by Andrew Pacholyk, MS L.Ac. ~
“Pinched nerve” is a general term that is used to describe the compression of individual nerves or groups of nerves.
Motor fibers and sensory fibers emerge from the spinal nerves. The motor fibers innervate particular muscles, while sensory fibers innervate particular areas of the skin. A skin area innervated by the sensory fibers of a single nerve root is known as a Dermatome.
A group of muscles primarily innervated by the motor fibers of a single nerve root is known as a Myotome (muscle). There is a total of 31 sets of nerves branching out of the spinal cord.
A Plexus is formed by the remaining anterior nerve divisions, which then distribute to the rest of the body. The nerves from each plexus innervate specific muscles and areas of skin in the body and are numbered according to the location in the spine from where they exit. The following are the four main plexuses:
The Cervical and Brachial plexuses innervate the upper limbs. The Lumbar and Sacral plexuses innervate the lower limbs.
Cervical plexus, C1 – C4, innervates the diaphragm, shoulder and neck
Brachial plexus, C5 – T1, innervates the upper limbs
Lumbar plexus, T12/L1 – L4, innervates the thigh
Sacral plexus, L4 – S4, innervates the leg and foot.
Having knowledge of dermatomes and myotomes can help us to differentiate different dysfunctions.
The Cervical and Brachial plexuses innervate the upper limbs and are often the cause of a pinched neck, shoulder, under arm or arm in general. The Lumbar and Sacral plexuses innervate the lower limbs and often the cause of a pinched nerve in the sacrum, the sciatic nerve and the legs or feet.
The pain may be coming from a muscle spasm or strain that’s putting pressure on the nerve, so you can try relaxing your muscles. Consider these remedies for relief:
– Alternating between heat and ice on the affected area: switch between them every 20 minutes and remember to wrap the heat and ice packs in a towel before putting them on your skin.
– Take a hot shower
– One of my favorite remedies is to Lay down with a rolled up towel under your neck. First fold the towel in half, the long way, then roll the towel up tight and lay on the floor or hard surface with the towel under your neck. The back of your head should be touching the floor once the towel is under your neck. Relax here for 15- 20 minutes. Repeat this three times a day. This helps to relax the muscles around the neck and shoulder, releases pressure around the dermatomes and helps to reshape the muscle memory around the curve of the neck.
– Use a handheld massager
– Get a massage
– Although you may not feel like it, you may want to try simply keeping your body and joints moving to find relief from pinched nerve pain.
Pinched Nerve in Shoulder/Neck
A pinched nerve can result in severe pain and disability in the shoulder and upper arm. After treating the pain with moist heat, consult your physician. Exercise therapy is one of the first courses of treatment.
Stand up and put both arms at your side. Shrug your shoulders up to your neck and try to rotate them toward your back before returning them to the starting position. Do 15 – 20 of these shrugs, take a 30-second break and repeat the set. Do this exercise, three times in a day.
Sit in a chair and interlock your fingers behind your head. Slowly move your chin toward your chest and turn to the right at the same time that you lower your chin. Hold this position for 15 – 30 seconds, then relax and return to your original position. Repeat this same movement to the left. Do it at least five times to each side. Do this exercise, three times in a day.
Pinched Nerve in Sciatic Region
Do these exercise up to 4 times a day. They help to relieve pressure on the nerve, decrease inflammation and help to retrain the muscles area affected around the nerve.
Exercise: The Back Strengthener
Lay on the floor, stomach down. Slowly lengthen out the spine as you raise one arm and the opposite leg. Exhale as you raise up into an arch. Hold this as your take two deep breaths. Slowly release back to the floor. Inhale, as your raise up the other arm and opposite leg, exhale. Hold this arch agian for two deep breaths. Lower down. Inhale. Then raise both arms, leaving both feet on the floor. Exhale. Hold the arch as you take two deep breaths. Slowly lower down. Inhale. Raise both feet off the ground, leaving both arms on the floor. Exhale. Hold the arch for two deep breaths. Slowly lower down. Inhale. Lastly, raise both arms and both legs off the floor. Exhale. Hold this full arch for two deep breaths. Slowly lower down. Inhale. Repeat entire sequence one more time. This exercise should flow easily with the breath. (Always feel the energy pulling out in both directions from the top of the head and hands and out the bottom of the feet.) Try to arch up further each time. This amazing exercise will relieve back pain!
Exercise: Abdominal Work
Ab work can be done on a daily basis. By strengthening the abdominal wall you are helping to support the lower back. 300, 400, 500 situps are not only a waste of time but allows for that many more attempts to injure yourself. It is the quality not the quantity of sit ups that makes all the difference. SLOW and controlled is the most powerful approach. Stretching a sore back will actually enhance the healing process. One good stretch for lower back pain is to gently bring your knees up to your chest. Once there, put a little pressure on your knees. Stretch, then relax. Repeat. Stretching will help the muscle calm down sooner than just waiting for it to calm down on its own.
Exercise: Sciatic Pain
Sciatic pain is generally the result of pressure on the sciatic nerve. When an intervertebral disc presses on the nerve root as it leaves the spine it causes pain and often numbness along the route of the nerve which travels down the buttock, down the thigh and sometimes down into the lower leg. This can result in a feeling of weakness as well. This is sometimes caused by a disc prolapsed or “slipped disc”. Since sciatic pain can be the result of a disc prolapsed, it is the prolapse that we need to understand. The prolapse is most often the result of a harmful habit or pattern of bending and putting stress on the spine. A herniated disc in the back, spinal stenosis and piriformis syndrome are also medical disorders that can cause sciatica.
Stretching a sore back will actually enhance the healing process. One good stretch for lower back pain is to gently bring your knees up to your chest. Once there, put a little pressure on your knees. Stretch, then relax. Repeat. Stretching will help the muscle calm down sooner than just waiting for it to calm down on its own.
A variation on this exercise is to lay on your back and gently bring one knee up to the chest. Keep the opposite leg elongated along the floor. Keep the energy of that foot moving out through the foot. Squeeze and hold the knee to the chest. You can make small circles with the knee. Pull your abs in and slowly lower the knee. Switch sides.
Stabilizing exercises are also best for strengthening the back. The most important aspect is sensing and controlling motion in the spine. Once learned, the body can eventually take over and do this without the level of concentration it takes early on.
In a standing position, cross right ankle over left knee. Now slowly bend your standing leg. Sit back in the position so you feel a stretch in the buttocks. To increase this stretch, use one hand and gently evert your foot by simple pulling the toes toward you. Keep the foot on the knee. Make sure you sit back into the buttocks in this sitting position. Switch legs.
Laying on the floor with knees bent, arms at sides, tighten abdomen and slowly raise alternate legs 3-4 inches from the floor. With the arms, lower the opposite arm over the head.
Laying on the floor with knees bent, feet on the floor, bridge upward, slowly raising the buttocks from the floor. These should all be performed with a rigid trunk. The pelvic tilt will be used to find the most comfortable position for the low back.
This same pelvic position is maintained while performing stabilizing exercises from the prone (on the stomach) position: With elbows bent and hands under the shoulders, raise one leg 2 to 3 inches from the floor. With elbows straight and arms stretched about the head, raise an arm and the opposite leg 2 to 3 inches off the floor.
Exercise variation can be done on hands and knees, raising the arms and legs only as high as can be controlled, maintaining a stable trunk and avoiding any twisting or sagging.
Raise one leg behind with the knee slightly bent and no arch in the back or neck. Raise one leg with the opposite arm with the knee slightly bent and no arch in the back or neck.
Exercise: Piriformis Syndrome
Lay on your back and gently bring one knee up to the chest. Keep the opposite leg elongated along the floor. Keep the energy of that foot moving out through the foot. Squeeze and hold the knee to the chest. You can make small circles with the knee. Pull your abs in and slowly lower the knee. Now gently stretch the knee so that it crosses your midline and hold the knee there for 15-30 seconds. Switch sides.
Acupuncture has been used in the treatment of various pain problems, including different regional myofascial pain disorders, tendonitis, joint pain and pain from nerve damage. Acupuncture has also been used for improving problems related to some internal organ functions, such as nausea and vomiting associated with chemotherapy, sinus congestion, and diarrhea. In addition, acupuncture has been used to aid in the management of some emotional disorders. Acupuncture also has been used to help individuals maintain a sense of well-being and “balance”.
Acupuncture and/or movement therapies can be combined with chiropractic manipulation for an amplified effect.
Animal studies showed that Spinal Manipulation by a chiropractor can produce a number of physical responses, such as decreased blood pressure and renal and adrenal nerve activity. It may also enhance immune function by increasing metabolic rates of certain white blood cells and increasing other substances that play a role in immune regulation and inflammation. These studies also show that spinal adjustment can reduce levels of inflammatory Prostaglandins and possibly increase levels of beta-endorphins, the natural painkillers in the body.
Chiropractic care is a cost-effective alternative to the management of neuromusculoskeletal conditions. It is also safer, increasingly accepted by the public as reflected in the growing utilization and high patient retention rates and there is much and repeated evidence that patients prefer chiropractic over other forms of care for the more common musculoskeletal conditions. The integration of chiropractic into the health care system should serve to reduce health care costs, improve accessibility to needed care, and improve health outcomes. There is an extensive body of literature demonstrating that chiropractic care for NMS disorders is effective.