Often confused but both painful ! So how do you know if you've trapped a nerve or pulled a muscle instead ?
" Hi, I'd like to book an appointment please. I'm not sure, but I think I might've trapped a nerve "...... Really, really common opening to many phonecalls with our patients. Sometimes the answer is yes. But trapped nerves can easily be confused with a pulled muscle or spasm or ligament pain if you don't know what you are looking for and they present with different problems and solutions.
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So why do muscles and nerves give different symptoms ?
Essentially it's because they are tissues built for very different jobs and so they respond to injury differently. .
Muscles are the locomotion system within our body, switched on by little electrical messages causing them to contract ( shorten ) and produce movement. This is what ALL muscle does whether it be in the legs, digestive guts or your heart. Muscle tissue is reasonably resiliant and can work for short periods with reduced levels of oxygen ( OK, maybe not the heart ! ). However, a prolonged lack of oxygen, will produce that distinctive crampy, stitch type pain - remember how you felt after finishing the cross country run at school ! A spasm is when the muscle contracts but then doesn't relax for some reason so it ' runs out ' of oxygen producing that characteristic pain.
Nerves are essentially the wiring system in our body, long ' wires ' carrying little electrical messages from the brain and spinal cord to and from allof the other tissues in the rest of the body. And they are very, very sensitive and NOT resiliant to reduced oxygen levels. Anything that restricts or lessens this delivery of oxygen to the nerve tissue can cause nerve pain and if severe enough can interfere with the messages travelling along the nerves. So a physical pinching or pressure or a sustained stretch can give the characteristic ' nervy ' symptoms e.g pain, tingly pins and needle type feeling. Now this can occur anywhere along the entire route of the nerve but some points more commonly cause problems than others. Confined bony tunnels such as the nerve exiting the spinal column, or passing near structures that can swell with injury or illness can also be areas of vulnerability for the nerve. e.g a slipped ( prolapsed ) disc or carpel tunnel syndrome.
How to tell if you have a trapped nerve vs a muscle spasm .
There are some similarities in the type of symptoms these two conditions cause such as pain and weakness in the affected area but importantly some specific differences too
Trapped nerve pain tends to be sharper, burny, and often worse at night. Pulled muscle pain tends to be more of a dull, achy throbbing type pain and is usally associated with movement as the muscle is use.
Trapped nerve pain often radiates to other areas around the affected nerve and to the area teh nerve supplies e.g sciatica can give lower leg pain but there is no probelm in the lower leg. Pulled muscle pain typically stays localised in the area around the muscle at issue.
Pulled muscles or muscles in spasm often swell while trapped nerves usually don't.
Pulled muscles ( and defintely torn muscles ) often make your limb feel stiff and weak almost immediately after the injury. Trapped nerves tend to create sudden bouts of, often painless, weakness. which can take time to develop over several hours.
" The type and nature of the pain is different for muscle and nerve "
Best ways to treat the pain
The prime goal in initial treatment of BOTH conditions is to reduce the pain and discomfort, especially important if sleep is being disturbed. Again, there are similarities in approaches
Rest - both conditions will require a period of relative rest to allow the body to start the healing process.
Strapping / taping can work well for both conditions to help ' offload ' the sore and sensitive structures and helping with confort and healing.
Painkillers ? Whilst I agree they are not the best long term solution for the vast majority of patients personally, I think there are times when it is perfectly appropriate to use them if you wish. If you cannot sleep or get your rehab done then I think it's a perfectly valid reason to use a painkiller. DON'T be a stoic - now is not the time !!!!!! DISCLAIMER : I am not a doctor or Pharmacist so can't advise on the type of painkiller - Pharmacists are a wealth of knowledge so ask them or your GP for advise.
Heat or cold packs can be valuable ways of reducing pain and spasm. Heat has a soothing sedative effect helping to calm muscle spasm and sooth frazzled nerves whilst cold or ice has a numbing effect which can act as a great painkiller. The choice really is yours, some people's bodies respond better to cold whereas others just find it intolerable and it causes more spasm than it solves. Neither is wrong, just don't use the packs for any longer than 15 minutes at a time.
Physiotherapy or sports therapy can help.
Soemtimes Mother Nature and home treatment alone doesn't quite cut it so treatment from a therapist can be hugely beneficial in speeding things up and getting you moving and feeling better. In clinic we are able to use manual therapy such as muscle energy techniques, acupuncture and electrotherapy to help encourage healing and settle down the pain. Exercise is fundamental but it does need to be the right exercise given at the right point in your recovery process in order to avoid provoking your symptoms. This is where the skill of your therapist comes into play.
Conclusion?
Don't panic ! Most trapped nerve probelms get better with treatment but it needs to be the correct treatment and also it may take a little longer than a simple muscle injury simply because the more specialised the tissue then the longer the healing rates. Many things sort themselves out but please don't be a stoic if your pain is not resolving within a week or so then please seek help.