Back Clinic Nerve Injury Team. Nerves are fragile and can be damaged by pressure, stretching, or cutting. Injury to a nerve can stop signals to and from the brain, causing muscles not to work properly and losing feeling in the injured area. The nervous system manages a great majority of the body’s functions, from regulating an individual’s breathing to controlling their muscles as well as sensing heat and cold. But, when trauma from an injury or an underlying condition causes nerve injury, an individual’s quality of life may be greatly affected. Dr. Alex Jimenez explains various concepts through his collection of archives revolving around the types of injuries and condition which can cause nerve complications as well as discuss the different form of treatments and solutions to ease nerve pain and restore the individual’s quality of life.
The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
It’s not unusual for runners to experience tingling, pins and needles, and numbness in their feet while running. Running foot numbness is a relatively common problem for runners and can be easily remedied. Numbness will present in one part of the foot or just the toes. Sometimes it can spread throughout the whole foot. Different causes, most of which are not serious, can be easily dealt with. Serious causes can be treated with chiropractic, massage, decompression therapy, and functional medicine.
Running Foot Numbness
Reasons, why the feet experience numbing sensations when running, include:
Improper footwear.
Laces that are tied too tightly.
Foot strike pattern.
Foot structure.
Training schedule.
Muscle tightness.
Compressed nerve.
Medical conditions like neuromas or peripheral neuropathy.
Footwear
A common cause of running foot numbness is having overly tight shoes that place added pressure on nerves.
If this could be the reason, the remedy is to get new shoes.
Try to find a store that specializes in running shoes and ask for help.
Footwear professionals look at the size of the foot, the shape, and running gait.
For example, individuals with a wide foot may need a style with a wider/larger toebox or the front of the shoe that houses the forefoot.
Get a pair that’s one-half to a full size larger than a regular everyday shoe size.
This is because when running, the feet swell, especially in hot and humid weather.
Going up a half or whole size will also accommodate thicker socks for individuals that run in cold weather.
Sometimes numbness can result from biomechanical issues that can be corrected with the proper shoe.
Tight Laces
Sometimes it’s not the shoes but the laces that are too tight.
Pulling a little tighter to get a firm fit around the ankle is common, but this can entrap nerves on top of the foot at the ankle/anterior tarsal tunnel, similar to the carpal tunnel in the wrist.
This can be problematic for individuals with high arches.
Loosening the laces are recommended.
However, runners may feel insecure with looser laces.
Experimenting with different lacing techniques is recommended to find one that keeps the shoes comfortable without creating undue pressure over the top of the foot.
Using padding under the tongue of the shoe can help.
Foot Fall Pattern
Sometimes running form can put pressure on nerves that, lead to numbness.
Overstriding– Landing heel first with the foot ahead of the body’s center of gravity places the feet on the ground for too long.
Correcting this issue can be achieved by shortening the stride and focusing on landing on the midsole.
This way, the feet will land directly under the body.
Running like stepping on hot coals is recommended, keeping the movements light and quick.
Correcting overstriding saves energy and lowers the risk of shin splints.
A sports chiropractor, physical therapist, or running coach can help fine-tune form for specific guidance.
Foot Structure
The anatomy of the feet, specifically the arches, can contribute to running foot numbness.
Flat feet mean the entire bottom of each foot is in contact with the floor when barefoot.
Overly flexible feet are more likely to experience nerve compression.
This can be corrected with shoe orthotic inserts.
Over-the-counter orthotics may work, but custom orthotics are another option if they don’t.
Muscle Tightness
Stiff, inflexible muscles can lead to anatomical conditions that generate nerve pressure.
Warm-up exercises before running will get the muscles loose and ready.
Stretching is very important before and after running.
Individuals prone to muscle tightness should include flexibility exercises.
Yoga can improve flexibility and body alignment.
Foam rollers and other massage tools will work out kinks in areas where tightness forms and affects nerves, like the quadriceps, calves, hamstrings, and I.T. band.
Regular sports massage and chiropractic can help keep the body pliable.
Sciatic Nerve Issues
A compressed nerve causes a decrease in the sensation to the areas the nerve supplies.
Foot numbness, especially around the heel or the sole, can be caused by sciatic nerve compression.
The pain from sciatica might originate in the back but can end up causing numbness in the feet and/or toes.
Poor posture, tight piriformis muscles, or other back injuries can also cause sciatica.
A chiropractor or physical therapist can prescribe decompression therapy, MET stretches, and rehabilitative exercises.
Prevention
Most of the time, running foot numbness can be treated by adjusting footwear or technique. Here are a few tips for injury prevention:
Evaluate Shoes
First, make sure the shoelaces are not overly tight.
If the shoes are uncomfortable when running, look for another set and get a custom fitting.
Running Form
Avoid overstriding by focusing on landing on the midsole instead of the heel.
This will take the pressure off of the feet.
Foot Orthotics
Individuals with flat feet, high arches, or overly flexible feet should consider orthotics.
Avoid Overtraining
Work rest days into the training schedule and gradually build up to avoid overuse injuries.
Stretch to prevent muscle imbalances, keep muscles loose, and improve the range of motion.
Chiropractic and Physical Therapy
If symptoms don’t improve, see a doctor, podiatrist, or chiropractor so they can rule out conditions and develop a personalized treatment plan.
Benefits of Custom Foot Orthotics
References
Aldridge, Tracy. “Diagnosing heel pain in adults.” American family physician vol. 70,2 (2004): 332-8.
Atik, Aziz, and Selahattin Ozyurek. “Flexible flatfoot.” Northern Clinics of Istanbul vol. 1,1 57-64. 3 Aug. 2014, doi:10.14744/nci.2014.29292
Jackson, D L, and B L Haglund. “Tarsal tunnel syndrome in runners.” Sports medicine (Auckland, N.Z.) vol. 13,2 (1992): 146-9. doi:10.2165/00007256-199213020-00010
Souza, Richard B. “An Evidence-Based Videotaped Running Biomechanics Analysis.” Physical Medicine and rehabilitation clinics of North America vol. 27,1 (2016): 217-36. doi:10.1016/j.pmr.2015.08.006
Sridhara, C R, and K L Izzo. “Terminal sensory branches of the superficial peroneal nerve: an entrapment syndrome.” Archives of physical medicine and Rehabilitation vol. 66,11 (1985): 789-91.
An acute injury or changes to the upper body over time can cause a compressed/pinched nerve in the shoulder. A pinched nerve in the shoulder happens when a muscle, ligament, tendon, or bone irritates or presses on a nerve exiting the neck. Shoulder nerve pain can develop from various sources, such as overuse work injuries, sports injuries, household chores, tendinitis, arthritis, torn cartilage, and other medical conditions, and injuries can contribute to symptoms. Chiropractors are highly qualified to treat pinched nerves. They are trained in whole-body realignment and rehabilitation techniques that find the root source and relieve pressure on compressed nerves.
Shoulder Nerve Pain
The shoulder joint is one of the most complex joints because of its wide range of motion. It is used so frequently that repetitive motion strain is common, often leading to injury. It is usually because of the continued use combined with an unhealed strain/injury that leads to shoulder nerve injury or when surrounding tissues like cartilage or tendons irritate or compress the nerves.
Pinched nerves also occur when a nerve root in the neck is damaged through wear and tear or an acute injury.
Individuals 50 years and older are likely to experience pinched nerves because of degeneration in the cervical spine and/or arthritis.
A nerve can become pinched when bone spurs form around the spinal discs.
Bone spurs are formations of bone that grow when discs weaken with age.
Bone spurs grow around the discs putting pressure on the nerve root.
Symptoms
Compressed Pinched Nerve/Cervical Radiculopathy
Pain sensations in the shoulder.
Tingling and/or pins and needles in fingers or hand.
Weakness in shoulder and arm muscles.
Symptoms have been known to overlap with shoulder arthritis, frozen shoulder, swimmer’s shoulder, or rotator cuff tears, so it’s always best to consult a chiropractor to understand possible causes. Other conditions with symptoms to compare:
Shoulder Arthritis
Stiffness in the joint.
Aching inside the shoulder.
Grinding when moving the joint.
Frozen Shoulder/Adhesive Capsulitis
Stiffness in the joint.
Pain in one shoulder.
Decreased range of motion and movement.
Swimmer’s Shoulder/Impingement
Pain and discomfort in the shoulder.
Weakness in the surrounding area.
Stiffness or tightness in the joint.
Impeded range of motion.
Rotator Cuff Tears
Pain and discomfort symptoms when moving the shoulder.
Weakness in the arm.
Deep aching sensations along the top and side of the joint.
Chiropractic Treatment
Chiropractors are experts on the neuromusculoskeletal system. First, a thorough medical examination will be conducted, including health history and regular activities, to understand the nature of the symptoms. Depending on the type of injury, tests, and exams may be needed to help diagnose and pinpoint the cause. Then the chiropractor will develop a personalized treatment plan. The objective is to relieve pressure and tension on the nerves and relax the muscles. In addition to adjusting the joint or other impacted areas, the therapy team will provide at-home exercises and stretches to maintain the adjustments and expedite healing.
Chiropractic Rehab
References
Kokkalis, Zinon T et al. “Nerve Injuries around the Shoulder.” Journal of long-term effects of medical implants vol. 27,1 (2017): 13-20. doi:10.1615/JLongTermEffMedImplants.2017019545
Leider, Joseph D et al. “Treatment of suprascapular nerve entrapment syndrome.” Orthopedic reviews vol. 13,2 25554. 11 Jul. 2021, doi:10.52965/001c.25554
Matzkin, Elizabeth, et al. “Swimmer’s Shoulder: Painful Shoulder in the Competitive Swimmer.” The Journal of the American Academy of Orthopaedic Surgeons vol. 24,8 (2016): 527-36. doi:10.5435/JAAOS-D-15-00313
Neviaser, Andrew S, and Jo A Hannafin. “Adhesive capsulitis: a review of current treatment.” The American Journal of sports medicine vol. 38,11 (2010): 2346-56. doi:10.1177/0363546509348048
Safran, Marc R. “Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve.” The American Journal of sports medicine vol. 32,3 (2004): 803-19. doi:10.1177/0363546504264582
Strakowski, Jeffrey A, and Christopher J Visco. “Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder.” Muscle & Nerve vol. 60,1 (2019): 1-6. doi:10.1002/mus.26505
A peroneal nerve injury/peroneal neuropathy can be caused by direct trauma to the outer knee with symptoms and sensations of numbness, tingling, pins-and-needles sensations, pain, or weakness in the foot that can cause a condition known as foot drop. Chiropractic can perform spinal manipulation, realignment, and decompression to restore the nerve’s function. They can also help with walking and mobility by providing muscle strengthening and stretching exercises to correct abnormal gait caused by foot drop and increase the range of motion in the ankle.
Peroneal Nerve Injury
The peroneal nerve begins near the sciatic nerve at the glutes/hip and buttocks. It travels down the back of the thigh to the knee, which wraps around the front of the leg and extends into the feet to the toes. It provides sensory input from the lateral aspect of the lower leg and the top of the foot. It also provides motor input to the muscles responsible for lifting the foot off the ground lifting the toes and ankles and turning the foot outwards.
Causes
Structural problems in the spine or misalignment can affect the functionality of the nervous system and lead to peroneal neuropathy. Traumatic nerve injury causes include musculoskeletal injury, peroneal nerve paralysis, compression, or laceration. Injuries by trauma and nerve compression include:
Compression of the nerve in the leg.
Knee dislocation.
Knee or hip replacement surgery.
Knee or leg fracture. Fractures of the tibia or fibula, especially in the areas closer to the knee, can injure the nerve.
Ankle fracture.
Blood clot.
Compression by a nerve sheath tumor or cyst.
Certain underlying medical conditions can cause symptoms of peroneal nerve injury. It is recommended to be evaluated by a medical professional who can diagnose and offer appropriate treatment options. Neurologic disorders that can cause similar symptoms:
Herniated lumbar disc
Multiple sclerosis
Parkinson’s disease
Amyotrophic lateral sclerosis – ALS or Lou Gehrig’s disease.
Metabolic syndromes – diabetes, alcohol abuse, exposure to toxins.
Symptoms
Nerve injury symptoms include:
Numbness, tingling, or loss of sensation in the top of the foot or outer part of the lower leg.
Inability to flex toes or ankles upward/dorsiflexion.
Inability to flex the ankle to take a step forward.
Inability to move the foot.
Weakness in foot eversion/rotating outward.
Flopping or slapping sounds when walking.
Gait changes – dragging the toes or lifting the knee higher than the other to raise the foot off the ground.
Tripping often.
Pain in the foot or lower leg.
Diagnosis
In diagnosing a peroneal nerve injury, a healthcare provider examines the leg and analyzes symptoms. Tests can include:
Imaging tests – CT scan, ultrasound, or MRI.
Magnetic resonance – MR – neurography is a specialized high-resolution MRI of the nerves.
An electromyogram measures how muscles react to nerve stimulation.
Treatment for a peroneal nerve injury depends on the severity and can be surgical or non-surgical. Non-surgical options include orthotic footwear, chiropractic care, and physical therapy. A physical therapy program could consist of the following:
Icing
Massage
Manual manipulation
Stretching
Strengthening exercises
Mobilization exercises
Balancing exercises
Ankle bracing
Ankle taping
Shoe inserts – splints, braces, or orthotics can improve gait.
Longo, Diego, et al. “The Muscle Shortening Maneuver: a noninvasive approach to treating peroneal nerve injury. A case report.” Physiotherapy theory and practice, 1-8. 31 Jul. 2022, doi:10.1080/09593985.2022.2106915
Milenković, S S, and M M Mitković. “Common peroneal nerve schwannoma.” Hippokratia vol. 22,2 (2018): 91.
Radić, Borislav et al. “PERIPHERAL NERVE INJURY IN SPORTS.” Acta clinica Croatica vol. 57,3 (2018): 561-569. doi:10.20471/acc.2018.57.03.20
Thatte H et al. (2022). Electrodiagnostic evaluation of peroneal neuropathy. ncbi.nlm.nih.gov/books/NBK563251/
T Francio, Vinicius. “Chiropractic care for foot drop due to peroneal nerve neuropathy.” Journal of bodywork and movement therapies vol. 18,2 (2014): 200-3. doi:10.1016/j.jbmt.2013.08.004
Nerve irritation occurs when the nerves exiting the spine become irritated and sensitized. Also known as nerve gliding restriction, it is a condition whereby a nerve becomes irritated by inflamed swelling of structures close to the nerve, such as joints, ligaments, muscles, or discs, that have sustained an accumulative strain which results in swelling and inflammation. A thorough chiropractic assessment and examination can diagnose the extent of the irritation and develop a personalized treatment plan.
Nerve Irritation
When swelling and inflammation interfere with the nerve root, the nerve transmits signals to the brain to let it know there is a threat. The brain interprets these signals and creates a protective response to avoid worsening the damage to the nerve. The protective reactions vary from person to person but can include the following:
Muscle tightness and guarding
Aching sensation
Cramping
Radiating discomfort or pain
Pins and needles
Tingling
Numbness
Nerve root irritation also inhibits the body from recovering as fast as it should.
Nerve irritation is not to be confused with nerve root compression or radiculopathy. This is when the nerve becomes compressed/pinched, resulting in the loss of its functions like muscle strength and sensation. Sometimes individuals with nerve irritation can also experience increased neural tension. The nerves adapt to the mechanical loads placed on them through regular movements. Restrictions to neural mobility can cause symptoms to worsen along the pathway and distribution of the nerve.
The nervous system consists of the brain, spine, and nerve branches.
The branches, similar to electrical cables, cannot stretch.
Tension is generated when straightening out body areas, creating a pull and gliding of the nerve to the spinal cord.
When nerve irritation occurs, signals are sent to protect the body, brain, spine, and branches.
Causes
Most commonly, nerve irritation occurs when a structure adjacent to the nerve; this could be a joint, ligament, and/or muscle that accumulates strain and becomes dysfunctional, swollen, inflamed, and/or spasms resulting from protective guarding.
Mild nerve irritation can include accumulated strain from postural overload and swelling from a minor tear in an adjacent ligament.
Often nothing shows as a problem on an MRI scan.
Severe nerve irritation can include disc herniation and shows up on an MRI scan; surgery could be required in some cases.
Symptoms
Stiffness
Tightness
Aches
Pains
Persist even after days of rest, stretching, targeted exercises, avoiding movements, etc.
Stretching feels good at first, but the pain returns or worsens a few hours later or the next day.
The irritation blocks the effective recovery of muscle, joint, tendon, and ligament discomfort symptoms.
Chiropractic Care
Treatment involves various therapies and strengthening the supporting structures while relaxing and releasing tight structures to avoid recurring injuries. Chiropractic care realigns the spine, corrects joints that have shifted out of place, helps to regulate the nervous system’s function, and relieves irritation and inflammation. Whether in the form of an adjustment, traction, or guided exercise, all systems in the body are moved closer to a balanced state. This includes the:
Nervous system
Immune system
Respiratory system
Circulatory system
Endocrine system
Skeletal system
All help support the body’s self-healing process and increase the nervous system’s function.
The chiropractic team will guide the patient through the rehabilitation process to get back to full strength.
Peroneal Nerve Irritation
References
Ellis, Richard F, and Wayne A Hing. “Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacy.” The Journal of manual & manipulative therapy vol. 16,1 (2008): 8-22. doi:10.1179/106698108790818594
Gibson, William, et al. “Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults.” The Cochrane database of systematic reviews vol. 9,9 CD011976. 14 Sep. 2017, doi:10.1002/14651858.CD011976.pub2
O’Shea, Simone D et al. “Peripheral muscle strength training in COPD: a systematic review.” Chest vol. 126,3 (2004): 903-14. doi:10.1378/chest.126.3.903
Rozmaryn, L M et al. “Nerve and tendon gliding exercises and the conservative management of carpal tunnel syndrome.” Journal of hand therapy: official Journal of the American Society of Hand Therapists vol. 11,3 (1998): 171-9. doi:10.1016/s0894-1130(98)80035-5
Sipko, Tomasz, et al. “Mobility of cervical spine and postural equilibrium in patients with spinal overload syndrome.” Ortopedia, traumatologia, rehabilitacja vol. 9,2 (2007): 141-8.
In cold weather, it’s normal to experience cold hands and fingers. But if there is a coldness in only one finger while the rest of the hand is normal, changes to skin color, numbness, tingling, or pain symptoms could be a sign of poor circulation or an underlying medical condition. Cold fingers could indicate various problems, including overuse injuries, vitamin deficiencies, Raynaud’s syndrome, hypothyroidism, anemia, arterial disease, or an autoimmune condition. Chiropractic care and massage therapy can increase circulation, release compressed nerves, relax the muscles, and restore mobility and function.
Cold Fingers
Blood circulates throughout, nourishing and maintaining body warmth. When compression, obstructions, or narrowing paths inhibit blood flow, the body cannot achieve proper circulation. Unhealthy circulation can cause several symptoms, including:
Pins and needles sensations along the shoulder, arm, hand, and fingers.
Weakened arm and hand muscles.
Numbness.
Cold finger/s.
Muscles aches, soreness, and tightness.
Swelling.
Pale or bluish skin color.
Overuse Injury
Repeating one movement or motion constantly over time can lead to overuse syndrome/repetitive motion disorder in the hands and arms. Certain jobs and activities can cause overuse syndrome, including:
Cashiers.
Food service work.
Graphic sign work.
Computer work.
Sewing work.
Landscaping.
All of these jobs and activities can put a lot of repeated stress on the hands and arms.
Vitamin B-12 Deficiency
Vitamin B-12 is required for proper red blood cell formation and neurological function. It is found in many foods, including eggs, fish, meat, poultry, and dairy products. A vitamin B-12 deficiency can cause neurological symptoms like numbness, tingling, and coldness in the hands and feet. Other symptoms include:
Anemia
Fatigue
Weakness
Difficulty maintaining balance
Depression
Soreness of the mouth
A doctor requires a blood sample to test for the deficiency. A common treatment is a high dose of an oral supplement or injections for individuals that have difficulties absorbing B-12 through the digestive tract.
Raynaud’s Syndrome
Raynaud’s syndrome is a condition that causes some areas of the body, usually the fingers, to feel cold and numb when exposed to cold temperatures or high-stress levels. This happens because the small arteries that supply blood to the skin are experiencing spasms. During an episode, the arteries narrow, which prevents blood from circulating correctly. The fingers can change color, going from white to blue to red. When the flare-up ends, and the blood flow returns to normal, there may be tingling, throbbing, or swelling. The condition isn’t usually debilitating, and treatment options often include medications that expand the blood vessels to improve circulation. These include calcium channel blockers,alpha-blockers, and vasodilators.
Hypothyroidism
Hypothyroidism is when the thyroid doesn’t produce enough hormones. Hypothyroidism comes on gradually and rarely generates symptoms in the early stages. Hypothyroidism doesn’t cause cold fingers but increases the body’s sensitivity to cold. Other symptoms include:
Fatigue
Muscle weakness, tenderness, and achiness.
Joint swelling, stiffness, and pain.
Puffiness.
Dry skin.
Hoarseness.
Weight gain.
High or elevated cholesterol levels.
Thinning hair and hair loss.
Depression.
Over time, the condition can cause complications such as obesity, joint pain, heart disease, and infertility. A doctor can detect hypothyroidism with a simple blood test. Treatment involves taking a daily dose of synthetic thyroid hormone.
Anemia
Anemia is when the blood has a lower-than-normal amount of red blood cells. It also occurs when the red blood cells lack a crucial iron-rich protein called hemoglobin. Hemoglobin assists red blood cells in delivering oxygen from the lungs to the rest of the body. A low supply of hemoglobin to carry oxygen to the hands can result in cold fingers. There may also be fatigue and weakness. Iron deficiency is what typically causes most cases. A doctor may suggest nutritional adjustments if blood work indicates low iron levels. An iron-rich nutritional plan and taking iron supplements can help relieve symptoms.
Arterial Diseases
Diseases that affect the arteries can reduce blood flow to the hands, causing cold fingers. This can be from plaque buildup or inflammation in the blood vessels. Any blockage in the blood vessels can prevent blood from circulating normally. Another arterial problem is primary pulmonary hypertension, which affects the lungs’ arteries and can lead to Raynaud’s syndrome.
Chiropractic Care
Chiropractic adjustments can remove misalignments, restore proper nerve communication, increase blood flow, and correct an overactive sympathetic nervous system. Massaging the shoulders, arms, and hands relaxes the nerves, and muscles, breaks up compressed tissues, and increase blood flow. The circulation of lymphatic fluid around the body is also promoted, which carries toxins away from the muscles and tissues. To improve circulation, the following may be utilized:
Deep tissue pressure is effective at relieving congestion and tension.
Percussive massage to break up scar tissue.
Non-surgical Decompression to stretch the spine and body out.
Lymphatic drainage is designed to improve the circulation of the fluid.
Bilić, R et al. “Sindromi prenaprezanja u saci, podlaktici i laktu” [Overuse injury syndromes of the hand, forearm and elbow]. Arhiv za higijenu rada i toksikologiju vol. 52,4 (2001): 403-14.
Ernst, E. “Manual therapies for pain control: chiropractic and massage.” The Clinical journal of pain vol. 20,1 (2004): 8-12. doi:10.1097/00002508-200401000-00003
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the blood circulatory system work? 2010 Mar 12 [Updated 2019 Jan 31]. Available from: www.ncbi.nlm.nih.gov/books/NBK279250/
Pal, B et al. “Raynaud’s phenomenon in idiopathic carpal tunnel syndrome.” Scandinavian journal of rheumatology vol. 25,3 (1996): 143-5. doi:10.3109/03009749609080004
Waller, D G, and J R Dathan. “Raynaud’s syndrome and carpal tunnel syndrome.” Postgraduate medical journal vol. 61,712 (1985): 161-2. doi:10.1136/pgmj.61.712.161
Neck injuries and whiplash symptoms can be minor and go away within a few days. However, whiplash symptoms can manifest days later and become varied and chronic, ranging from severe pain to cognitive problems. These are collectively called whiplash-associated disorders because of the varied complexity of the symptoms. A common condition is a whiplash nerve injury. These injuries can be severe and require chiropractic treatment.
Whiplash Nerve Injury
Surrounding muscles, tissues, bones, or tendons can cause a whiplash nerve injury. The neck’s spinal nerve roots become compressed or inflamed, leading to cervical radiculopathy symptoms of tingling, weakness, and numbness that can radiate down the shoulder, arm, hand, and fingers. Typically, cervical radiculopathy is only felt on one side of the body, but in rare cases, it can be felt on both sides if more than one nerve root is affected.
Neurological Cervical Radiculopathy
Neurological problems can become severe and can reduce the ability to perform many routine tasks, such as gripping or lifting objects, writing, typing, or getting dressed.
Cervical radiculopathy involves one or more of the following neurological deficiencies.
Sensory – Feelings of numbness or reduced sensation. There can also be tingling and electrical sensations.
Motor – Weakness or reduced coordination in one or more muscles.
Reflex – Changes in the body’s automatic reflex responses. An example is a diminished ability or reduced hammer reflex exam.
Symptoms
Because every case is different, symptoms vary depending on the location and severity. Symptoms can flare up with certain activities, like looking down at a phone. The symptoms then go away when the neck is upright. For others, symptoms can become chronic and do not resolve when the neck is resting and supported. Common symptoms include:
Fatigue
Decreased energy levels could be related to sleep problems, depression, stress, pain, concussion, or nerve damage.
Memory and/or concentration problems
Cognitive symptoms could involve difficulty with memory or thinking.
Symptoms can start shortly after the injury or not appear until hours or days later.
Cognitive problems could be from a brain injury or related to various types of stress.
Headaches
This could be neck muscles tightening or a nerve or joint becoming compressed or irritated.
Dizziness
Dizziness could be from neck instability, a concussion/mild traumatic brain injury, and nerve damage.
Vision problems
Blurry vision or other visual deficits could result from any number of causes, including concussion or nerve damage.
Vision problems could also contribute to dizziness.
Ringing in the ears
Also called tinnitus, this can be ringing or buzzing in one or both ears and can range from intermittent and minor to constant and severe.
Whiplash complications such as injury to the brain region that controls hearing, nerve or vascular damage, jaw injury, or stress can lead to tinnitus.
Chiropractic Care
The appropriate chiropractic treatment is unique to each whiplash nerve injury and is directed at the primary dysfunctions detected during the initial examination. A personalized treatment plan addresses factors in an individual’s work, home, and recreational activities. Treatment includes:
Massage manual and percussive for nerve and muscle relaxation
Goldsmith R, Wright C, Bell S, Rushton A. Cold hyperalgesia as a prognostic factor in whiplash-associated disorders: A systematic review. Man Ther. 2012; 17: 402-10.
McAnany SJ, Rhee JM, Baird EO, et al. Observed patterns of cervical radiculopathy: how often do they differ from a standard “Netter diagram” distribution? Spine J. 2018. pii: S1529-9430(18)31090-8.
Murphy DR. History and physical examination. In: Murphy DR, ed. Conservative Management of Cervical Spine Syndromes. New York: McGraw-Hill, 2000:387-419.
Shaw, Lynn, et al. “A systematic review of chiropractic management of adults with Whiplash-Associated Disorders: recommendations for advancing evidence-based practice and research.” Work (Reading, Mass.) vol. 35,3 (2010): 369-94. doi:10.3233/WOR-2010-0996
Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1, 2nd ed. Baltimore, MD: Williams and Wilkens, 1999.
Pinched Nerves and Muscle Spasms: A pinched or compressed nerve can occur in various body regions, from the wrist to the foot. When a nerve is compressed, a pins and needles feeling can present until the pressure is relieved, or there can be no sensation symptoms, but other symptoms like muscle spasms, especially in the arm or leg, can appear. Individuals will feel a repetitive fluttering or twitching when the arm or leg is not in motion. A pinched nerve could be the cause of spasms in the back or extremities. Injury Medical Chiropractic and Functional Medicine Clinic can help if symptoms are not stopping or worsening.
Pinched Nerves and Muscle Spasms
When multiple symptoms appear, individuals may not realize they are connected. Individuals may think aches, pains, and spasms are normal aging processes. Pinched nerves occur when there is an impingement on any one of the numerous nerves of the spine. Impingements can be caused by:
Repetitive motion injuries
Disc degeneration
Herniated/ruptured discs
Bone spurs
Arthritis
Trauma injury
The pain symptoms from the spasm can be quick, sharp, or pulsating and throbbing. The muscles respond by tightening or spasming as the nerve sends interrupted/incomplete signals. In addition to muscle spasms, a pinched nerve can contribute to other symptoms, including the following.
Tingling
Numbness
Pins and needles sensation
Reduced range of motion
Muscle weakness
Signs a Pinched Nerve Might Be Causing Spasms
Sudden shooting pain that radiates down the leg or arm.
Weak muscles
Muscle atrophy – shrinking or deteriorating.
Chronic tingling in the extremities.
A burning sensation in a specific area; this could but is not necessarily the source of the pinched nerve.
Electrical shock-type pain accompanies the spasms.
If a pinched nerve is left untreated and continues to generate symptoms, it can affect daily life and lead to uncomfortable long-term issues. Severe nerve compression combined with inflammation can cause damage to nearby soft tissues and muscles, leading to chronic conditions. When the nerves are damaged, it can be harder to control the muscles making certain motions uncomfortable or difficult to move certain body parts.
Chiropractic Care
Chiropractic care, massage, and decompression therapy will relieve pinched nerves and muscle spasms and restore neuromusculoskeletal system function. The body will be realigned, and patients will be trained on stretching exercises, muscle strengthening, posture training, and nutritional support to optimize the body’s natural healing abilities to repair the damaged nerves.
Low Back Pain
References
Bustamante, S, and P G Houlton. “Swelling of the leg, deep venous thrombosis, and the piriformis syndrome.” Pain research & management vol. 6,4 (2001): 200-3. doi:10.1155/2001/104091
Chu, Eric Chun-Pu, and Robert J Trager. “Thoracic Schwannoma as an Unusual Cause of Sciatic Pain in the Chiropractic Office: A Case Report.” The American journal of case reports vol. 23 e938448. 16 Nov. 2022, doi:10.12659/AJCR.938448
Coletti, Roger H. “The ischemic model of chronic muscle spasm and pain.” European journal of translational myology vol. 32,1 10323. 18 Jan. 2022, doi:10.4081/ejtm.2022.10323
Hirayama, Jiro, et al. “Relationship between low-back pain, muscle spasm and pressure pain thresholds in patients with lumbar disc herniation.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 15,1 (2006): 41-7. doi:10.1007/s00586-004-0813-2
Kennedy, John G, and Donald E Baxter. “Nerve disorders in dancers.” Clinics in sports medicine vol. 27,2 (2008): 329-34. doi:10.1016/j.csm.2008.01.001
Waddell, Roger K. “Chiropractic care for a patient with spasmodic dysphonia associated with cervical spine trauma.” Journal of chiropractic medicine vol. 4,1 (2005): 19-24. doi:10.1016/S0899-3467(07)60108-6
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Whiplash Nerve Injury
