“Dear Osteopath, I have a trapped nerve”. “Dear Patient, where does it hurt?” “Right here. In this spot!”
We hear so often from patients that they think they have a pinched or trapped nerve. They feel an acute pain that is not normally felt and believe it is a trapped nerve. Most of the time, however, it is nothing of the sort.
What is a trapped or pinched nerve?
Nerve impingement is a condition where either an exiting nerve root can be commonly impinged by a bulging inter-vertebral disc (slipped disc) or affected by common impingement sites along its course. Examples of common impingement sites are the piriformis muscle in relation to the sciatic nerve, the cubital tunnel for the ulnar nerve and the thoracic outlet for the brachial plexus. There are, of course, other sites and causes.
Whatever the cause of a ‘pinched nerve’, the symptoms are almost always the same. We can experience radiculopathy, parasthesia and weakness, in other words shooting or lightning-like pain down the course of the affected nerve, pins and needles, numbness or sensory changes, reduced strength and reflexes.
This means that when someone comes in and says “I have sciatica” or “It hurts in my back or buttock” but not down the course of the nerve – down the back of the leg, possibly to the foot – there is a very good chance that it is not sciatica or a pinched nerve.
So, if it is a pinched nerve, what can be done?
I can mobilise and ‘stretch’ nerves, releasing pressure from impingement sites and adverse neural tension. I can safely manipulate joints that may affect the area and give patients some exercises to floss or stretch the nerves.
Here is a great clip from YouTube showing how a nerve glides and how it can directly be affected.