Nerve Damage from Your Cervical or Lumbar Spine

Neck and arm pain
Neck and arm pain. Yagi Studio/DigitalVision/Getty Images

Generally, neck and back pain is benign. That is, it's neither serious nor caused by a specific disease or condition. In these cases, muscles and other soft tissue tend to be at the root of the pain. 

When it is serious, which is about 15 percent of cases, according to a 2017 article on the authoritative site Up to Date, causes may include bone fracture, infection, tumor, cauda equina syndrome, herniated disc or spinal stenosis.

The last four of these, tumor, cauda equina syndrome, herniated disc and spinal stenosis, involve pressure on nerves, nerve roots and/or the spinal cord. The pain that results is known as nerve pain, or neuropathic pain.

What is Neuropathic Pain?

Neuropathic pain occurs when nerve fibers become damaged, traumatized and/or otherwise dysfunctional. 

To best understand neuropathic pain, let's talk briefly about what nerves do. Their job is to relay messages to and from the brain and spinal cord about what's going on, and what to do about it, in tissues, organs, muscles and more.  

If you burn your hand on a hot stove, for example, your nerves go right to work communicating this input to the brain and spinal cord. Nerves also carry response signals from the brain, delivering these back to those body tissues that were involved in the inciting incident, in this case, your hand. The response signals show up as pain and impulses to move.

They will likely prompt you to take your hand away from the stove burner, or to run it under cold water to decrease the pain.

This pain felt from this example of the normal workings of nerves is not neuropathic pain, but nociceptive pain. Nocioceptive pain refers to pain related to actual tissue damage.

In the hot stove example, it's your skin, and not your nerves, that experiences the nocioceptive pain.

But according to the American Chronic Pain Association, neuropathic pain is a chronic condition. 

This means the signals sent to you by the damaged fibers may sometimes "go haywire." They may seem like they don't make sense. The reason is, over time, these nerves may become active for no reason. That is, they "fire" but it's not in response to changes that are going on in the tissues, organs or muscles they serve.

Peripheral Nerve Damage from Your Cervical or Lumbar Spine

Although over one hundred types of neuropathic pain exist, only a few of these are spine related. Generally, cervical or lumbar related neuropathic pain occurs when a spinal nerve root is pressured by an abnormality in a nearby structure. In this case, yes, you may experience back or neck pain, but you'll also likely experience symptoms that go down one leg or arm. Many people call the pain that goes down one leg sciatica, but the real name for this condition, whether in the leg or the arm, is radiculopathy.

The spinal nerve root is a collection of nerves that branch off the spinal cord, and then branch off into individual peripheral nerves that go out to all areas of the body.

Spinal nerve roots are present on either side of the spine, at every level, from cervical to lumbar.

With lumbar radiculopathy, which is a disease of one or more spinal nerve roots, the sciatic nerve may be affected. When this is the case, you may experience radiating hip, buttock and/or leg pain.

The sciatic nerve is a peripheral nerve, the largest in the body.

While radiculopathy is frequently the cause of sciatica symptoms, it’s not the only one. Because other ways for the sciatic nerve to be irritated exist, the term radiculopathy refers to radiating hip, buttock and/or leg pain when irritation of the spinal nerve root, and not, for example, a tight piriformis muscle that entraps the sciatic nerve, is what causes them.

By the way, the term sciatica does not apply to pain or other symptoms that are experienced in one arm.

A common type of neuropathy that affects the neck and the peripheral nerves that branch out from that part of the spine is cervical radiculopathy. Cervical radiculopathy is often caused by a herniated disc in the neck.  

Lumbar and Cervical Peripheral Nerve Damage Symptoms

Symptoms of neuropathic pain can be very severe. They can feel like pins and needles, electrical shock, and/or burning that travel down one extremity. Other symptoms include numbness, weakness or altered sensation anywhere along the path the nerve travels. In the case of cauda equina syndrome, symptoms may get progressively worse and also include bowel or bladder dysfunction and saddle amnesia, which is a loss of feeling in the seat area.

If you have these symptoms, it's best to seek medical attention as soon as possible. Cauda equina syndrome is considered a medical emergency.

 

Sources:

American Chronic Pain Association. Neuropathic Pain. American Chronic Pain Association website. https://www.theacpa.org/condition/Neuropathic-Pain

Chou, R., M.D., et. al. Patient education: Low back pain in adults (Beyond the Basics) Up to Date. Oct. 2017. www.uptodate.com/contents/low-back-pain-in-adults-beyond-the-basics

Gould, H., MD, Phd. Understanding Pain: What It Is, Why It Happens, and How It's Managed. AAN Press. 2007. St. Paul, MN.

Guyton, A., MD, Hall, J., MD. Textbok of Medical Physiology. 11th ed. Elsevier Saunders. 2006. Philadelphia.

Hanline, B., MD. Back Pain Understood: A Cutting-Edge Approach to Healing Your Back. Medicus Press. 2007.

Continue Reading