Also Known As – Nerve Root Injury, Nerve Root Damage, Pinched Nerve, Nerve Root Trauma and Nerve Root Pain.
An accurate diagnosis of a nerve root irritation is extremely helpful to aiding a fast recovery. If not identifed it may lead to long delays in recovery. Nerve root irritation can be a significant part of many conditions and is commonly left undiagnosed.
If not identified, you may feel better and return to normal activities, but often the condition reoccurs. There are many conditions where nerve root irritation may be the primary cause including:
Back or neck pain
Local leg or arm pain, burning, pins & needles and/or numbness
Radiating pain, burning, pins & needles and/or numbness in the leg or arm
Nerve Root Irritation Diagnosis
Nerve root irritation can be quickly resolved with skillfull musculoskeletal physiotherapy treatment to the nerve root and structures around it that are the cause of the problem. All of our Physiotherapists are highly skilled at performing the gentle manual assessment required for diagnosing nerve root irritation.
This is done by hands on manual therapy techniques to decrease irritation of the nerve and quickly restore its free movement and reduce the symptoms. In the vast majority of cases this can be achieved less than a week (three to four sessions).
Without the correct treatment the average time for this condition to settle maybe up to several weeks; in cases it won’t settle without good treatment; and at the worst end of the spectrum (with loss of muscle power) surgery is normally required.
We successfully treat this condition on a daily basis, including the diagnosis’s causing it, such as disc bulge, ligament strains, joint strains etc.
How does nerve root irritation present
Nerve irritation is not to be confused with full ‘pinching’ of the nerve. A full pinching of the nerve is very serious. Also known as ‘nerve root compression’ it may lead to a loss of conduction of impulses resulting in complete loss of muscle function in an arm or leg and complete loss of feeling. This is a rare condition, and is important to seek immediate medical care if this occurs.
Nerve root irritation most commonly results from a structure close to a nerve, such as a joint, ligament and/or muscle, which has sustained accumulative strain which results in swelling and inflammation.
How does your body respond
The nerve root is a very sensitive structure and sends strong signals to the brain to let it know when it’s suffering. The brain interprets these signals and then creates a protective response to avoid further damage to the nerve. Everybody is different and the responses to this condition can vary. This is another reason why this condition is tricky to identify and deal with.
The protective response is predominantly radiating pain down the arm or leg, with muscle tightness and guarding. Sometimes the protective response is a feeling of numbness, pins and needles, tingling, cramping, tightness or an ache.
What can you do about it
Firstly, seek an assessment from a fully qualified professional to confirm the diagnosis and then seek treatment – be very diligent with following the advice obtained during the treatment!
Nerve root irritation is problematic to deal with because it usually doesn’t follow the normal rules of rest to help the condition resolve. Rest without good treatment often delays recovery significantly. Sometimes it even feels good to try to stretch the arm or leg affected or to do some light exercise. This temporarily ‘warms up’ the condition and for this reason it doesn’t feel so bad. Unfortunately, by doing this you are actually aggravating the condition while it is warmed up and the pain comes back worse soon after you cool down, or in some cases, the next day. The sooner you get good treatment the sooner you can be back to your daily activities.
While you are in the process of receiving good treatment and having the nerve irritation released, the best thing you can do in between sessions is avoid re-aggravation. This means spending as much time as possible either up and moving around or lying down. When lying on your back try placing pillows under your knees and when lying on your side try pillows between your knees, plus, line a pillow along your rib cage either hugging the pillow at the front or lying on it along your back.
A good rule is to minimize sitting and minimize driving as this usually aggravates the joints and ligaments that are causing the nerve root irritation.
Your physiotherapist will describe to you how severe your nerve root irritation is and it is important to follow their specific guidelines.
For most cases where the condition is easily re-aggravated the following rules apply:
If you have to sit ensure you utilise the best possible ergonomic position, sit in a firm chair (like a dinning chair) and avoid sitting on couches.
If you have to drive ensure the seat is as close to the pedals as practical and your elbows are quite bent as you drive. Where possible get someone to drive for you, especially if you are having troubles using the stick or pedals – Safety first.
When you walk take small steps and do your best to avoid limping.
The general rules to avoid aggravation are:
DO NOT stretch
DO NOT exercise
DO NOT sit for longer than absolutely necessary
DO NOT use the arm or leg in a stretched out position – No feet-up while sitting, no striding out with walking, no reaching behind to the back seat, no carrying in that arm or over that shoulder.
DO NOT prop your head up with pillows to read/use a computer while lying on your back or lying on your side to read or having the laptop up high enough on cushions so you don’t have to prop up your head is OK.
Our aim is to ensure you get back to a healthy life as soon as possible
There aren’t many conditions where we ask you to avoid or severely limit exercise, but this is one of them. All going to plan, you will only have to miss a few days of most of your regular life activities.
We will guide you, your family/significant others, your trainer and/or coach on how to best help you get back to your usual routine as quickly as possible.
We also look forward to showing you exercises and activities that you can do to speed up your recovery, after the nerve root irritation is nearly 100% cleared.
What does good treatment involve
We work very hard to ensure our treatment is the fastest possible method of recovery from a nerve root irritation while working towards long term prevention of recurrence of the condition.
This is not a permanent condition and with effective help you can be pain free and fully active after you have gone through the three phases of recovery:
Phase 1 – Treatment to settle the Nerve Irritation until the nerve has full mobility without restriction and this mobility remains improved for more than a day (most often 2-4 sessions in a week).
Phase 2 – Treatment to the underlying cause of the condition to get your joints, ligaments and muscles de-loaded and moving fully with no restrictions (most often 2-4 sessions in a week or two).
Phase 3 – Gradually returning to full activities while integrating new muscle control to ensure you minimise the risk of recurrence. In most cases this will have you performing better than you did before the condition. (most often 2-4 sessions over a few months).
The best way to remain pain free is to get regular check-ups (every 6 months) just like you would with your teeth. We are very proud to utilise such a high level of care using the Ridgway Method, providing these amazing results!
How bad is my condition and how my recovery is progressing
A sensitive manual therapy test that a good physiotherapist performs can measure the extent of a nerve root irritation condition.
Even with good treatment, pain may not initially respond proportionally to the rate of improvement. You may have to be patient for a few days until the treatment effect is nearly 100%. This means even if the nerve irritation is improving you may not ‘feel’ like it is getting better. The way to know for sure is to rely on the manual therapy test as this gives an accurate measure of progress and reveals how close you are to being fixed
Please note – This information is general and individual cases will most likely vary, so it is very important you get good advice from your Physiotherapist about how this condition might relate to you.
If you have any questions about this, or any other musculoskeletal condition, please feel free to ask a your Physiotherapist: Call us on (08) 7225 5117 (Adelaide CBD) or (08) 8555 5961 (South Coast)