If you have ever had a pinched nerve or formally been diagnosed with stenosis, than you know the serious nature of the symptoms. Pain, tingling, and numbness can radiate down a specific nerve, creating consistent and repeatable suffering. The purpose of this blog post is to educate what it is, which types are most common, and how to treat it.
“Why is my nerve being pinched to start with?”
Technically speaking, a “pinched nerve” is not a formal diagnosis. It is simply accepted by the general public as describing several different origins of nerve compression. I’m going to break this down into 2 primary conditions:
- Peripheral Nerve Entrapment
- Foraminal Stenosis
Peripheral Nerve Entrapment
The key to understanding any diagnosis is breaking down the language. To take this quite literally, it means that the nerve is being compressed on the periphery, or, away from the spine itself. Most commonly, the nerve is being pinched by a muscle or soft tissue structure. A common example of this is Thoracic Outlet Syndrome or Piriformis Syndrome. In both examples, there are nerves being compressed by a large muscle group. In the thoracic outlet syndrome, a group of the lower cervical nerves can be compressed, creating pain, tingling, and numbness down the arm and into the hand. In the piriformis syndrome, the same concept is applied, except typically the sciatic or lower lumbar nerves are compressed in the piriformis muscle and the result is pain, tingling , and numbness down the back of the leg and into the foot.
Treatment of a peripheral nerve entrapment is dependent on the total analysis of the diagnosis. Meaning, “why is the muscle compressing the nerve to begin with?” In some cases, strategic stretches or exercise can reduce the compression and resolve the symptoms. In other instances, we can look to the posture and alignment to determine the reason why the muscles are in spasm or chronically tight to begin with. My advice to you: find the root cause of why the nerve is being compressed, as opposed to just treating the symptom. It will make for a more permanent recovery.
Foraminal Stenosis
Foraminal stenosis is often diagnosed on MRI or X-Ray. In this condition, the space between vertebrae where the spinal nerves exit the spine is being narrowed significantly to create pressure on the nerve root. As opposed to the peripheral entrapment, foraminal stenosis is compressing the nerve directly at the spinal level. This type of condition occurs generally in an older individual with moderate to significant amounts of osteoarthritis, and degenerative joint and disc disease. When the disc becomes compressed, the joints become arthritic with bone spurs and osteophytes. A combination of reduced disc height creating smaller foramen size, along with added bone growth from the arthritis creates the nerve compression.
Treatment for the foraminal stenosis requires analysis of the spinal alignment. Often times cervical arthritis results from abnormal spinal postures, notably, forward head postures and loss of cervical curve. Increasing the curvature and improving function are vital to reducing the symptom.
We help people everyday in the Walnut Creek community suffering from pinched nerves, foraminal stenosis or peripheral nerve entrapment’s.
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