Earlier today, a patient came to our Pompano Beach Chiropractic clinic for the first time with what she called a "Pinched Nerve". Her husband was with her, since she was in so much pain that she was afraid to be alone. Today was day two of this excruciating neck pain that was radiating into her left shoulder, arm, forearm, and hand. The slightest movement triggered lightning like spasms and more tears.
For the past two days, this woman has been seeking help. Yesterday, she even had an neck MRI to search for the cause of her pain. She was told she had a bulging disk, but that it shouldn't be causing this much pain.
A little digging into the recent patient history revealed the all too familiar fatal mistake; she has been using heat on the acute pain problem. Heat initially seemed to help ease the pain, but now it seems to be worsening rather than getting better.
I'll get to the rest of this story in a couple minutes. But first, let's discuss what a pinched nerve is.
The diagnosis "Pinched Nerve" is usually given when patients have pain that radiates from the spine into either an arm or leg. The slightest move in the wrong direction seems to pinch the nerve more. A move in the other direction seems to unpinch the involved nerve to some extent. But the reality is, in most cases, the nerve is not acutally "pinched".
The pinched nerve diagnosis is one of those visual names sometimes given by doctors so that the patient has something to understand. It is a lay description of a stretched, impinged, or irritated nerve. The problem with the diagnosis, however, is that the mental image of a pinched nerve is one that is trapped between two bones; kind of like a garden hose trapped under a car tire. But x-rays and MRI's rarely demonstrate bones and herniated discs to be pinching spinal nerves.
Herniated disc material is sometimes demonstrated as approaching or even pressing against the thecal sac, a protective bag that surrounds the spinal cord. But in the hundreds of MRI's I have seen, I have never seen a "pinched nerve". That does not mean that they do not exist. However, anatomically it is very unlikely to occur.
So if the nerve is not pinched, what is causing all of this pain?
The usual "pinched nerve" actually involves an irritated nerve. There is usually some degree of damaged tissue that causes inflammation. Inflammation takes up space and can increase the pressure on the spinal nerves. When heat is added in the form of hot packs or a heating pad, the amount of inflammation can easily increase, which is why heat tends to make the radiating pain worse with "acute" problems.
Over the years I have had many patients that first went to the hospital with their extreme neck and back pains only to be referred by the Emergence Room physicians to the chiropractor. In almost every single case, the patient had a lesser pain problem and put heat on it thinking it would get better. But within a couple hours of applying heat, the pain became unbearable creating the need for an ER visit.
You may be wondering "What can a chiropractor possibly do for such extreme pain... isn't it true that chiropractors can't prescribe anything for the pain?". The answer might surprise you.
I am certain that chiropractors understand these problems and can help patients with these problems better than any other health care professionals out there. That might sound like a pretty bold statement to make. But the reality is, that is what we do.
These problems are almost always caused by a "vertebral subluxation complex". Locating and correcting subluxations is what chiropractors do. It is true that chiropractors do not prescribe medicine. They do not even treat the pain. Chiropractors are more interested in locating and correcting the cause of the problems.
So back to my patient:
In this case, no x-rays were needed. Sometimes we take x-rays and sometimes we don't. Just yesterday, she had an MRI and was told that they didn't see a cause for such pain. If no structural problem was causing it... what was it?
After a brief exam to rule out other possible causes... remember, the pain radiated into the left arm... I had to rule out a heart attack of course. I was able to locate a functional problem that caused the pain. She had a vertebral joint that was inflammed and not funtioning properly. After a little gentle soft tissue work, I was able to give a gentle spot-on osseous adjustment that provided some degree of immediate relief. We then did very gentle specific range of motion exercises to help pump some of that excess inflammation out of the area. We then applied ice packs to vaso-constrict the vessels and minimize any new inflammation to the area.
During a follow up visit later in the day, the patient was doing better. A slightly more agressive specific osseous chiropractic adjustment provided even greater relief. I expect her to be more than 50% better tomorrow.
If you think you have a pinched nerve in your neck or back, make an appointment to see your chiropractor today.
Dr. Michael Haley
Pompano Beach, Florida 33060