In my clinical practice, I've been seeing many pinched nerves lately. Radiculopathy, better known as a pinched nerve, is caused by a dysfunction of the nerve, nerve root, or both at the spinal cord. When a nerve is compressed along the nerve pathway, it can become inflamed and cause pain, weakness, and numbness down the arms or legs, depending on the nerve root it affects. Pinched nerves can be in the neck, mid-back, or lower back.
Causes of Radiculopathy
Radiculopathy is usually caused by changes in the tissues surrounding the nerve roots. These tissues typically can be bone from the spinal vertebrae, cartilage, muscles, tendons, and intervertebral discs. These tissues can shift or change in size from degeneration or spinal injury. With these changes to the tissues, the opening where the nerves enter and exit the spine can narrow, causing nerve impingement. Some causes of nerve compression can be due to:
Disc herniations at the spinal cord
Bone spurs - extra bone growth due to osteoarthritis, trauma, or other degenerative conditions.
Referral pain from trigger points in muscles
Muscle imbalances
Thickening of spinal ligaments
Tumors
Radiculopathy vs. peripheral neuropathy
Radiculopathy and peripheral neuropathy have symptoms that overlap. Radiculopathy is damage to the nerve root at the spinal cord, while peripheral neuropathy is damage to the peripheral nerves from nerve entrapment further from the spine. For example, carpal tunnel syndrome is a peripheral neuropathy because the nerves at the wrist are damaged or entrapped. Peripheral neuropathy could also be a side effect of chemotherapy. Acupuncture is a safe and effective treatment modality for peripheral neuropathy and radiculopathy.
Common Nerve Entrapments
Nerve entrapments are more common than you might think. Most of the time, musculoskeletal pain and numbness are not caused by a disc issue but instead by a muscle imbalance from compensation patterns. In the photos below, the nerves are pictured in yellow, and the muscles are in red. You can see that the nerves run through many muscles, so it can be very easy for the nerves to be compressed when the muscle is tight and restricted. Here are a few common examples:
The sciatic nerve can be compressed by tight piriformis and gluteal muscles, leading to pain and numbness down the leg.
Brachial plexus syndrome is caused by tight scalenes and pec muscles entrapping the brachial plexus, causing numbness and tingling in the arm and hands.
Tight suboccipital, upper trapezius, and semispinalis capitus muscles in the neck can compress occipital nerves, causing migraines and/or neck pain.
Acupuncture Treatment for Pinched Nerves
Acupuncture is an effective treatment for pinched nerves if the cause is tight and weakened muscles entrapping the nerve pathway. Motor point acupuncture can activate weakened muscles from inflammation and loosen tight muscles from the body's compensatory mechanisms. Motor point acupuncture also helps bring blood and oxygen to ischemic muscles that are not nourished due to injury.
Trigger point acupuncture can deactivate muscle knots that mimic cervical or lumbar radiculopathy (or pain going down the arms or legs, respectively). Releasing these muscle knots can also free up the range of motion in the joint. Suppose you are not getting any relief from your pain management injections, chiropractor, or physical therapist. In that case, trigger points in the muscles most likely inhibit your body's healing process. Other modalities, like cupping and gua sha, can bring blood flow to the area to reduce inflammation and activate the body's natural healing response.
Want to see if acupuncture can reduce the symptoms of your pinched nerve?
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