How to Find Relief from Pinched Nerves

Pinched nerves are not exactly what most people would call a good time. A pinched or compressed nerve can cause pain, numbness, tingling, or weakness in your arm or leg. It can be debilitating! When the nerves are leaving your spinal column they have very little protection.

And if a disc, ligament, or bone spur get near a nerve…ouch! The pain can start there and then travel the entire length of that nerve root resulting in pain that radiates into your arms and legs. Let’s just say that your nerves don’t like being pushed around. 

Find Natural Relief from Pinched Nerves

The good news is that you can experience a lot of relief by taking the pressure off of the nerves. Research has shown that chiropractic adjustments can help reduce the pinching or compression on those delicate nerves roots. And with less pressure on the nerve, you can finally find relief. 

- Your nerves communicate with every organ, tissue, and cell in your body

- Bone spurs, ligament overgrowth, or disc problems can cause pressure on these nerves 

- Adjustments gently open the holes, or canals, of your spine, thereby decreasing the pressure on the nerves to help you function and feel better! 

Next Steps: 

Take a look around and do some "people watching" today. You will see that many people walk crooked or bent over towards one side. Sometimes this is the result of a pinched nerve. They are trying to lean away from the pain and open up those nerve channels. But, by staying active, maintaining a full range of motion, and getting periodic chiropractic care- you can count on standing tall for years to come! 

Science Source: 

Cervical radiculopathy: a systematic review on treatment by spinal manipulation and measurement with the Neck Disability Index. Journal of the Canadian Chiropractic Association 2012

Symptomatic, MRI Confirmed, Lumbar Disc Herniations: A Comparison of Outcomes Depending on the Type and Anatomical Axial Location of the Hernia in Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulation. Journal of Manipulative and Physiological Therapeutics. 2016

If you are a chiropractor? Learn more about this topic and much more here at The Smart Chiropractor.  

How to Keep Your Spinal Discs Healthy

Spinal discs are the shock absorbers between the bones, or vertebrae, of your spine. The discs have a tough outer ring and a jelly-like center. Their job is to help us move, bend, and twist while absorbing the weight of gravity. But, over time, our spinal discs can become degenerative.

Injuries, aging, and the effects of gravity all contribute to disc degeneration. The good news is that degenerative discs rarely cause pain unless they budge or herniate, placing pressure on the spinal nerves. So how you can slow down the degenerative process and keep your discs healthy?

Top research journals have recently discovered that movement and hydration are two important factors to keep your discs healthy. A well-hydrated disc can more easily adapt to movement and is less prone to injury. Many chiropractic techniques are designed to “pump” your spinal discs. This motion helps bring nutrients into the disc and pushes out inflammation and waste. That is a fancy way to say that chiropractic care can help keep your spinal discs healthy! Here are the key takeaways:

Your spinal discs act as small shock absorbers between the bones of your spine .

Movement helps bring nutrients into the disc and pushes out waste and inflammation; helping them stay healthy. 

Torn, herniated, or bulged discs can cause pain by irritating the nearby nerves. Researchers have found chiropractic care to be one of the best ways to heal and feel better!  

A combination of chiropractic care and staying well-hydrated are two ways to keep your spinal discs healthy and pain-free. But, don’t forget to stay active between your adjustments. And here is one more tip to slow down Father Time- daily exercise and stretching. Exercise and stretching will not only keep you fit and trim but can also potentially slow down the degenerative changes of your spine keeping you healthy and active for many years to come! 

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Chiropractic Before or After a Spinal Injection: The Facts!

Suffering through the pain associated with a disc herniation can be debilitating. When a spinal disc is pressing on a nerve it can result in excruciating pain that may seem like it will never go away.

Quite often medical doctor’s recommend nerve root injections (also known as Epidural Steroid Injections) if they see on an MRI that the disc is pressing on a nerve. But how many times do they also recommend chiropractic care with the injections? Not often enough.

Over 9 million spinal injections are given every year for spine-related pain. That is over 24,000 every day! Injections are often given when a patient is suffering from radiculopathy or a compressed nerve root.

Over 24,000 SPINAL injections are given every day!

I believe there is a better, research-supported way to find relief. But first, let's set the stage a bit.

Click Here to Download a Powerful Free Research Brief

The 3 tissues that can pinch a nerve and cause pain are:

• Spinal Discs

• Bone Spurs and Osteophytes

• Ligament Overgrowth and Hypertrophy

Whether the compression is caused by a disc, ligament, or bone- the nerve doesn't care. It's aggravated and causing pain. Statistically, many of these people are going to visit their medical doctor to find relief. Over 30% of the patients in a primary care doctors office are there for treatment of a musculoskeletal complaint.

When they go to see their medical doctor with radiculopathy, the medical doctor may prescribe an anti-inflammatory, and perhaps physical therapy. Then an MRI is ordered. 

What do they find? 

Well, if it's a disc pressing on the nerve, the next stop for that patient is quite often a physiatrist, pain management doctor, or neurologist for a spinal injection. The goal of the injection is to decrease the inflammation and "numb" the area, which may provide temporary relief at best. And what happens when the injections stop working? It's off to the surgeon.

I believe there is a better path to relief.

I thought it would be interesting to look at the research showcasing the use chiropractic or injections for the treatment of radiculopathy. First up was a study from JMPT in 2013. The title is "symptomatic MRI-confirmed lumbar disc herniation patients comparing high-velocity low amplitude spinal manipulative therapy or image guided lumbar nerve root injections."

 And guess what the researchers found?

The researchers found, "both of the treatment groups had significant decreases in their pain scores at one month with a 60 percent reduction for the spinal manipulative therapy cohort and a 53 percent reduction for the nerve root injection group".

The spinal manipulation group had much better outcomes than the nerve root injection group.

Additionally, they found, "lumbar nerve and injections are commonly used, and accepted treatment option for these patients whereas lumbar spinal manipulation as a treatment for disc herniation remains controversial amongst some healthcare professionals." 

That tells us that there is some work to do on the relationships building front. With the volume of nerve root injections and all the risks- people should be exploring conservative care, such as chiropractic, first!
(in the absence of red-flags and extenuating circumstances)

Keep in mind this is a symptomatic, MRI-confirmed lumbar disc herniation. The disc is placing direct pressure on the nerve. And while both groups found improvement, the chiropractic group, the spinal manipulation group, ultimately outperformed the nerve root injection group. That's exciting!

The fact that a conservative care option can outperform a ton of steroids being dumped on an inflamed nerve is impressive.

Additionally, another study titled "spinal manipulation post-epidural injection for lumbar and cervical radiculopathy: a retrospective case series" had some interesting results. For instance, happens if you give an adjustment to someone who has already had an injection? 

Unfortunately, many people believe they are past chiropractic when they get the injection. And the researchers found the opposite is true.

They found, "the majority of the patients showed a positive response with only one treatment procedure".

Additionally, the researchers found, "theoretically epidural injections are proposed to address the inflammatory and central components of spinal pain whereas spinal manipulation is proposed to address the mechanical and neural aspects of the pain syndrome". 

Spinal manipulation is proposed to address the mechanical aspect of the pain, and you're getting physical motion into the joint with many chiropractic techniques. But they also cited the neural elements such as the impact to a central nervous system and the opening of the foraminal canals, decreasing the pressure on the nerve.  

Finally, the researchers found, "this data suggests that spinal manipulation post-epidural injection is a safe non-surgical procedure to use in the treatment of a patient with radiculopathy of spinal origin." 

So not only do many patients get well with chiropractic care before (or instead) of getting an injection, but even those individuals who went through an injection still saw improvement with chiropractic care.

This research is important information for your patients to know and is also as a great conversation starter for the providers in your community. Those conversations may save dozens, if not hundreds of people from going through expensive and sometimes dangerous, injections. 

We've featured both of these pieces of research as monthly research for our members of The Evidence Based Chiropractor; which is the complete system for relationship building with other healthcare providers in your community. Click here to learn more!

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What Your Spine Surgeon Hasn't Told You...

Did you know there was a study released in 2010 that found people with herniated discs in their lower back that received chiropractic care had the same results as those who underwent surgical intervention?

Yes, that is true. 

This study was done by JMPT, and it was titled "Manipulation or Microdiscectomy for sciatica: a prospective randomized controlled study." We know millions of people every year suffer from bulged or herniated disks that cause pain in their low back that can travel down their legs. 

And far too many people end up taking medications that do not work, perhaps injections that do not work, and ultimately they end up in surgery. Over 500,000 spinal fusions are performed each year in the United States. Surgical "correction" is when the disc that is pressing on the nerve is chopped away. Well, in this study the individuals went through chiropractic care were able to improve the disk, take the pressure off the nerve, and find sweet relief. 

Far too many people don't know about chiropractic. They've tried physical therapy. They've tried medications. They've tried injections. The think the only option left is to go under the knife, and it's not true.

This study took individuals that had failed all of those measures. People that had already gone through therapy, already gone through massage, already gone through medications, and then put them either into surgery or chiropractic. 

So if you are somebody out there that maybe has tried therapy tried injections and even tried medications and not got the relief you desired. Do not think that surgery is your only option.

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"these patients must have also failed at least three months of nonoperative management including treatment with analgesics (which is medication), lifestyle modification, physical therapy massage therapy, and or acupuncture." 

"most of the patients who are considered surgical candidates for the treatment of radiculopathy improved with standardized spinal manipulative care to the same degree as those who underwent surgical intervention." 

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There is a time and place (in a tiny percentage of individuals) where surgery is the best and only option. But the beauty of this study is that if you undergo chiropractic care, you have the same opportunity to improve as if you had surgery right off the bat. But here's the catch. If you go through surgery first, any chiropractic care after that is working on a spine that has been altered and or compromised. However, if you try chiropractic care first, and let's say that does not get where you need to be, then you still have surgery as an option down the road. So do not burn those bridges too quickly with surgery before it's necessary. 

Additionally, these researchers found that 10 to 20 percent failure rate for individuals who go through that microdiscectomy. And I think that might be a little bit conservative. 

So if you are somebody who has been suffering from low back pain, from sciatica, from challenges with the disks and the nerves in your spine do not dismiss chiropractic care. I know there are a lot of individuals out there that maybe aren't exposed to chiropractic care.

They end up going to their primary care doctor, who might not have the best tools for spine-related pain and a medication script as written. The patient of course doesn't get well because they have a mechanical problem not a medication issue. So the patient goes back because they still have pain. The primary care doctor says, "Why don't you go get an MRI since you didn't get well with the medication."  Lo and behold what do we find? The MRI shows a disc that is bulged or herniated, pressing the nerve causing pain. That doctor then correctly says, "A-ha that's the problem, a disc is pressing on the nerve." And what happens next? An injection loaded you up with steroids and hoping for the best. Many times that is not a permanent solution and that individual ends up going down that path towards surgical intervention. 

I want to bring it out there that there is an alternative path. Chiropractic needs to at least be a pit stop on that road. Research showing that chiropractic care can succeed at least to the same degree as surgical intervention is extremely important for people to understand because many times they may not be getting this information from their primary care doctor. 

So there you have it. 

What your spine surgeon may not have told you is that you need to try chiropractic care before entertaining the idea of any surgical intervention. 

It's smart. The research proves it, and you will ultimately be better for it. Chiropractic care has been shown to decrease intradiscal pressure, opening up those delicate holes  (foraminal canals) where the nerves travel out and has helped get millions of people well from injuries to the disks and the nerves. 

So if you have heard that an injection or that surgery might be in your future, be sure to try out chiropractic care first. Or if you have a loved one, relative, or a friend who has been guided down that path; be sure that you bring up chiropractic care to them. It just may save their life! 

Maintenance Chiropractic: Does the research support it or vilify it?

Maintenance chiropractic care: does the research support it or does the research vilify it? That is our topic of the day. And right off the bat, I would love to know if you prescribe or recommend maintenance care in your practice?

Maintenance chiropractic care has been around a long time, and there's always been, in my opinion, some questions regarding the criteria for it. Does it help people or does it not? And to date, there has been very scant research that looked at it in any capacity whatsoever.

But we were very fortunate in the year 2011 SPINE, the esteemed top-tier research journal, took a look at maintenance care.

So SPINE published a fascinating paper. The paper is titled "Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome." Again I'll say that one more time in 2011s SPINE put out a research paper titled "Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome".

I'm going to read a couple of quotes from the study that I believe to be very important and start to tell the story. The researchers found "nonspecific low back pain represents about 85 percent of low back pain patients seen in a primary care center and about 10 percent will go on to develop chronic disabling low back pain". So they just kind of setting the stage. 

We know historically, through The Evidence Based Chiropractor, 30% of a primary care doctors daily volume of patients are a spine or musculoskeletal patient. What they're saying is nonspecific low back pain represents about 85 percent of those individuals. What they're also saying is about 10 percent will go on to develop chronic disabling low back pain chronic pain over three months of course. 

Now the researchers also touch on something else that has chiropractors I think we could find very interesting. The researchers also found  "the postulated modes of action of manipulation include disruption of articular adhesions, improvement of trunk mobility, relaxation of hypertonic muscle by sudden stretching, the release of entrapped synovial folds, attenuation of Alph motor neuron activity, and enhancement of proprioceptive behavior and the release of beta-endorphins." This gets down to the mechanism of action on a chiropractic adjustment.

The third quote that I want to bring up from this paper is compelling. The researchers found "as patients did benefit from the maintenance treatments we believe that periodic patient visits permit proper evaluation, detection, and early treatment of an emerging problem, thus preventing future episodes of low back pain." 

Let me say that one more time. The researchers at SPINE concluded, "as patients did benefit from the maintenance treatments we believe that periodic patient visits permit proper evaluation, detection, and early treatment of an emerging problem thus preventing future episodes of low back pain." 

I'll tell you I've practiced in multiple multi-disciplinary clinics where I've interacted with orthopedic surgeons, neurosurgeons, physiatrist's you name it, day in and day out. And one thing that I will say is that over the last ten years I've noticed that, from a surgical perspective, a lot of the docs do have an understanding that spine related complaints are a result of long-term deterioration and degenerative changes with microtrauma throughout an extended period of time. 

Many times when people end up in the surgery realm or in the interventional realm they have degenerative processes and changes that have taken a long long time to get there. And what I have seen and found over the last 10 years is that MD's and DO's are more open than ever to the fact that these are ongoing processes. So if you, as a chiropractor, are doing the right thing to encourage the person to stay active and to increase segmental mobility. You know they're going to continue to live on planet Earth, gravity is going to continue to take its toll. But when you can do some things periodically to help that patient stay as active as possible, that's a huge win. 

At The Evidence Based Chiropractor, a lot of what we focus on is the research and building relationships with other healthcare providers from a relationship standpoint. No surgeon is excited to "go back in" on a patient with repeat surgeries. There is a law of diminishing returns with surgery. That is an understatement. So it's an essential for us, as chiropractors, to be able to articulate what the research has showcased regarding maintenance care. Now that doesn't mean you see the person one time every day for the rest of their lives. Don't get me wrong. Everybody is different. 

Think about 90% of people experiencing spine pain in their life, that's significant. And 10% of those individuals potentially going on to develop chronic disabling pain that often results in surgery. Well, its reassuring to know chiropractic care has the potential to break that cycle. 

Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome?