Rethinking The Pinched Nerve Theory


The pinched nerve theory suggests that muscular or bony obstructions catching a nerve cause pain during movement in the affected area. It also suggests that by removing those obstructions, the pinched nerve would be freed if the condition became a perpetual issue.

Today, many top neurophysiologists agree that this is an outdated theory. They suggest that successful manipulation of the joint is what takes away pain. The pain is reduced by stimulation of nerve fibers, and this reduces how excitable the cells of the CNS are.

Pain Memory: The New Approach

When it comes to current research, biomechanical pinched nerve theory has shifted to neurophysiological pain memory theory. This is especially considered in studies focusing on back pain. According to recent research, about 60 percent of people who complained of back pain said that their normal daily activities were impaired by it. Also, research shows that every third day of missing work due to disability can be attributed to back discomfort. However, about 85 percent of back pain sufferers are not properly treated.

Researchers suggested that continuing movement through a rehabilitation program was an optimal solution for back pain. They pointed out that long periods of rest have often been connected to chronic pain rather than temporary aches. When physical activity is eliminated or reduced, the spine’s condition weakens and worsens. This leads to bad posture and more pain. Researchers suggested that patients with back pain work with a specialist to continue a movement regimen that strengthens the back instead of resting and weakening it.

Movement Program Considerations

Researchers were careful to note that precaution was important with movement continuation. Continuing movement may not mean resuming all previous daily activities. Researchers emphasized that people should speak with a professional about which activities to continue and which ones to avoid. Movement programs that include dynamic neuromuscular stabilization and a computer-assisted rehabilitative environment for proper walking are optimal for treating compressed, pinched and inflamed nerves in the back.

When pain is triggered in the body, it causes an electrical impulse in the nerve fibers. This travels to a point in the spinal cord, and there is a chemical reaction in the CNS. Reactions lead to cell learning, and they change their functions if they are perpetually stimulated with pain. This means that repetitive wrong movements or activities contribute to chronic pain.

The key to relief is a balance of proper movement and mild rest. As cells learn and become more sensitive, the surface area of the pain reaction can also grow and lead to widespread debilitating back pain. This increases the risk of developing a chronic illness or a secondary health problem if the person becomes inactive. However, the severity of the reaction depends on immunological and hormonal factors of the individual.

Therapy Plans

People who injure their backs should contact a dynamic neuromuscular rehabilitation specialist for best results. Rehabilitation programs that focus on natural movement to relieve pinched or inflamed nerves are more beneficial to overall health than other options.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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