♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ on the internet. ♪
- Hi, folks,
I'm Bob Schrupp, physical therapists.
- Brad Heineck, physical therapists.
- Together we are the most famous physical therapist
on the internet.
- In our opinion of course, Bob.
- Today we're gonna talk about
five tests to determine
if you have a pinched nerve in your neck.
Let's get right into it, Brad.
- Yeah, why waste time?
- So, a pinched nerve means there's pressure applied
to a nerve as it's exiting the neck.
- Right.
- It comes in through your arms
and provides sensation and strength.
Now the pressure could be from a disc.
It could be from a bony like overgrowth.
- You're right.
- Spur? I suppose.
It could be from muscle even. - Sure.
- Muscle can tighten up over.
- Some inflammation. - Yup.
- Maybe you had some trauma or whatever reason.
- Yup.
- Yeah.
The nerve becomes irritated up here,
impinged, sends symptoms and pain down the arm
all the way to the fingertips sometimes.
- And that's the number one thing.
We'll first talk about five things you might see,
- Sure.
and then we'll show you five tests.
- Yup.
- You might see, yeah,
pain radiating to the arm
especially if it goes beyond the elbow.
- Yes.
- 'cause regular pain can even go to the elbow.
- Right.
Or sometimes shoulder pain will radiate down typically
to the elbow.
- Right. Right.
- If you have hand, arm or shoulder weakness,
- Oo.
that could be a pinched nerve.
It could be other things too.
So you always wanna make sure
you're goin' to a doctor to check these things out.
- Yeah.
- If you have numbness
or decreased sensation in your arm, wrist or hand.
Now this again could be carpal tunnel or it could be,
- Yeah, they overlap.
And this is one of those tough ones.
That's not always easy to clarify.
- Yeah, it could be a pinched nerve anywhere.
You know, it could be a pinched nerve in your elbow.
That can extend pain down to your forearm and hand.
All right.
If you have tingling and pins and needles sensations
the same thing down here
down in this area.
That would often or can be a sign
of a pinched nerve in your neck.
- Sure.
- So sometimes you have both,
pain and the arm, wrist and hand
which is aggravated by any neck movements.
So like if you move your neck
and oh, that hurts down here.
- Yes. Right.
- That's a pretty good sign actually,
that your you have a pinched nerve.
Go ahead.
- Oh, before we finish,
I want to add one more, I think.
- Alright.
Feeling the hand fall asleep,
which, you know,
well my hand will fall asleep
if I sleep in my arms up over my head.
- Right. Yeah.
- But if it's falling asleep
and you're not really doing anything to it,
it could be a pinch nerve.
- Turnaround once, Bob.
- Sure.
- Another, all the way around, there we go.
So if you were having pain
in the shoulder blade area,
that's a good possibility,
it's coming from the low neck too.
Typically shoulder pain goes down the arm
or in front of doesn't refer backwards.
So that's another thing to keep in mind as well.
And sometimes you get shoulder pain
and then it radiates down.
- Right. Right.
So good point, Brad.
So, all right.
I'm going to have Mike now put up an image
of the nerves in your hand.
We have what is called dermatomes in our hands.
And each nerve provides sensation
to a certain part of the hand.
- Right.
- So the median nerve is more
the thumb and the two and a half digits.
So, if there's numbness and tingling or pain in this area,
that might be your median nerve.
- Sure.
- Ulnar nerve is over on this side.
- Pinky.
- And then radial nerve is in the back.
- So all three of these nerves
come from different levels out of the neck.
They go down and they form it to one nerve
in the brachial plexus or the shoulder
and then they start to branch off
and it's really like a map.
- Sure. And it can kinda give you a sensation.
If it's the median nerve, that's often,
that is the carpal tunnel nerve.
- Yep.
- So that'd be a sign that maybe you do have carpal tunnel
or maybe you have a pinched median nerve.
Up in the neck.
- Exactly, or you could have both.
- Yep. You could have both.
So we're gonna show you five tests, now.
The first one is for the median nerve.
- Okay.
- So you just take your arm out like this.
- Ya gonna smack me?
- Yeah. I'm gonna smack ya.
You bend it down like this.
And one thing you might find,
that I find that quite often, Brad,
is that if you have a good arm and an involved arm,
the the good arm, the wrist will bend forward further
than the bad one or the involved one.
- So you could do bad side.
- Yeah.
- And then go over to the side that's symptom free.
- I've got to do, probably the good side first.
- Sure. Yup.
- So you can know what it feels like.
- But not at the same time.
- Not at the same time.
So you bend it and then you bend your neck away.
So you bend the wrist
and bend your neck away.
- Elbow needs to be straight.
- Straight, yep.
That's putting a lot of stress on that nerve,
is what you're doing.
So, same way on this side, you bend away.
- So you get it up level and tilt your head away.
- Yup.
- Not looking, but sideways.
- So this next one's a little weird.
So this is the ulnar nerve.
So to get the ulnar nerve,
you make a circle like this
and you actually bring your wrist to like this.
Now what I found with a lot of people,
is they can't even get it very far.
They can only go like this.
- Yep. If I'm younger, you can.
- Yeah. If you got good motion of the ulnar nerve
you can get all,
you're trying to make an eyeglass, basically.
- Yeah, but don't do this at the same time.
- Yeah.
- You know, when we were kids, we used to that.
- Yeah. Yeah, yeah.
- That's how I remembered it in PT school.
- Right.
So you test it.
And then you actually can bend away while you're doing it.
There you go.
And if that brings on pain, that might be your
ulnar nerve involved.
Radial nerve.
So you're gonna stand,
I'm gonna go ahead and stand on this one, Brad.
Face away
and then you're gonna lift up like this.
- Okay.
- And bend away at the same time.
So stand, face the palm away.
Palm up to the ceiling, bend neck away.
- And you do that standing up?
- Well, just, it's hard to do here.
- Oh because, so, if you're off the edge,
like this one, I could do it.
- Yeah. You could certainly do it.
- I just thought we'd clarify it.
- Yep. All right.
These are a little bit easier tests I think to do.
So the neck compression test, this is just
it's called Spurling's test or Spurling test.
This is an overall to check kind of all the nerves here.
- Yep.
- And what you're gonna do
is you're gonna extend your head
and tilt to the painful side.
Then you can actually apply a little pressure
gentle pressure.
- Straight down.
- Yeah, straight down.
And you're compressing the spine together.
And you're closing off those holes, the foramen.
And if there's a pinched nerve there from that area
it's going to make it worse.
- Now, if you just do this, that might be enough,
- Right.
- to irritate it and cause,
you know you don't have to continue.
- Yeah, you don't have to go any further then.
- Yeah.
- Same thing, if you're going to do the other side.
You're going to extend the head.
Tilt to that side
and you could, like I said,
apply a little pressure if you wanted.
- A little pressure.
- Yeah.
- Typically it's the arm that's not involved.
'Cause the other one's gonna hurt
and it kinda gets in the way.
- Now this is the opposite of this.
This is one's that you check out
to see if you get relief from a position.
So let's say I'm having pain in this arm here.
- Yep.
- I'm gonna put it on a pillow and support it.
- Sure.
- and then I'm gonna tilt away.
And now I'm opening the holes up here.
There's plenty of room now for the nerve to come through.
It's being supported.
And does this give you pain relief?
Well, if it does,
then you may have a nerve issue.
- Yep.
- And that's actually,
a lot of times with people that have nerve problems.
I actually have them use a pillow, all the time.
- Sure.
- Because it provides some relief.
Even if it's a shoulder problem too.
- Right. Exactly.
Now that one it's possible,
if I got a patient
and they do this and it hurts down here
or this, sometimes that way will pinch it more.
But if it's a bulging disc that might actually push it
out a little bit, too.
- It might.
I could make it worse.
But generally I don't think it pushes it out enough
to cause a problem.
But I see what you're saying.
I see what you're saying.
- So really associated neck movement creates pain down here.
- Right. Right.
- It's probably up there
and not carpel tunnel.
- Yup. Good point, Brad.
Very good point.
All right.
This video is a part of a series of videos on neck pain.
They're all free.
Just go to Bobandbrad.com,
go to the program section, look for neck pain.
and Brad?
Along be with it,
we have a PDF printout
with a review of the video and exercises.
Pictures of them.
It's a wonderful way
to know exactly what you're gonna do.
You don't have to go back and look at us
and we don't expect anything from you.
- (laughing) Come back to look at us.
- Well Bob, why would they want to keep looking at us?
- That's true. - They got a piece of paper
you know.
- Yeah and there's like 20, 30 videos, I believe,
on neck pain.
Just watch the ones that pertained to you.
- Right. Just look the titles.
They're usually around 10 minutes, or less.
- There we go.
This one's only nine.
- Take care.
- Thank you.
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