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How One Problem In Your Spine Can Create Many Problems In Your Body

Every orthopedic doctor has his or her favorite injured body part to heal. Some physicians like working with elbows more because the anatomy of the region is relatively simple and straightforward — bend, straighten, or twist — while others may prefer the delicate complexity of the shoulder with its nearly two dozen muscular attachment sites. I remember years ago, when I was studying physical therapy with my classmates in university, the spinal joints were always the most intimidating and least preferred area for us to treat. Our more experienced professors would try to console us by saying: “Don’t be afraid of the spine. It’s a joint, just like any other joint in the body.” Looking back now, more than twenty years later, I can unfortunately say that this gross over-simplification couldn’t be further away from the truth.

The spine is closer to resembling a piano than it ever could be an elbow…

With its elaborately scaled system of individual keys and tones, a piano is capable of creating an essentially limitless quantity of music to delight, or displease, our ears. The spine is similar in that it too has separate “keys,” or vertebrae, running from the base of the head down to the tailbone; and it also has very distinct “tones,” or spinal nerves, that flow out from between these vertebrae and send highly complex combinations of electrical signals throughout the entire body. This “biologic keyboard” is positioned vertically to also support the framework of the skeleton, which makes possible all the functional movements of our daily lives.

One of the most classic examples demonstrating this electric “tonal” system of our spinal cord would be in the condition of sciatica. If you are not aware of this horribly painful diagnosis, be grateful. It can be caused by a disc herniation, degenerative disc disease, foraminal stenosis, but probably not from the “infamously over-diagnosed” piriformis syndrome. Whatever the specific pathologic mechanism may be within the low back, they all still cause a similar underlying effect of nerve compression. And, although the injury is actually occurring within the spinal column, itself, the sensation of pain or burning can “travel” far down the back of the leg so that it seems as if there’s an imaginary problem in your foot.

Again, think of tones, notes, and electrical wires. We touched upon the unique phenomenon of “nerve pain” in our earlier discussion on the different types of painful stimuli. This distinct traveling pain from the spinal cord is referred to in medical diagnostic language as “radicular neuritis,” “radiculitis,” or “radiculopathy,” and can happen at the neck level too. At a specific neck, or cervical, level it might cause tingling in the hands that mimics carpal tunnel syndrome.

If you’re starting to suspect there could be a little bit of confusion between the symptoms of hand numbness from carpal tunnel syndrome compared to the exact same presentation from cervical radiculopathy, then you’re right. In fact, you’ve just accidentally opened up a virtual pandora’s box of “misdiagnoses.”

But before we get into all the carpal tunnels, cubital tunnels, thoracic outlets and other double crush phenomena, let’s talk about something that explains them all in a much simpler way… “the garden hose analogy.”

The function of your nerves depends on good circulation and blood supply, in the same way a bed of flowers depends on a garden hose suppling water to nourish it and allow it to grow. When the water valve is turned on and the flow is strong and forceful, then there is a plentiful amount of hydration delivered into the soil for all those plants to produce green leaves and vegetables, or flowers, or whatever. However, if you accidentally put a kink in the hose and get it caught under a rock, then the power of the water in the hose will be less. The plants will still get wet enough to survive without too much concern, but the whole watering system is now a bit slower and compromised. It becomes susceptible to other smaller obstructions in the hose that you may not have noticed before. If someone steps on the hose somewhere else down the line, the flow of nutrition to the plants may become completely shut off and they will soon dry out and die.

You may not realize this, but nerves actually have their own tiny little blood vessels that nourish all the electrical nerve cells inside the larger nerve bundles, keeping them healthy. If the nerve gets squeezed by a herniated disc in the neck for example, then those same nerve fibers will become susceptible to other, lesser squeezes in other parts of the arm, such as in the carpal tunnel region of the hand.

This is basically the mechanism behind the “double crush phenomenon” that causes so many painful problems for people with neck and back injuries.

As a physical therapist, I can use various manual techniques to check and see if there’s a reason to suspect spinal nerve root compression. By carefully shifting and gliding certain vertebrae off of a pinched nerve, I will observe if the patient’s symptoms change in other related parts of the body.

In fact, any time an irritated nerve touches a nearby muscle, it will cause some degree of spasm, and possibly even pain. I cannot tell you how many people I’ve treated for “chronic hamstring tightness,” who were actually suffering from an undiagnosed bulging disc.

It’s almost never a simple case of one problem only. Your hand numbness may be caused 65% by a bulging disc in the neck, 25% by an entrapped brachial plexus at the thoracic outlet, and 10% by compression in the carpal tunnel of your wrist. But, you should always address the biggest problem first, as the smaller problems may sometimes simply resolve on their own.

A good spinal specialist will save you a lot of headache and wasted time by ordering an MRI of your spine if they suspect one of these “syndromes.”

The spine is especially interesting, apart from other more common “push-pull” joints, because it actually has multiple different types of joint structures holding it together. You could rightly say that it has joints within its joints! There are disc joints that can herniate and bend you out of alignment, facet joints that can crack when your twist your back, rib joints that move when you take a deep breath, and many others that can “mimic” other painful conditions in your body when injured.

If you have a stubborn chronic pain problem that you suspect may be coming from your spine and you would like an expert to evaluate you, then click here to schedule an appointment with us today.


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