- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck. physical therapist.
- And together we are the most famous physical
therapists on the internet.
- In our opinion of course
- Think fast. Today we're gonna talk
about what is a pinch nerve.
A lot of people get a pinch nerve
or they get a pain.
And they say they've been diagnosed
and they say, well somewhere you
have a pinch nerve.
We're gonna kind of go talk
about where you can pinch a nerve
and what it is and, and what,
what symptoms it gives you.
- Sure.
- So first let's talk about the symptoms.
What are the things you're gonna feel when
you have a pinched nerve?
One thing you might have quite often is pain
'cause you're getting compression
on a nerve is what is is happening.
And the nerves are coming out
from your spinal cord and going
from the spinal cord into your arms
and into your legs.
- And in this area, they wrap around the trunk.
- Sure. They wrap around the trunk
so you can get actually pain
or a compression of a nerve anywhere
in the body in essence.
- Right.
- So let's start talking
about some of the common symptoms you're gonna feel.
First off, you can have pain
you can have radiating pain, pain,
that's going down.
- Right?
- The extremity, you can have-
- Numbness, burning, tingling.
A lot of times, people in the clinic.
I know that when they got it in their low back
and it's going down their leg, I just
had a woman yesterday.
It feels real tight, a pulling sensation.
- Right.
- It's hard to describe a nerve pain compared
to like a pain where you're, you know,
if you break your arm
or a mechanical pain is very clear
where nerve pain is also.
- It can be ever changing too.
- Yep, exactly weird.
- Quite often when people start getting
and that's a good way to put it.
A lot of times when people come in
they're having really strange symptoms.
I often go, you know what?
That sounds like nerve pain, 'cause nerve pain.
It just gives you really weird things.
You can get like hot and cold sensations.
- Sure. Yeah, exactly.
- Pins and needles.
If you start getting weakness in the arm,
that's often quite often can be-
- That's getting more serious.
- That's getting more serious spasms
that can be from from nerve compression too.
- And, and one thing I wanna point out
as a therapist or a physician
or a chiropractor, we pay attention
to where that you feel the pain, you know,
is it on the front of your arm
or the back of the arm, inside of the leg
outside of the leg, because that tells us possibly
which nerve is actually being pinched.
We know it's all mapped out where L three
the nerve coming out of L three and your Lumbar spine
where that goes down in your leg, you know what?
L five goes down the top of your foot
if you feel symptoms there.
- Right.
So where you're having the pain
it could be where you're having the pinch nerve
but quite often it isn't.
- Right.
- And it's a real, it's a real treasure hunt here.
Kind of trying to figure out investigative job
trying to figure out where
the problem is coming from.
So let's talk about a couple, some
of the common areas where you might
have a pinch nerve.
Nancy, could we have the spine right away?
Who's catching.
- There ya go.
- Okay. We got our spine here
- Spine.
- This is really where a partial head here.
These are the bones that stack
up to make your back, you know,
within the bones itself there's a canal
and that's your spinal cord.
And coming off the spinal cord are these nerves.
All right these are the nerves
that can get compressed or pinched.
- Right.
- All right. One of the common areas
that can get pinched is right
when it's coming outta these holes here,
the right right in that spot here,
as you get older you want to zoom in
and Brad, can you kind of point out?
- Sure. Yep.
Okay. So now the nerves remember
are not a half inch long like I'm here.
They, they actually, the nerves
are go down into your arm the nerves
and this area will wrap around your chest
and the ones out here go down to your legs.
But here's that whole valve talking
about where the nerve exits
from the spinal cord directly connected
to the spinal cord.
- As you get older there,
your neck will become arthritic.
- Sure.
- I can tell you from age 20 on it's deteriorating
these holes start to get smaller just
from arthritic changes.
- Right.
- And so there's less room
for the nerve to get out.
If let's say the nerve gets a little bit
swollen suddenly there's, there's no room
for it to come out and it's getting pinched right
Where as it comes out.
- Sure.
- Less common in the lumbar area
cause these holes are quite bigger
but what can happen in the lumbar area?
Brad, bigger, the holes there are larger,
- Larger.
- Okay. The holes there are larger.
- Okay.
- And so there's a lot more room
for the nerves to come out.
So it's unlikely that you're gonna get pinching
from the hole itself in the lumbar area
but you can get a disc problem.
- And here's a nice model.
You talk about a slip disc.
That's really not correct is a herniated disc
and a herniated disc, you can see here.
Can you zoom in on this pretty good?
The bald dried here?
- Why don't you show a healthy disc first, Brad
- This is a healthy disc.
- Sure. That's a good idea.
A healthy disc is kept in here.
Usually a little thicker in the front
a little narrower in the back and
- It's all contained it.
- Exactly.
Boy. We know we've got another video
on some details on the disc without getting into
that the disc will actually bulge out
- Put Pressure.
- Yeah.
- Put pressure on the, on a specific nerve.
And that nerve will send symptoms wherever
that nerve tracks.
And here they go down into the leg
- And that the
the pain that you get often
from nerve pain is off quite often.
Some of the worst pain you'll have.
- Yeah. It is.
- Nerve pain is not fun.
- Exactly.
- I know when you can tell
when someone's drilling into a nerve
that, you know that's the way they'll
make you talk, If they wanna torture you.
So the other thing that could be causing pressure
on a nerve is even scar tissue.
- Sure.
- If you a nerve, the nerve
can actually get scarred down
and when you move it,
it actually puts pressure on it.
Cause increased pain.
We've had sometimes I've had people that have
had scar tissue on a nerve in their back.
And we actually had to stretch that nerve
- Right.
- To break up that scar tissue.
- After a surgery sometimes you
can have scarred filled up or an injury.
- So the other thing is, as the nerves come out
anywhere along this path,
they can get pinched somewhere.
- Sure.
- And the common one that many of you probably
know about is carpal tunnel syndrome
and there's a band or ligament
that goes across here and the
the nerve crosses underneath that ligament.
And especially if you do a lot
of repetitive activities like typing
or where you're bending your wrist this way
or this way or
- Factory type work
- Or factory type work that ligament
can thicken up and there's less room
for the nerve to go under.
And that's where you can get pinched nerve also.
So the job of the physician or doctor
or physical therapist is to figure out
where along this path for your arms,
are you getting a pinch nerve or where along
you know your legs, where from the back to the legs
are you getting a pinched nerve.
- Right.
- And which we usually call sciatica.
- Sure.
- The other thing we thought
we talked about a couple fun ones, right?
Brad, there's some names out there for
for nerves that get pinched.
And these are the ones that are generally more
of a temporary pinch
but one is called Saturday night palsy.
And this is apparently what happens
if you fall asleep like
on a bar or over the, over a chair like that
you get pressure on the back of your nerve, your
your arm there, that's a radial nerve palsy
and you wake up and you're so drunk
that you, you don't wake up at all.
You wake up in your arms,
you can't move your arms.
They're they're they're yeah.
- They, they, they cut off so much that the
the nerves cannot fire the muscles.
It's I've never experienced that.
- You don't even know what that would be.
But another one would be
honeymoon P- honeymoon palsy.
You fall asleep and your honey's
on your arm like this.
- Yeah. This looks like your honey.
- Yeah. This is my honey.
And all night long, you're afraid
to get away from her.
And there's a joke too, about nodding off.
That also causes a palsy in your arm.
Another one is, could be related
as a handcuff neuropathy.
- I wouldn't about that either
- That are too tight
they can actually put pressure on the nerves.
And the last one we're gonna mention is,
is a crutch palsy.
I wish we had some crutches here but
that's why when we, when you use crutches we try
to teach you that you're really not trying to
to hang on them or, or lean on to them onto them.
- It should not put pressure to your armpit,
- Right.
- It should be going through your arm.
- You got a big plexus of nerves coming
through your armpit here and into the arm.
And if you lean on those crutches
they're actually going to cause
the crutch pad is not made for padding
to put up-
- The pressure should be on your
your palms
- Right.
- And squeezing the, the crutches in.
So that they're-
- I got another one though Bob
I can show you this one,
- Another palsy?
- Yeah. I don't know what you call it,
but she can't see me.
- Oh.
- If I go to sleep on my stomach
which I don't much anymore.
Cause I bother with my back.
But if I sleep like this
I've waken up and hours are completely
sleep completely. I can't do anything.
I've already done this.
And I bit my hand, ah, like you
can't feel those thing.
It's pretty fun.
- Oh, I actually, I woke up one time
and the alarm's going off in both arms like that.
Yeah. And I'm going like this, turn, the knock
turn the alarm off.
- That's kinda fun.
The other one that is a common one that is
you're driving along.
This is why you shouldn't wear your wallet
and your back pocket.
- Yeah.
- You're gonna -you're gonna actually
pressure on your CIC nerve.
And I had it one time where my foot fell asleep
and I was hitting the brake
and I couldn't feel it.
And I'm coming to a stop light and I
I can't stop the car because I'm pushing as well.
All my might.
So I stopped wearing my wallet in the back.
- Yeah.
- Back pocket there.
- That's that big thick wallet.
- Well, I just got papers in it.
There there's nothing else in it.
Believe me.
- All right.