Until recently, chiropractors had explained pain using the “pinched” nerve analogy for decades and their patients repeated it to the general public for just as long. The commonly used term “pinched” nerve is a misnomer. The origin of this misconception comes from the time when chiropractors used to talk about a “pinched” nerve as they explained the importance of correct spinal alignment.
Spinal nerves exit between the vertebrae that compose the spinal column through holes. These holes are called vertebral foramina (sing. foramen). You can see them exiting the vertebral bodies and facet joints on the left. In the old days, we (chiropractors) believed that incorrect alignment of the spine would narrow the vertebral foramina compressing spinal nerves, triggering pain and affecting the function of many areas and organs.
Now we know that this is untrue. Mother nature designed the vertebral foramina (holes) comfortably larger than the nerves that exit them. This design allow us to bend forward, back and to the sides, and to rotate our spines to the left and right without compromising the integrity and function of spinal nerves and the structures they innervate. So basically, unless you have some pathological process brewing in your spine, your little aches and pains are NOT likely to be caused by a “pinched” nerve. At least not from the spine.
But what happens when we have bad posture? When the spine doesn’t move correctly, its structures become overstressed. When this happens, spinal joint components (ligaments, discs, cartilage, etc) may become injured and inflammation ensues. If posture and joint movement are not corrected, inflammation will impair the repairing process, our spine deteriorates and pain along the spine and in other areas like the shoulders and hip develops. If you are wondering, yes, pain can develop over the course of a few hours in a bad position (watching TV, working on a computer, sleeping) or over years doing the same movements over and over again as in the case of a career hair stylist or flight attendant (like I used to be). Some people call this kind of pain “pinched” nerve, when in reality the nerves have not yet been affected at all.
Can bad posture or spinal “misalignment” give you a actual “pinched” nerve? Well, sort of. Bad alignment can set spinal deterioration in motion. Unfortunately, if we do nothing to improve our posture and biomecanics over the years (the way you move, stand, sit or even lay down to sleep), the spinal structures we overstress fail. Our discs can degenerate decreasing the space between vertebrae, as well as the size of the vertebral foramina. Our vertebrae can develop osteophytes (bony growths) that can also decrease the size of the vertebral foramina (as it happens with osteoarthritis). Carry this level of deterioration to the extreme and nerve irritation or compression might become a reality for some. A “pinched” nerve might become a reality for some.
Also, nerve entrapments like carpal tunnel syndrome or space occupying lesions like a disc
extrusion on a nerve root would qualify as a “pinched” or compressed nerve. Depending on the duration and severity of the event causing a real pinched nerve, patients will experience a combination of pain (often electric), numbness and tingling, loss of strength and sensation in the areas supplied by the nerve involved. A real “pinched” nerve must be taken care of immediately.
The take home lesson from this entry is. Yes, pinched (compressed) nerves exist in rare cases. And no, if you can go to work and do your daily chores, chances are you do NOT have a pinched nerve. The diagnosis of a “pinched” nerve should be left to a health professional. Even then, it is highly unlikely that the health professional will call it a “pinched” nerve. So, why should you?