Nerve roots, or major nerves being compressed by local tissues
Possibly the most misused phrase we hear is “I’ve got a pinched nerve”. Understandably, when there is sudden sharp shooting pain – a pinched nerve sounds reasonable. However, from the osteopath’s perspective – there are so many sources of this type of pain, and it is usually not a pinched nerve.
Tiny ligaments and muscles close to the spine can be acutely strained and sprained to give this effect. Intervertebral disc pain can do it. Vertebral joints themselves can have tissue linings that can become pinched in a way may cause this.
Of course pinched nerves do exist, but in ‘medical terms’ we are usually referring to a spinal nerve root being compressed by disc or bone, as in sciatica. There are plenty of nerve roots exiting the spine: 8 cervical, 12 thoracic, 5 lumbar as well as sacral, coccygeal and cranial nerves, but by far the most common spots for this sort of ‘pinch’ to occur are in the lower neck and lower back.
Pinching nerves away from the spine is less common again, but the more popular areas are the elbow (median / ulnar nerve), hip (sciatic), and wrist (carpal tunnel syndrome). Treatment for this sort of problem targets the interfaces where the nerve’s pathway is more restricted. The spine can be mobilised the free up the exit point of the nerve, and the various joints, muscles, ligaments and tendons that nerves pass by along their course can be mobilised too.
One thing to be aware of with nerve entrapment type problems is that when a nerve has been under pressure, its fine blood supply vessels are damaged and can take a while (weeks – months) to regenerate and ultimately de-sensitise. So it is important to recognise when treatment has done all it can for a problem like this, and to be patient while the body completes the repair process.