Arm and leg pain are often attributed to a nerve being “pinched”. Many people also think that “pinched nerves” cause neck, middle back, and lower back pain. “I think I pinched a nerve,” say many people that call our office and offices of other doctors. This mode of thinking may lead to a perception that nerves are pinched from bones being out of place, and chiropractors need to move the bones off the nerves to un-pinch them to remove the pain. Although this is a simple way of describing pain syndromes, in almost all cases it is INNACURATE! There are some instances that nerves (typically nerve roots) are actually pinched, but these cases are very rare as compared to the common sources of pain.

Also, the actual cases of “pinched nerves” or “nerve root compression” are not typically caused by bones pressing on nerves; rather, they are a result of disc herniations. Some nerve root compressions may be caused by bone spurs and advanced joint wear and tear (arthritis). Also, there are other cases of “pinched” peripheral nerves, such as in carpal/tarsal tunnel syndrome.

Symptoms that people often describe as a “pinched nerve” include sharp and dull pain, numbness, tingling, pins and needles, aches, soreness and tightness, and spasms. Pain/tingling/buzzing/numbness down an arm or a leg does not necessarily mean you have pinched a nerve. Often these extremity symptoms are referred pain, also called sclerotogenous pain. So what exactly is sclerotogenous pain, you may be asking?

Pain from the bones, ligaments, and/or fascia is sclerotogenous pain. Most current research cites the soft tissues surrounding the the spinal column, as well as the joints that comprise the spinal column, as one common source of back, neck, arm and leg pain. These soft tissues include the intervertebral discs, joints, ligaments, and muscles/tendons. Irritated discs and facet joints are the most common causes of neck, middle back, and lower back pain.

When a patient experiences sclerotpgenous pain, their body “tricks” them into thinking the problem is with their arm or leg, however, actually the generator of pain is the neck or back. Usually when the neck or back is successfully treated and improved, the arm or leg pain frequently diminshes or disappears. Prevention is ALWAYS better then crisis intervention.

Many people will call their medical physician or chiropractic physician only when a major crisis (pain) arises. We try to educate our patients that it is cheaper and easier to maintain what is well then to fix what is already broken. Many people will stop their chiropractic care once their pain is gone, will stop their home exercise program, and forget about proper posture and ergonomics that was learned during the course of the care! They often find themselves upset when the pain returns in the future. Just like your car and even your teeth, your body requires daily upkeep or you many unnecessarily find that your work, relationships and/ or hobbies being negatively impacted.

Originally written March 1999 by Dr. Peter Percuoco, DC, CCST, DACNB. Revised February 2008 by Dr. Anthony C. Distano, M.S., D.C.