Pain - is it a pinched nerve

[su]

Hi,

I fell down the stairs and am having constant pain after that.
The doctor said nothing was broken and prescribed ibuprofen for the pain.

I can only walk very slowly and sitting down or getting uo causes a pinching/grinding pain in my left side.

I am also using ice and heat which relieves the symptoms for a
few seconds but then it comes back. The ibuprofen helped initially, but is not helping much anymore.

I need to get back to work - what do I have and how long will it last?

Thanks,
Su

[CCF Neuro[P] MD, RPS]

Dear Su:

You ask a very difficult question to answer over the internet, since we do not get to examine you or see the films.  Nerve pain usually is sharp and radiates and worsens with particular movements, contusion pain is usually muscular and achy, and worsens with all movement.  Since there is no fracture, I think your physician is correct in Rx NSAIDs and rest.  Ice will help during the initial 24 hours then heat (but not too hot).  I can't tell you how long it will last, your doctor knows better since he/she examined you, ask them.

CCF Neuro MD

[dylan]

I just have a brief question related to pinched nerves.  Can you have a pinched nerve and be unaware of it?  What I mean is it just an acute pain or is it capable of creating pain throughout the body?

[Karen R.]

I have been having this constant lower back pain since I had an accident at work,(delivery truck hit picnic table where I was sitting,my right knee was caught between the table and a wall,my knee recieved a contusion the doctor daid)when ever my right knee starts to hurt the lower back hurts at the same time,which makes both legs&ankles hurt,& they then have a heavy& burning sensations.I can't stand for more than 1-2 hours,then they start hurting extremely bad.I have MS(DX9/99)my doctor says its will go away,but this has been going on since June 4,1999,and getting worse,what can I do???Also I was perfectly healthy before the accident.Within 3 days my world feel apart & MS began.Could MS have been brought on by the accident,One doctor said he believes this is why my MS came on,Is there any documented cases where this has happened? Between the chronic lower back pain,& the fatigue dont know how I can keep going on like this. Thank You if you can help me.

[CCF Neuro[P] MD, RPS]

Dear Karen:

Trauma, especially peripheral trauma does not cause MS.  MS is an autoimmune disease that has an unknown etiology.  Your MS diagnosis is separate from you knee injury.  Sounds like you have a bad knee that might lead to leg pain due to gait changes.  I would see a ortho specialist and see if your gait is off and that might be inducing you pain.  Again, your MS is not due to your knee injury.

Sincerely,

CCF Neuro MD

[[e-mail]]

I need any information relating to herniated disc in the neck. This causes severe pain down my right arm and numbness in my fingers. This severely limits the use of my hand. Doctor recommends surgery, removing the disc. Any information on this surgery is also of interest.

Thank you!

[CCF Neuro[P] MD, RPS]

Dear azappone@:

Your symptoms certainly sound like you have a radiculopathy from your disc problem.  I would see a neurologist who is familar with disc problems.  As you have probably read, surgery is the last resort and can be, depending on the degree of the problem, either beneficial or have no effect at all.  Get a second opinion also from a rehab specialist.  See what your options based on your individual problems and what is out there.  Usually, we recommend a good trial of PT, rehab, and change of lifestyle as the initial therapy (but this is dependent on the lesion).

CCF Neuro MD

[kay Buffington]

Since March 1998 I have had constant pain down my left leg and into my foot.  It hurts to sit, walk and stand.  I have had a myelogram, cat scan, EMG and specta-scan.  The specta-scan shows that I have arthritis L3-4 and the doctor says that he can do a bone fusion. All other tests are normal.  Of course , I don't want back surgery! My Chiropractor says that I could have a muscle that is squeezing the nerve somewhere along the line.

Do you have any suggestions?

***@****

[CCF Neuro[P] MD, RPS]

Dear Kay Buffington:

Not being able to see the test results I cannot really make a comment.  Get a second opinion from another neurosurgeon or neurologist.

Sincerely,

CCF Neuro MD

[Patti]

Since 3/99, have had almost constant pain in my mid-cervical (c-5 or 6, I think) spine area and down my right arm, with tingling in several fingers of right hand, particularly thumb and ring finger.  Pain in arm eventually resulted in tennis elbow, for which I was treated first with pt, then steriod shot, which resolved the acute elbow pain.  The neck pain never not better, as a matter of fact has gotten worse, and arm pain is still there also, as well as finger problems.  Also have had migraines most of my life, but not very often.  The mirgriaines recently progressed to 1/2 a week.  Was on nortryptiline plus various pain/nsaids meds+ chiropractic for most of last year to to avail.  Have been seeing neurologist/doing pt/taking neuronitn 300 mg 3x/dy for almost 3 mos. and have had one occipital nerve injection plus one injection in the large muscles at the top of the back which were supposed to loosen things up (as I'm supposed to be very tight).  Am now in the twilight of the pt, and have more flexibility in upper neck, but have not seen any improvement in my primary symptoms, except the migraines, which are less frequent.  Med seems to mask neck/arm pain, but when it wears off,  pain/tingling always returns...sharp, shooting down my right arm into my forearm and fingers and involuntary intermittent jerking or fingers plus sometimes wierd worm like sensations in forearm area previously affected with tennis elbow.   No MRI has been done, but xrays of cervical and lumbar spine showed degeneration in those areas.  Pain is/has been disabling.  Are my symptoms indicative of anything and how long should I tough it out before getting second opinion?

[CCF Neuro[P] MD, RPS]

Dear Patti:

Tennis elbow is subluxation of the radial head and not due to a C-spine lesion, so your tennis elbow is due to minor long term trauma of your elbow and not your back.  That needs to be treated separately and will not be resolved until you do something about the elbow.  The neurontin level your on is small and pain relief might be better with higher doses.  But we are only talking about symptomatic relief.  The issue is your spine and some of the symptoms you describe are related to that area.  I would see if your neurologist would do a MRI and look at whether you might have a radiculopathy from a herniation or foraminal problem.  The sooner scerenio would be better than waiting.  Likely, things are not going to improve unless the lesion is found and rehab can begin.

Sincerely,

CCF Neuro MD

[Patti]

Thanks for your advice.  I did get the MRI and it shows "moderate amt. of asymmetric spurring at c5/6 on rt. side of midline which encroaches to some degree upon intervertebral neural foramen and encroaches significantly on anterior/posterior dimensions of rt. side of cervical spinal canal and, as a result, cervical spinal cord is displaced posteriorly somewhat at this leve l; also some slightly asymmetric bulging of the annulus at c6/7; all else normal (cerebellar tonsils lie above the foremen magnum.  .  Earlier this week had 1st of a series of 3 epidurals, which so far has not helped at all.  Both my neurologist and anesthesiologist mentioned possibility of surgery if epidurals don't work.  My questions at this point are:  Can me continuing pt cause more damage if done improperly since my pain perceptions are dulled considerably due to Neurontin?   Should I be seeing a Neurosurgeon rather than a Neurologist at this point?  Is my MRI consistent with recommendation of surgery if epidurals fail?  Do these types of problems ever do into remission on their own or do I have to do something (other than just treat the pain) to prevent further damage?   Thanks again.

[CCF Neuro[P] MD, RPS]

Dear Patti:

Since I haven't seen the films or done the physical examination I can't tell you what sort of rehab might be best.  But, I would base my decision, if I were you, on what the PT, rehab physician think of your case after a trial of rehab.  Second, the neurontin dulling the pain is a good thing, because you need to undergo exercises and stretches that will likely induce pain.  If you think that the pain is not much and you can forgo pain meds, then go without, only you can make that decision.

Sincerely,

CCF Neuro MD

[connie nelson]

I am a certified massage therapist and have been helping people with various problems for 10 years. I went to school in Lapeer, Mich. H.E.C. for 2 years, worked in the office for 3 years in charge of all the workshops.  I learned many things from my clients as I love "Feedback" of what worked, what didn't work etc.I have worked with many people with numbness down the arms with, and without pain.  In fact while I was in school, I had a similar problem.  Some were diagnosed with CTS. I found that numbness and or pain down the arms can be coming from the Scalene Muscles.  There are 3 scalenes in the neck.  People who have had pathology tests to rule out heart problems,etc. and can't find anything wrong. But the client still KNOWS something is wrong, I would go for the scalenes. These muscles can cause a person to "drop" things all of a sudden, can mimic chest pains, Can radiate (referred pain) between shoulder blades, and on the head.They are associated with thoracic outlet entrapment, AND ARE OFTEN OVERLOOKED.They areattached to the transverse processes of the cervical vert.  attach to the first rib (medius), and scalenus posterior, to the second rib.  So they stabilize the cerv. spine against lateral movement and elevate the first and second ribs to assist in inspiration.  Deep tissue work, slow and deliberate to "Release" these muscles have a profound effect on stubborn problems.  Psoas and Illiacus muscles for the low back can cause bizzare symptoms, again when pathology and an ok from your doctor, Please give massage therapy a try you have nothing to loose, and something hopefullly to gain!!    I am a believer of what massage can help with.  "BURNING" can be a symptom of MYOFASCIA tie up. I hope this helps someone here, and I am not stepping on someones toes. I just am going through and was interested in all of the things I was reading and thought this would be helpful. Make sure, like with anything else, you get someone who went to a licensed, accredited school and Knows what they are doing and WHY they are doing it.  Do not ever be afraid to ask questions, questions!
God Bless.    Connie Nelson.

[Cindy]

dear dr
i havea far left lateral protrusion of the disk which dieviates the exited left l3 root-can you explain what that means and do you think its treatable? im in pt and have pain in right buttocks and down to knee especially when i sit! thanks alot-i live reading your answers-i can understand some!lol

[CCF Neuro[P] MD, RPS]

Dear Cindy:

This means that the cushions between your vertebrae have become misaligned and now are protruding backward.  Yes, we usually will try rehab measures first to see if by strengthening the muscle groups along side the spine we can correct the problem.  If not and the pain becomes too severe, surgery may be required.

CCF Neuro MD

[Kathy]

I injured my left ankle in a work related injury. I have had 3 bone scans, MRI, Neuorolgy work up and the bone scan just showed bruising of the bone and no fracture. They did a nerve ectomy on part of a nerve a saw there was damage. I was in physical therapy for awhile but heat cold and severe weather changes bother it. If  I am on my ankle for any period of time my ankle is in extreme pain and have a burning sensation and nerve impulses up my ankle to my toes... My ankle feels like its tight and wants to pop into  place but wont any ideas? why its still hurts been almost 2 years now

[suzie]

My husband has been expriencing a pain in the left side of his chect that radiates down his left arm.  It only happens when he does something stenuous and gets his heart rate elevated.  He is concerned that it may be a heart problem.  He is 34 yrs old and has been doing construction/carpentry work as well as working with concrete.  It started two weeks ago today.  He does not expirence jaw, back or sholder pain and has no other symptoms.  Could it possibly be a pinched nerve or muscle?  He did have an ekg and the Dr. told me they only thing he saw was adverted T waves???  Can you clearify??  Thanks

[Patti]

Hi again.  Had my last in series of 3 epidural injections 3/22, which helped neck pain somewhat, but did nothing for arm pain. Had emg 5/3 with apparently normal results.  Have appt. in June with Neurologist, but am wondering if am barking up the wrong the tree for arm pain, in lieu of emg results which , if I understand correctly, show arm pain is not caused by nerve entrapment; and am becoming increasingly frustrated as pain has been/continues to be severe, arm seems to be gradually becoming deformed, even with pt., and only thing that helped at all was steriod shot in elbow, tho. even it didn't help that much, and only for a short time.  Am considering going back to ortho who gave me steroid shot in elbow and who referred me to neuro., tho. hate to "waste" a visit w/him if that is not the way to go.  All I know is, something has got to give...any suggestions.  I have already posted twice earlier in this same message.  Thx.

[Dale Sinclair]

A week ago I was literally doing nothing and began having a sharp pain between my shoulder blades on the back.  Within 24 hours I couldn't sit or lie down and the pain was radiating up to my neck and as far down as my waist.  A trip to my local emergency ward was in order given the severity of the pain.  I was x-rayed for a neck or spinal injury.  None was found. I was sent home with anti-inflammatories (naproxen) 250mg three times daily and Tylenol #3 for any breakthrough pain.  It is a week later and the pain is still constant.  I cannot turn my head right or left due to the incrased pain with this movement.  The tylenol #3 just makes me sleep and the naproxen upsets my stomach.  What could be wrong?  Possibility of a pinched nerve or can the fibromyalgia I've been diagnosed with 6 months ago be causing all of this pain??

[Dale Sinclair]

A week ago I was literally doing nothing and began having a sharp pain between my shoulder blades on the back.  Within 24 hours I couldn't sit or lie down and the pain was radiating up to my neck and as far down as my waist.  A trip to my local emergency ward was in order given the severity of the pain.  I was x-rayed for a neck or spinal injury.  None was found. I was sent home with anti-inflammatories (naproxen) 250mg three times daily and Tylenol #3 for any breakthrough pain.  It is a week later and the pain is still constant.  I cannot turn my head right or left due to the incrased pain with this movement.  The tylenol #3 just makes me sleep and the naproxen upsets my stomach.  What could be wrong?  Possibility of a pinched nerve or can the fibromyalgia I've been diagnosed with 6 months ago be causing all of this pain??

[marcia]

I have  a severe burning pain in the right buttock and right ankle. Is this a pinched syatic (sciatic) nerve?

[Margie Re:to patti]

Patti, you just finished your 3 Epidural Steroid injections?
i am advised to try this and i am very scared.
what are the risks and side affects?
What do you mean by deformed arm?
Is it from the steriods?
Did you have swelling?
I have been living with this DDD c4567 buldging disk for 4 years,
and have tried everything from pt-tracation to Chiro.
Injections were/are last on my list.   Did they help your
neck tremendously?  I cannot sleep because of the pain!
Thank you, and I hope you continue to heal.
My forearm pain comes and goes, as does the numbness in my fingers,  it's the neck and shoulder that kills me.  If the Epidural shots help, I will go for it.
You can email me at ***@****
Thank you, Margie

[Euna Oh]

Dear Doctors:

My husband was diagnosis with Pinched Nerve just few days ago.  He also has Rheumatoid Arthritis that he developed over 8 years ago.  Is there any connection?

Thank you,
email:  ***@****

[Becky Haese]

"Comment By: Marcia on Tuesday, July 11, 2000

I have a severe burning pain in the right buttock and right ankle. Is this a pinched syatic (sciatic) nerve?"


I didn't find the answer to this question.  I really would like to know what would cause this pain, because I have the exact same problem.   Thanks for your helpfull site.     Becky

[Dana Johnson]

I have been having for the last year headaches up the back of my head, and my neck fells real stiff and tense, when these headaches come on it takes about 2 weeks or so for them to get better, i have had mri's, and cat scans which show nothing, they continue to tell me it is tension headaches, i of course sometimes take the medication or sometimes i don't but they eventually go away.  could this be a pinched nerve.

thanks,Dana

[Jim]

my friend's back and sholder hurts a lot how can I massage it.

[Barbara]

can a pinched nervw cause one not to be able to put any pressure on one foot when yoou first get up from any rest period. After a while on my foot I can walk , however I am still aware of the pain.  At bed time my foot and whole leg throbs for a while.  Thanks

[blrsigr]

A related discussion, Muscular pain in back shoulder plate was started.

[dwfranks]

A related discussion, neuritis? was started.