When a nerve is pinched in the neck’s spinal column, pain can be such a prominent symptom that more subtle, but diagnostic, aspects are overlooked.

By way of background, the spinal cord in the neck is connected to the nerves of the arms through pairs of spinal nerves. These spinal nerves, also known as roots or “radicles,” transmit incoming messages (electrical impulses) from the arms’ nerves concerning sensations of touch, pain, heat and cold on various patches of skin. Additionally, the cervical roots convey outgoing messages (also electrical impulses) through the arms’ nerves to their muscles, causing them to contract.

So when a cervical root is pinched, the pinch can cause not just pain, but–by blocking incoming and outgoing nerve impulses–it can also produce numbness of patches of skin, weakness of muscles, or both. The syndrome caused by the pinch in the neck is called cervical radiculopathy. The suffix “-pathy” means damage or impairment, so radiculopathy means damage or impairment of a radicle (root).

There are four pairs of cervical roots connecting the spinal cord to the arms’ nerves and they are named for the segment of spinal cord to which they are attached–C5, C6, C7 and C8, with the “C” designating cervical. While a pinch of any of these roots typically produces searing, deep pain in the shoulder which preoccupies the unfortunate person who has it, the shoulder pain is the least identifying or diagnostic component of the person’s symptoms.

The pain often shoots into the arm on the affected side, and certain movements of head and neck can worsen or reproduce this pain. While the arm component of the pain is less intense than that felt in the shoulder, its location is often the key to figuring out which root is pinched. Moreover, the pattern of numbness or weakness also varies according to which root is pinched. These patterns are almost identical from person to person and are as follows:

C5 impairment can send pain over the top of the shoulder in the first fourth of the arm which is also where numbness occurs, when present. When there is weakness, it involves the ability to elevate the arm sideways to the level of the shoulder or above. There are no good (rubber-hammer-type) reflexes the doctor can use to test this root.

C6 impairment can send pain as far as the thumb which is also where numbness occurs, when present. When there is weakness, it involves the ability to bend the elbow. The doctor can additionally test for C6 impairment with the biceps-reflex which involves striking a tendon in the crook of the elbow.

C7 impairment can send pain as far as the middle fingers which is also where numbness occurs, when present. When there is weakness, it involves the ability to straighten the elbow. The doctor can additionally test for C7 impairment with the triceps-reflex which involves striking a tendon on the back of the elbow.

C8 impairment can send pain as far as the little finger which is also where numbness occurs, when present. When there is weakness, it involves certain hand-movements, including the ability to join the tips of the thumb and the little finger and also to spread the fingers sideways. There are no good reflexes the doctor can use to test this root.

Having identified the typical syndromes, the next step is to understand what caused the pinch in the first place. It is typically one of two things–a herniated (“slipped”) disk or a bony spur. Younger adults are more likely to have a herniated disk and older adults are more likely to have a bony spur. Disks are soft structures sandwiched between each pair of spinal column bones (vertebral bodies). Their ordinarily tough outer membranes can weaken and allow extrusion of inner disk material–somewhat like toothpaste squeezed out of a tube–into the side-canals through which the spinal roots must pass. This traps and compresses them. Bony spurs, in contrast, are not soft at all. Instead, they are hard ridges of excess bone located on the edges of the back-bones. They are produced by arthritic degeneration. They, too, can trap and compress the spinal roots where they exit the spine.

How is cervical radiculopathy diagnosed? As described, the patient’s history and examination are often very informative and specific. When the pattern of nerve-impairment is ambiguous, tests of nerve and muscle electricity–called nerve conduction studies and electromyography–can help localize the impairment. These electrical tests can also detect impairments in the nerves of the arms which might mimic cervical radiculopathy, but require different medical management.

Until the 1980s myelograms made the best pictures of the pinches occurring in the spine. To perform a myelogram a doctor started with a lumbar puncture (also known as a spinal tap) in the patient’s lower back and injected x-ray dye into the watery space within the membrane covering the spinal cord and its roots. The patient was then tilted so that the dye ran into the corresponding space in the neck. Standard x-ray pictures showed the column of dye together with any indentations of the column caused by a herniated disk or bony spur.

Magnetic resonance imaging (MRI) was developed in the 1980s and created similar pictures but without having to do a spinal tap or dye infusion. Computed tomographic (CT) scans, developed in the 1970s, are generally the least useful of the spinal imaging techniques, except when an immediately preceding myelogram has been performed, in which case they can be strikingly helpful. Each of these these imaging tests has its strengths and weaknesses–none of them is always the best–so testing must be tailored to each case.

And how about treatment of this condition? Well, that’s a story deserving its own essay. Stay tuned.

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Educational Services

We are neuromusculoskeletal specialists offering not only expert personalized care but also access to the latest technology offered in chiropractic diagnostics. Our clinic has specialized computer diagnostic equipment available at only a few chiropractic clinics in the entire metroplex. This new technology assists us in finding any misalignments, which may be putting pressure on nerves therefore causing irritation, pain or discomforts in the back area or other parts of the body.

Chiropractic Services

• Chiropractic Neurology
• On Site X-rays and Diagnostics
• Detection / Correction of Misalignment & Slipped Disc
• Extremity Manipulations
• Mechanical Traction
• Electrical Stimulations
• Nerve Conducting Tests
• Ultrasound Testing
• Joint Mobilization
• Performance Enhancement
• Sports Injury Care
• Wellness Programs

What is Spinal Decompression Therapy?

Spinal decompression therapy is a non-surgical, comfortable traction therapy for the relief of back and leg pain or neck and arm pain. During this procedure, by cycling through distraction and relaxation phases and by proper positioning, a spinal disc can be isolated and placed under negative pressure, causing a vacuum effect within it.

What can this vacuum effect do?

The vacuum effect accomplishes two things. From a mechanical standpoint, disc material that has protruded or herniated outside the normal confines of the disc can be pulled back within the disc by the vacuum created within the disc. Also, the vacuum within the disc stimulates in growth of blood supply, secondarily stimulating a healing response. This results in pain reduction and proper healing at the injured site.

What machine is used for this purpose?

There are a number of spinal decompression machines presently used in the United States. After significant research, Hopkins Clinic for Physical Medicine has chosen to use the Triton DTS machine manufactured by Chattanooga, Inc., the premier manufacturer of physical therapy machines.

Who can benefit from Spinal Decompression Therapy?

Spinal decompression therapy is designed to unload the spinal disc. Any back pain or neck pain caused in whole or in part by a damaged disc may be helped by spinal decompression therapy. These conditions include herniated, protruding or bulging discs, spinal stenosis, sciatica or radiculopathy (pinched nerves).

Are there conditions where Spinal Decompression is not indicated?

Spinal decompression therapy is usually not recommended for pregnant women, or patients who have severe osteoporosis, severe obesity or severe nerve damage. It is not recommended for patients over 70. However, every patient is evaluated on an individual basis. Spinal surgery with instrumentation (screws and metal plates or “cages”) is also contraindicated. Surgery to the discs without fusion or fusion using bony replacement is not contraindicated.

How often do I take treatment sessions? How long does each session last?

Each session includes decompression therapy and spinal stabilization exercises and takes about 1 hour. Spinal decompression is usually performed 3-5 times a week for 15-20 sessions.

What are the results of Spinal Decompression Therapy?

Over 70% of patients have good pain relief. This success rate is similar to surgical results.

I have had spinal surgery, but continue to have pain. Can I try Spinal Decompression Therapy?

Spinal decompression therapy can help people with back pain after failed spinal surgery. It can be performed in most patients who have not been left with an unstable spine after surgery.

Do you suffer with low back pain, neck and carpal tunnel?  Have you been told you need back surgery?

Decompression Therapy is an effective treatment for these conditions. It is very affordable, less expensive than surgery.

You may refer to our -FAQs for more information and helpful answers about this non-surgical treatment.

The Decompression-Reduction-Stabilization therapy is an effective treatment for:

• Herniated Disc
• Degenerative Disc
• Facet Syndrome
• Sciatica
• Post-surgical Patients
• Spinal Stenosis

Do you have a herniated disc, multiple herniated discs, degenerative disc disease, facet syndrome, or any other type of spinal problem? Is you doctor suggesting surgery, pain management or physical therapy? Have you tried Chiropractic and just could not get enough relief?

Research indicates the disc is responsible for a significant number of lumbar/leg pain and neck/arm pain syndromes. Compression increase intradiscal pressure leading to annular compromise and possible extrusion of nuclear material.

Since the disc is an avascular structure, it doesn’t receive fresh blood and oxygen with every beat of the heart. It requires “diffusion” created by motion and ‘decompression’ to restore nutrients and enhance healing.

Decompression is defined as reduction in pressure (intradiscal). Recumbent positions (both prone and supine) decrease intradiscal pressures in comparison to standing and sitting. However focused, axial mechanical+Y translation traction, (creating ‘decompression’ i.e. unloading due to distraction and positioning) has been shown to reduce disc pressure and enhance the healing response even further.

There is some suggestion in the literature that extruded nuclear material may be “drawn in” by the reduction of intradiscal pressures. This concept however is not uniformly accepted since the length of time the material stays ‘drawn in’ has not been established in controlled studies. However, a temporary reduction in intradiscal pressure can still have a profound effect on the healing process via increased contact with the blood supply and fibroblast migration (so called phasic effects). This is in addition to the pain relief created neurologically by stretching soft tissue (e.g. stretch receptors, mechanoreceptors etc.) make decompression therapy a logical and viable addition to a “passive” pain care regiment.

Clinically it is important to establish criteria both in the utilization of Decompression therapy and in defining its utility. (As with many therapies, hyperbole and overstatement are common.) Axial Decompression (both lumbar and cervical) is first and foremost a “passive” therapy and as such has definite limitations in “curing” a chronic musculoskeletal condition. Its value is most specific in helping referral pain not solely low back or acute low back pain (symptoms for which manipulation has proven beneficial).

Loss of local muscle control, abnormal posture and alterations in spinal curves are the probable underlying source of most spinal ‘compression’ and degeneration. Therefore a “passive” therapy has little effect in truly fixing the underlying problem.

However, that being said, Decompression therapy (done safely within established protocols and a clear understanding of it’s limitations) can often effectively enhance the healing process and render quick, effective and often amazing pain relief in a properly selected patient population (many who have previously failed other treatments). Additionally it may also be very useful in determining the overall prognosis of passive care and expediting the phase-in of rehab protocols.

Indications and Use

Any non-acute (>1 week) low back or neck pain syndrome not related to a disease process, canal stenosis or acute strain/sprain injury is theoretically treatable by decompression. Disc and facet pain can often be relieved by early intervention with decompression. The acute inflammation of injuries however should be reduced by other means, in most cases, prior to beginning Decompression. Contraindications are similar to manipulative therapy, however since mechanical stretch creates no impact, mild to moderate Osteoporosis may not be contraindicated. (This holds true overall for frail and elderly patients who could potentially be injured by manipulative thrusts. Disc fragmentation, calcification, severe arthritis and any surgical spinal appliances are all relative contraindications.

Our clinical findings suggest Decompression will create a relatively quick initial response. Patients who will do well tend to feel a sense of relief (which can be direct pain cessation or a centralization of pain and/or reduction to an ache or stiffness) within six sessions. Full relief, if attainable through this passive treatment will usually be in 8-12 sessions. (Occasionally a ‘stubborn’ pain syndrome may continue to improve slowly over 15+ sessions though this is not the norm). Often patients will be treated 4-6 sessions and notice enough relief to allow active rehab to begin. Their Decompression may continue (pre or post rehab depending on the methods chosen) for 4-6 further sessions before discontinuing or reducing the frequency.

Typical frequency is 3-5 times per week. The extent and seriousness of the symptoms will determine if more than three sessions per week should be utilized. Our experience suggests Decompression is also an excellent supportive or maintenance treatment for those cases where pain relief is marked but prone to exacerbations.

The Triton DTS represents the finest Decompression Traction System available today. Cervical, lumbar, and wrist Decompression Traction can be delivered utilizing the Triton DTS in a controlled and proven method.

Decompression therapy is very affordable and cheaper than surgery. Spinal Traction is highly recommended by Neurological Research. It was found that out of 778 cases of patients receiving spinal decompression 92% said that they showed improvement (Neurological Research; Volume 20, Number 3, April 1998).

Spinal Disc Decompression, utilizing Decompression-Reduction-Stabilization, is a unique, non-surgical therapy developed for the treatment of chronic lower back pain, herniated discs and degenerative disc diseases.

The Spinal Decompression table in conjunction with additional modalities effectively relieves the pain and disability resulting from disc injury and degeneration, by repairing damaged discs and reversing dystrophic changes in nerves. Spinal Disc Decompression addresses the functional and mechanical aspects of discogenic pain and disease through non-surgical decompression of lumbar intervertebral discs. Studies verify the significant reduction of intradiscal pressures into the negative range, to approximately minus 150 mm/HG, which result in the non-surgical decompression of the disc and nerve root. Conventional traction has never demonstrated a reduction of intradiscal pressure to negative ranges; on the contrary – many traction devices actually increased intradiscal pressure, most likely due to reflex muscle spasm. The Decompression table is designed to apply distraction tension to the patient’s lumbar spine without eliciting reflex paravertebral muscle contractions.

By significantly reducing intradiscal pressure, Spinal Disc Decompression promotes retraction of the herniation into the disc and facilitates influx of oxygen, proline and other substrates. The promotion of fibro elastic activity stimulates repair and inhibits leakage of irritant sulphates and carboxylates from the nucleus. The most recent trial sought to correlate clinical success with MRI evidence of disc repair in the annulus, nucleus, facetjoint and foramina as a result of treatment and found that reduction of disc herniation ranged between 10% and 90% depending on the number of sessions performed, while annulus patching and healing was evident in all cases.

The most recent clinical study of 778 patients has showed that Disc Decompression Therapy was more than 70% successful in the treatment of herniated discs, degenerative disc disease, facet syndrome, and sciatica. In this same study, 92% of patients had a reduction in their pain of at least one point on the 0 to 5 scale.

I learned that my back’s vertebrae were compressed together and pinching nerves…

“Before I came to Dr. Adorable, I had pain in my lower back and neck everyday. I then learned that my back’s vertebrae were compressed together and pinching nerves. After 3 weeks of treatment, my pains began to go away and are now obsolete. Every morning I wake up, I am very grateful for everything that everyone in Advanced Wellness and Rehab Center has done for me.” – Brian Pelleg