Wow. What a broad category “pinched nerves” are. It’s one of those catch all terms that encompasses dozens of conditions and symptoms. To narrow it down for your sake and mine, let’s focus on the top three most common types of pinched nerves in my next series of blog posts: Joint Dysfunction (SUBLUXATION), Disc Herniation, and Thoracic Outlet Syndrome (TOS). Let’s also discuss how very treatable those three conditions are under the care of a chiropractic physician.
The Joint Dysfunction
Old-school chiropractic philosophy was very simple. A joint dysfunction, also called a subluxation, is a BOOP (Bone Out Of Place). The general idea is that a vertebra or extremity bone rotates out of position and physically puts pressure on the nerve that runs right alongside of it. I don’t criticize that old school oversimplification because they didn’t have the complex testing and diagnostic equipment we have today. 100 years ago they didn’t have the level of technology we have today so it would have been impossible for them to truly know what was happening on a cellular level. I think they did a pretty good job for the level of knowledge they had at the time. Remember…150 years ago medical doctors were using leeches and cutting patients to let them bleed the sickness out. 50 years ago they prescribed cigarettes. So all in all, early chiropractors did a good job.
Yes, when you are a patient in this office I still describe a joint dysfunction as a rotation of a joint that can put pressure on a nerve and “pinch it”. It’s an oversimplification to avoid an hour long explanation of the science behind what is truly happening. Since we have the time to explain it in a blog post, let’s do it now!
With a joint dysfunction, one side of a vertebra becomes stuck. Why it becomes stuck can be a dozen different reasons. Sometimes the cartilage of the joint sticks under one part of the joint and won’t let the bone move. Or the two bones of the joint jam together during an injury and stick to each other. Physically one bone gets in the way of the other bone moving freely. It’s like trying to open the door of your house but something is blocking it from swinging open on the inside. Sometimes the muscle on top of the joint spasms so hard it prevents the joint from moving and actually pulls the vertebra and rotates it. So YES, the vertebra does actually rotate a little bit during a subluxation. However it’s only a few millimeters. It’s a VERY SMALL rotation, but it can have HUGE impacts.
Everyone experiences the symptoms of joint dysfunction differently depending on their threshold for pain. Some people can feel the pain immediately. Some people can go decades and never know what’s happening in their spine. Over those decades however, the immobility in the joints will cause the cartilage to break down and we end up with arthritis in the spine.
So when a joint dysfunction occurs, in your spine or in any joint in your body, you have hundreds of little nerves that can sense the loss of motion. They don’t feel the pain from it, but they can tell that the joint is not moving properly. As a result, the tissue around the joint (muscles, fibroblasts, the joint capsule itself, the vertebral disc, etc.) release inflammatory chemicals. Inflammatory chemicals are released by the body when you have an injury and actually activate the healing process. Some of these chemicals send an “OUCH” signal to your brain and some of them tell the body to start healing the injury.
Inflammatory chemicals also cause swelling. This is the PINCHED NERVE part of the speech. The swelling will grow and grow and start to push against all the tissue around the joint that is subluxated. In the spine, one of those local tissues is the spinal nerve! It’s very rare during a subluxation that a bone rotates and causes the pinched nerve. 99% of the time, the rotated vertebra causes severe inflammation, causing swelling around the nerve which “pinches” it. So now wherever that nerve travels to (the heart, your pinky finger, etc.) might not function like it is supposed to.
Now that we’ve explained what a joint dysfunction/subluxation truly is and how it can be classified as a Pinched Nerve type disorder, let’s take a step back and explain why if this is happening to you – you need to be under the care of a chiropractic physician.
With most of your body, inflammation is just the first step in the healing process. Once the inflammation starts to diminish, the healing will continue until you are back to normal and healthy. With a joint dysfunction, until the joint starts to move properly again the inflammation never goes away. So you never leave the first step in the healing process and you can never go back to normal. It starts a vicious cycle that leads to more and more inflammation. Which means more and more swelling and pressure on that nerve!
(Prostagladins are one of the inflammatory chemicals referred to earlier)
So until that joint dysfunction is fixed, you can’t get healthy. Years and decades of inflammation cause crippling pain and arthritis, abnormal walking patterns and bad posture, and of course pinched nerve symptoms! Chiropractors like to use the safety pin analogy to explain what is happening…
So that means we have to fix that joint dysfunction. The joint isn’t moving remember, it is essentially stuck. So we as physicians have to help the joint to move again. ONLY chiropractic physicians, medical physicians, osteopaths, and doctors of physical therapy are licensed to perform manipulations (aka an adjustment) to the body. However, over 90% of all manipulations ever performed were done by a chiropractor. Just based on the amount of training we receive in manipulation techniques, we are by far the most adept at it. A manipulation technique is to use our hands or an instrument to help the joint start to move again.
In some patients, the results are almost instantaneous. Some patients that walk in using a cane for the first time practically jump off the table and walk out without the need for the cane. Remember that’s just our best case scenario but it can definitely happen! By helping that joint start to move again we can bring an end to the inflammation, help the healing process finish, restore range of motion, decrease pain, and alleviate muscle spasm. One treatment can’t fix you, but it can be a very powerful healing technique!
So obviously the whole process is a lot more complex than you might think. We try and break it down simply for you in the office. Joint is stuck -> can cause a pinched nerve -> helping that joint move again will relieve a lot of your symptoms. But I love the science behind it, so feel free to ask me more questions about the specifics.
This is a lot more common than you might think. If you aren’t a patient in this office ask around and find one of your friends who sees a chiropractor and ask them how their lives have changed. Give us a call at 336-270-3050 and find out for yourself how we can help your pain.
Next week let’s talk about Disc Herniations!