occupying lesion” such as a tumor. Another less common source of pinched nerves can be instability of the spine such as spondylolisthesis. In this case, of spondylolisthesis, there is slippage of one vertebra on another which results in traction forces or compressive forces on the nerves because as one vertebra slips forward on another the tunnel which is made up of the back part of the vertebrae does not line up and when the holes of the tunnel don’t line up, nerves can get pinched as they descend from one part of the tunnel to the next part of the tunnel. Technically, I should call this a canal, as it is technically the central canal or neural canal. Nerves can also be pinched on either side between the vertebrae where we have smaller holes called foramina.
My spinal decompression treatment is the most effective nonsurgical approach to treating pinched nerves, by pulling the vertebrae apart, and relieving pressure on the nerves. Generally, by getting pressure off of the nerves, the inflammation of the nerve root will subside once the pressure is off of it. Therefore, steroid injections are not necessary. There are occasions, however, when all of the pressure cannot be taken off of the nerve root with spinal decompression treatment. In this circumstance, I will send people for the epidural corticosteroid injections. I probably do this, however, only in about 5% of cases. Without the use of spinal decompression treatment, probably about 30% of people will end up getting epidural corticosteroid injections for their pain. And some of those will end up getting surgical treatment.
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