Nerve impingement.
When the nervous system speaks, it's worth listening carefully, and finding the right source.
Pressure on the messenger.
Nerve impingement, also called nerve compression or radiculopathy, occurs when a nerve is under pressure or irritation along its pathway. This can produce sharp or burning pain, tingling, numbness, or weakness that radiates away from the spine along the nerve's distribution. It's commonly associated with disc issues, arthritic joint changes, or narrowing of the spaces through which nerves pass.
The symptom and the source are often apart.
Nerve symptoms rarely come from the nerve alone. The nerve is the messenger. The compression or irritation that produces the symptoms is what needs to be identified and understood. Common contributing factors include disc protrusions that encroach on nerve roots, restricted movement in the joints adjacent to where the nerve exits the spine, muscle tension or spasm that can compress peripheral nerves at sites along their path, and postural or movement patterns that place sustained load on vulnerable spinal levels.
The location of symptoms does not always correspond directly to the level of the problem. A nerve exiting the lower lumbar spine can produce symptoms all the way to the foot. A cervical nerve root can refer into the arm, hand, or fingers.
Identifying the source is the first step.
Pain relief reduces the discomfort. It does not address why the nerve is under load. For some people, nerve symptoms settle naturally as the initial source of irritation resolves. For others, if the contributing pattern, whether a disc issue, joint restriction, or postural load, remains unchanged, symptoms persist or progress.
Identifying the source accurately is the critical first step. Assuming where a symptom is felt corresponds to where the problem is can lead to incomplete management.
Find the load. Track the direction of change.
Nerve impingement requires careful assessment. We take a thorough history of symptom onset, behaviour, and progression. We assess spinal movement, posture, and neurological function, including reflex testing, sensory mapping, and muscle strength assessment where clinically appropriate. Surface EMG may provide additional objective data on how the nervous system is functioning in the affected region.
We identify where the nerve is under load and build an individualised plan around that finding. Reassessment is built into the process, because with nerve involvement, the direction of change matters as much as the starting point.