Do Pinched Nerves Hurt?
Most of us have been taught if we have a pinched nerve that we will feel it and, in most instances, it will be very painful. As I will explain using neuroanatomy and neurophysiology, up to 90% of pinched nerves don’t hurt and we just will not feel them at all. When certain types of nerves are pinched, oh yes, they can be extremely painful. That of course gets us to finally pay attention and seek some form of solution.
Are Nerves Easily to Pinch?
Since nerves are so important in the function of our bodies, we have been engineered or developed to not allow them to be pinched easily. Nerves inside the brain or in the spinal cord are protected by bone since they are so important. When nerves leave the spine, they are also protected by a fibrous membrane called the neurolemma. Nerves outside the spinal cord, or peripheral nerves, especially the large nerves run under muscles and tissues close to the bone. While some muscles and soft tissue structures can cause pressure or grow scar tissue and adhesions to the nerve, compression syndromes are common in the average human. Soft tissue compression syndromes happen through repetitive or significant traumas as in factory workers and seasoned athletes.
Nerve Vulnerabilities
There are a few areas in the body however, that nerves are vulnerable to pressure. In all of these instances it is a harder tissue or bone that compresses the nerve. While nerves can be pinched in the bones of the wrist and foot the most common area of vulnerability and pressure is when they exit the spine. In between every two vertebrae there exists a whole where the spinal nerve root exits the spine. This whole or foramen is moveable since its roof is comprised of the lower portion of the vertebra above and its floor is comprised of the top portion of the vertebra below. Its front wall is mostly the interverbal disc and its back wall consists of parts of the above and below vertebra that are tongue and grooved and slide on one another called facets. While this foramina is built to be dynamic and the nerve root usually has plenty of room sometimes this space becomes narrowed. When vertebrae are abused over time and they become misaligned, this process wears out the tissues in and around the foramen eventually decreasing the size of this nerve whole and causing pressure on the nerve root.
What Happens to the Nerve Root When Compressed? 
The word pinched is a general term for pressured, compressed, compromised and any other terms describing abnormal force being applied. What happens to the nerve root and individual nerves varies depending upon the type of pressure and what type of nerve fiber is being pinched. First of all, there are 31 paired nerve roots exiting the spine. Each one can be comprised of up to one half million individual nerves. Therefore, depending upon the level of the spine there can be 1 million individual nerves passing from each spinal level. Roughly 50% enter the spine or are sensory and 50% exit the spine or are called motor nerves since they control skeletal muscle or internal organ muscles. So, if you pinch a motor nerve you won’t feel it. You may see a weak leg, arm/hand or it could result in a lazy diaphragm or bladder causing difficulty to breathe deeply or hold your urine. If you put pressure on a sensory nerve entering the spine you many feel this, but it's not very likely. Most sensory nerves entering the spine are not sensory for anything we can feel. These nerves are sensory for muscle movement, lung expansion, arterial pressure in our extremities, chemical makeup of the bolus of food passing from our stomach into the duodenum, etc. Only 10 % of the sensory nerves entering our spine carry signals we comprehend as a feeling. Some may carry pain, but most carry other sensations like cold, heat, vibration, stretching. That is why the most common sensation we have when we feel a pinched nerve is tingling or what is called paresthesia. Some people will feel a burning sensation, or it feels cold or it feels like ants are crawling all of which depends upon what type of nerve is pinched.
My Back Doesn’t Hurt but I Still Have Sciatica or Foot Problems
While its confusing to most people, many of us have spinal nerve problems but don’t have back pain. Our brains also have a great ability to turn the pain volume down. While the brain knows there is a spinal issue and is tightening muscles around the spine or pulling the pelvis down to take pressure off the back, we don’t feel it unless we aggravate it. This happens in our necks when we sleep on it wrong. The problem is there, and we aggravate it by sleeping on it. The same goes for our low back. We often have a problem, the brain accommodates and either we don’t feel it at all, or we feel it in the buttock, knee, ankle, or foot. We think it's a knee problem or foot problem only to find the orthopedic exam and x-rays don’t show any problems.
Piriformis Syndrome
A commonly misdiagnosed condition is a piriformis syndrome. While the piriformis muscle can pinch the sciatic nerve this does not happen often. It has been shown to only happen in approximately 5% of all sciatic presentations. This presents more often in athletic injuries or someone who stresses that area of the body regularly as in hockey or soccer players who do a lot of lateral leg movement. In 95% of sciatic cases it is the lower lumbar spine compressing the nerves which make up the sciatic nerve.
How To Prevent Pinched Nerves
While it is good that we don’t feel all pinched nerves, the negative result is that we don’t know until the nerve compression is more advanced. To find them, have a chiropractic examination. Chiropractors see a spine in a much different way than the rest of the medical profession. They specialize in finding and correcting spinal problems before they present with symptoms so the spine and nervous system can become and remain healthy. Just like we have been taught to have our teeth examined when we are young to prevent cavities and tooth decay, I recommend that all parents have their children’s spine checked for spinal misalignments before they cause nerve pressure. Chiropractic care for children is applied using a very light force, does not consist of an acute repetitive corrective visit schedule and in most cases saves the child and parents from having many of the not really normal childhood sickness. Even adults who get in before their conditions become advanced find care to be beneficial and report of feelings of increased range of motion, energy, and an overall feeling of well-being.
Dr. Stephen Upchurch
Upchurch Chiropractic, LLC
2436 Rochester Rd.
Royal Oak, MI 48073
visit us at Upchurchchiropractic.com or call (248) 545-8550