Nerves - like discs - often inspire fear in people. Yes, they can be injured just like other structures, but nerve problems are not necessarily more severe than other types of orthopedic problems.
We temporarily impact nerves all the time, stretching them and compressing them just like other structures. You bang your funny bone and your arm throbs for a minute. You sit on your leg and your leg and foot go to sleep for a few minutes. These examples teach us both how resilient nerves can be and how irritation and compression can create symptoms. (Perhaps even more importantly, they teach people that nerves can send symptoms away from where the root of the problem is.) Understanding how your body works is the first step in mitigating fear when something goes wrong.
Most nerve irritation problems I see stem from the nerves being irritated near the spine. These irritations create variable symptoms; it can feel like the numbness and tingling you feel when you compress a peripheral nerve in your arm or leg or it can be pain, tightness, heat, etc. Nerves serve the very important role of relaying information and sensation throughout your body, and, like other structures, they can usually heal given the right environment.
I sat at a performance years ago with my legs crossed for at least 30 minutes without moving. When I went to get up I almost fell because there was little power in my ankle muscles nor was there great sensation. I realized what had happened and I wasn’t afraid. On the contrary, I thought it was really fascinating how I couldn’t lift my foot up at all. I expected it to resolve in 15 minutes or so and it did. I often remember that incident when I happen to be sitting with my legs crossed, the back of one knee over the other.
Big picture: don’t be afraid when it comes to nerves. If they get compressed or irritated wherever in the body, most of the time, by removing the compression (typically with movements) and by giving it an environment to heal, it will heal. To be clear, many neurological symptoms (having to do with nerves) are not orthopedic in nature, but they too can usually be fixed if you get the correct diagnosis. --Laura
In brief, spinal nerves are responsible for sensation in a certain area and power to certain muscles. There are thirty-one spinal nerves, numbered according to the area of the spine where they emerge. We often name nerves that are the combination of two of more spinal nerves, such as the sciatic nerve, which is the combination of lumbar nerves 4 & 5 and sacral nerves 1, 2, & 3. (The sciatic nerve is usually irritated by way of the fact that one of its five spinal nerve roots - at the level of the spine - is irritated. As I’ve written before, nerve entrapments in the periphery, outside of the spine, are rare.) Spinal nerve roots are commonly irritated.
In contrast, cutaneous nerves, which are named, are responsible for sensation in a certain area, but do not power muscles. In the absence of direct trauma or compression (including due to surgery), it’s rare to irritate these nerves.
Even though their sensory areas overlap, in the presence of a sensory problem (numbness, tingling, pain), there’s a way to determine which is at fault. We have clinical nerve tension tests, muscle power testing, and repeated movement testing to indicate which nerve is the problem. We don’t have to guess. -- Laura
Certain diagnoses create constant symptoms. Certain diagnoses create consistent symptoms. Constant numbness, tingling, pain, etc. means it’s there every waking moment. It may vary in intensity, but it’s there regardless of your activity or position. Consistent is similar to predictable. Each and every time I jump my knee hurts. Each and every time I bend to put on my shoes my calf feels like it’s on fire. Each and every time I play golf three days in a row my shoulder acts up. As a clinician, I need to know which questions to ask and then how to interpret the patient’s answers to accurately diagnose.
Painful thumbs? Numb fingers or hands? Weak grip? The nerves in the neck and the upper mid-back control the hands. Specifically, nerves C6, C7, C8, and T1. (The "C" stands for cervical, which means neck. The "T" stands for thoracic, which refers to the mid-back.) Most hand issues are a result of the nerves in the neck/upper mid-back being compressed. If someone has problems in BOTH hands, the issue is almost ALWAYS coming from the spine. While it is normal for your hand to fall asleep if you lie on it in a weird position, it is not normal to experience numbness/tingling/pain on a regular basis, even with sleeping. If I determine that your hand symptoms are indeed coming from the nerves in your spine, I treat it with two things: movements to decompress the nerves and postural correction. Posture can refer to your sitting, lounging, and/or sleeping habits. I often suggest modifications to your car seat too. --Laura
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