Gettin' the Skinny on Pinched Nerves
By Dean Moyer
Author of Rebuild Your Back
Have you ever wondered if your symptoms might be the result of a pinched nerve? How would you know? How could you tell if it was? After all, pinched nerves won't show up on X-rays or other diagnostic scans.
Today, we're going to look at how your doctor checks for pinched nerves and ways you can assist him in diagnosing your situation.
The more you know about pinched nerves, the better you'll be at communicating with your doctor, and the better chance you'll both have of arriving at an accurate solution.
Understanding The Terminology
Doctors use a lettering system to identify the sections of your spine. They label each segment of your spine corresponding to the individual vertebrae themselves. For example the bones of the cervical spine in your neck are labeled C1-C7 from top to bottom. The five lumbar vertebrae are labeled L1-L5 in the same fashion.
As the nerves branch off from the spinal cord they are referred to as nerve roots because they resemble the roots of a tree. The nerve roots run through the bony spinal canal and branch off in pairs at each level of the vertebrae.
In the cervical spine (or neck), the nerve root is named for the lower segment of vertebra that it runs between. For example, a pinched nerve at the C6 root is so named because it exits the spinal cord at the C5-C6 segment.
In the lumbar spine, a pinched nerve root is named for the upper segment that it runs between. Therefore, a pinched nerve at the L4 nerve root will be located between the L4-L5 segment.
Typical Symptoms of Pinched Nerves
As it turns out the two most commonly pinched nerves are L5 (lumbar 5) and S1 (sacral 1) so we'll look at those bad boys first.
The L5 nerve supplies the nerve impulses for the muscles that raise the foot and big toe. So a pinched nerve at L5 may cause weakness in your foot or toes. Another sign of a pinched L5 nerve would be if you experience numbness in the top of your foot.
The S1 nerve provides the nerve impulses to the back of the calf. Therefore, a pinched nerve at S1 may cause weakness of the large muscles at the back of the calf. Most notably, you may find it difficult to push off with that foot. The S1 nerve also supplies response for the ankle jerk test, which is similar to the knee jerk test your doctor may have performed during your last physical checkup.
Your back pain specialist may tap the Achilles tendon to see if this causes the foot to push downward. If this reflex is not present it indicates that you may have a pinched nerve at the S1 location.
A third indication of a pinched nerve at S1 is a feeling of numbness on the outside of the foot.
What About The Nerves in Your Neck?
The most common pinched nerve in the cervical spine is a tie between either the C6 or C7 nerve roots. The second most common pinched nerves are C5 or C8. In any case, this gives us four possibilities to consider. Depending on which pinched nerve we're dealing with, the following symptoms may occur:
A pinched nerve at C5 will result in shoulder pain, weakness in the deltoid muscles, and possibly numbness in the shoulder area. Your back pain specialist may check to see if your biceps reflex is strong or if it has been reduced.
A pinched nerve at C6 will cause pain in your arm that runs down into your thumb. You may experience weakness in your biceps or wrist muscles. Your doctor or other back pain specialist may check your mid-forearm reflex to see if it has been diminished.
A pinched nerve at C7 will cause pain or numbness that travels down the arm to the middle finger. Your back pain specialist in this case will check the triceps reflex, which is the muscle on the back or your upper arm.
Finally, a pinched nerve at C8 will result in pain or numbness in the outside of the hand. This is because the C8 nerve controls the function of the hand and so your back pain specialist will check for hand reflex impairment.
Treatment For A Pinched Nerve
Pinched nerves tend to heal slowly. It's just a fact of life and we all have to live with it. How long it takes will depend on how much damage was done when the nerve was pinched. Be prepared for it to take several weeks or even months to heal. Usually a pinched nerve does not mean that you will have a loss of function or that you need to worry about such things as paralysis.
It is also a fact of life that the body heals itself. There is nothing you, your doctor, your physical therapist or other back pain specialist can do to heal a pinched nerve. All treatment for pinched nerves is limited solely to the relief of pain. After that, the nerve must be allowed to heal on its own.
It is an interesting fact that pinched nerves need both inflammation and pressure to be painful. So as you go about rebuilding your back, you will want to concentrate on exercises that relieve the pressure on the nerve. If you relieve the pressure, you will most likely relieve the irritation that is causing the inflammation.
Once the pressure is relieved the pain will probably subside even though the pinched nerve is not fully healed. Don't make the mistake of stopping your reconditioning program or the pain may come back. Also, be patient and keep in mind that it may take longer to relieve the pain of a pinched nerve than for any other form of back or neck pain.
About the Author
Rebuild Your Back
Rebuild Your Neck
The Pain Relief Manual
Last updated: April 12, 2010