Could Your Body Aches Really be a Pinched Nerve? Video Transcript

A lot of times I see patients who are so confused because they have horrible pain down their arm but everyone is telling them that the problem is in their neck and they're confused about that.

So, just to get started -- a little bit of the anatomy:  there’s a series of bones and in between are the discs which are the cushioning.  And the disc is made up of an outer harder part with a softer part in the middle and it’s in this harder shell -- the shell has concentric areas that will weaken with time and that’s what ultimately leads to the disc herniation which I’ll show you.  And you can see, you’re looking at the front and then the spinal cord is in the center and then there’s bones in the back. 

Here’s another picture of it and you can see in the one on the left the outer shell here is intact and in the one on the right there you can see where it is weakening and the softer part of the disc is going to herniate out and pinch that exiting nerve group and that’s where people come in with pain.

Often times they’ll be in my office like this (arm raised and bent toward top of head).
I can tell right away, they don’t even have to talk to me, I know what the problem is.  So not everyone does that, but when you see that, it’s very clear that the nerve is getting pinched by this softness squishing up against it.  And what’s on the other side of it is bone, so that nerve doesn’t have a chance.

So, what are the different symptoms?  A lot of people have neck pain, but don’t walk away from this thinking every time you get a pain in your neck that you have a herniated disk because neck pain can be due to multiple different things.  Most of the time it’s really arthritis, or you pulled a muscle, or something very simple and most people don’t need any surgeries for that.

Arm pain – I mentioned to you, and it’s interesting, that the arm pain can be in different places and it depends on which nerve is getting pinched -- that helps me to know anatomically and narrow it down which disc is going to be the problem -- is it just up here, is it by the shoulder blade, does it go down the back of your arm, the front of your arm, all these things have a different meaning, as well as the numbness, is your thumb numb or is your pinkie numb, all of these things get me more information.

A lot of patients will talk about an electrical shock especially if they turn their head a certain way or lean forward, they’ll get a shock sensation and that’s another important sign.

Many patients will have headaches, and once again just because you have a headache doesn’t mean you have a herniated disk but when you put it all together that is commonly associated with it.

And certainly muscle weakness is something that we look for and when I see a patient to do an exam I’m going to test the strength in each of those muscles groups -- we isolate out each of those muscle groups.

And then of course the testing -- so not everybody needs a fancy test right away.  That’s also very important, because some of you will go to your primary care doctor and say “my arm hurts, my neck hurts”, and many times they’ll order physical therapy first.  Which is not a bad thing, because 70% of the people who have these symptoms will get better just doing some very conservative physical therapy.  And the pain goes away, you’ve saved yourself money in co-pay for an expensive test, so keep that in mind, don’t be mad your doctor when they don’t do the MRI right away.   Often times just some therapy is all you need.

So now we have the test and we see a herniated disk, so the question is what do we do now?  Surgery or conservative treatment?

I’ve listed here for you guys many of the conservative things that we do and I always try to do those things first, because personally I wouldn’t want to have a surgery if I didn’t try some nonsurgical things first.  There’s different approaches for surgery.

You can still exercise but you want to pick low impact exercise, like walking, swimming -- things that don’t jar your body.  Your workspace, if you work on a computer you want to make sure you’re sitting upright, staring straight ahead, not leaning way over your desk to see the letters.  All of those things need to be looked at.   And again, the smoking issue, you’ve gotta stop smoking.

<< Back to video.