Dr. Chung
Anatomy of a Pinched Nerve
Anatomy of a Headache I decided to tackle another common problem we see every single day in the office.
Pinched Nerves When someone gets an acute pinched nerve, it can be amongst the most painful problems that afflict human beings. Pinched nerves can leave people in lying in bed with an inability to work, exercise, sleep or play. When it happens people take on really strange and awkward postures to try to avoid the pain. But there's a lot of misconceptions about what a pinched nerve actually is. A lot of people feel like if their neck or back has a pinching or stabbing type pain, then it's likely a pinched nerve. However, multiple types of neck pain can lead to a pinching type of pain. A true pinched nerve involves multiple factors. 1. A Tissue Offender There are several different types of tissues that can pinch a nerve. Bone, muscle, tendons, and calcified ligaments are all compress nerve tissue throughout the body. Even tumors can cause pinched nerves, but those are in much more rare circumstances. The overwhelming majority of pinched nerve pain stems from a problem you're probably familiar with. The slipped/herniated disc. Tearing of the outer part of the disc allows for a gel like material to spew out into a small space where a nerve travels. Most herniated discs don't cause problems. I can take an MRI of 100 random people with no pain and chances are high that many of them will have a disc herniation. The herniation only becomes problematic when it is large enough, or you move in a way to force this gel into the nerve against some of the other hard structure in the spine. 2. Soft and Sensitive Nerves Nerve tissue is soft and sensitive. Even small amounts of pressure against a nerve can make it go haywire. They are like the iPhone charging cables of the tissue world. Just a little bit of stress and the whole thing comes unraveled. That's why your body protects the most sensitive nerve tissue (brain, spinal cord, spinal nerves) in a case of bone called your skull and your spine. But it's not just sensitive to pressure. It's also sensitive to chemical signals like inflammation. Which brings us to the third important piece of anatomy. 3. Inflammatory Chemicals Inflammation from a torn or damaged disc can build up around the nerve and stimulate the nerve to create a pain response. This is especially true when you injure a disc very suddenly....like in a car accident or picking up a heavy box. Cells from your immune system rush to the site of damage and try to clean up the mess. The result is a large number of inflammatory molecules called cytokines and substance P fills that area and can trigger a pain response from the nearby nerve. I always compare the body's use of inflammation to a fire/burning process. When your body uses inflammation it is like using a fire to burn away germs or damaged tissue in the body. The main problem with fire is that it can sometimes cause damage your own body too. This is especially problematic when inflammation affects a nerve.