Pinched Nerve or Slipped Disc?

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Dr. Pablo Tagle M.D.
Dr. Pablo Tagle M.D.

 

It is all too often that you hear someone tell you that they have a pinched nerve.  Or sometimes you may even hear someone say that their disc has slipped out of place.  What does that mean?  How can you tell if you have a pinched nerve or a slipped disc?  What symptoms would you feel?

Back pain is a very common condition that most of us have experienced at least once in our lives.  The extent of the back pain or the nature of the problem is what varies.  Conditions vary from generalized achiness to sharp stabbing pain and even reoccurring numbing, tingling, and burning sensations down to other areas of your body that are related.  Not everyone with the same exact issue will experience the same exact pain or sensations.  So, what is the reason for the different symptoms from individual to individual?

To understand fully the mechanism behind the injury, you must first understand the anatomy of the spine.  Your spine is comprised of your 7 Cervical (neck) vertebras, 12 Thoracic (mid-back) vertebras, and 5 Lumbar (low back) vertebras that sit on your sacrum.  In between each vertebra you have a disc.  Your disc is comprised of 2 layers: a tough outer layer called the Annulus Fibrosus(AF), and an inner layer that is a gel filled sac, which acts like a shock absorber called the Nucleus Pulposus(NP).  Your spinal cord travels down a hole called the Vertebral Foramen.  It starts at your brain stem and travels all the way down to your lumbar region.  Your spinal nerves are smaller nerves that originate from the spinal cord and exit these holes called Neural Foramina’s that are in between each vertebra.  This would be enough to give you a generalized understanding of the spine without trying to get very detailed and specific.

So, what is a “pinched” nerve or a “slipped disc”?  The term pinched nerve is easily described: it is a nerve that has been pinched.  When referring to a “slipped disc,” it is a little misleading.  Your disc does not exactly slip out of place.  Basically, your disc is protruding out of its normal position because the disc is either bulging or it has been herniated.  This is the most common way a nerve can be pinched, usually due to a bulging or herniated disc.  The difference between a bulging and a herniated disc is that in a bulging disc, the annular fibrosus has been torn and is protruding out and pressing on the spinal nerve that is exiting at that disc level.  In a herniation, the inner nucleus pulposus has been torn and has torn through the outer layer, pinching the nerve at the respective level.

Either way, the nerve is being pinched and can be extremely painful.  Another way a nerve can be pinched is due to a vertebrae being misaligned, also known as a sub-luxation.  Whichever vertebral level the subluxation is at will directly affect the spinal nerve traveling out at that level.  The third way you can pinch a nerve is by having a muscle being very tight and entrapping the nerve.  This is usually the case when you have sciatica.  The sciatic nerve travels down your glute muscles to the bottom of your leg, and when you have certain gluteus muscles that are tightened, it will pinch the sciatic nerve causing sciatica.

So what are your options to help fix your condition?  That will depend on several factors.  1.) Do you have a bulge or a herniation?  And if you do have a bulge or herniation, how big and how much is it pressing on your nerve?  If you have a bulging disc or herniation, unfortunately, it is there to stay.  Alternative medicine, such as chiropractic, physical therapy, massage, and spinal decompression have been shown to help reduce the symptoms and help the pain, but they will not completely fix the problem.  When referring to a pinched nerve due to subluxation, chiropractic care or physical therapy can help resolve and fix this problem.  If you have a pinched nerve due to a muscular entrapment of a nerve, chiropractic, physical therapy, or massage can help alleviate the problem.

How do you know if you have a pinched nerve?  Always discuss your conditions with your health care practitioner so that they may properly diagnose your pain.  They can help you determine whether it is a minor ache or if there is a deeper problem.  In more extreme cases, surgery is required to help relieve the pinched nerve.  Usually an MRI is needed to detect whether you have a bulging or herniated disc.

Listen to your body.  Your body is the most amazing tool that will let you know something is wrong as long as you listen to it.  If something is bothering you, that’s your cue that something is not in balance in your body.  Stretching is one thing that you can do daily to make sure you keep your range of motion in your spine.  Exercise helps keep your muscles strong and helps prevent the deterioration of your spine.  Lastly, it is extremely important to manage your weight.  The more weight you gain, the more weight and pressure you put on your body, as well as your spine.  So, to an already damaged disc, this will inevitably increase the pressure on your disc and directly affect your nerve.  Love your body and treat it right, because you only have one body in your journey through life.