SaveYourself.ca • Sensible advice for aches, pains & injuries
published 8/04/07, updated 8/26/11
EXCERPT This article is a condensed excerpt from three of SaveYourself.ca’s advanced tutorials about low back pain tutorial, neck pain, and myofascial trigger points. All three of those tutorials discuss this concept in greater detail.
I recently came across this full-page advertisement in National Geographic magazine:
“Do you feel burning pain in your feet?” the ad asks. “Or uncomfortable tingling, numbness, stabbing, or shooting sensations? If so, you may have nerve pain.”
Yes, you might. But it’s not bloody likely! The clinical reality is that neuropathy is a lot less common than nearly all patients and most doctors believe.
Nerves make people nervous! So to speak. The whole idea of nerves gets people anxious. Could it be a nerve? people ask. Is this a nerve problem? What if it’s a nerve? Is something pinching my nerve? Something must be pinching a nerve.
The kind of advertisement you see above greatly aggravates that anxiety about nerves. It drives me nutters, in fact, that I spend my career trying to demystify nerve pain and guide patients towards the much more common causes of their pain — and then Pfizer comes along spends about a gazillion dollars on a marketing plan that will create more anxiety about nerve pain than I can counteract in an entire lifetime of low-budget public education! Bummer.
So, I promised a story today …
Yesterday I was working with a young woman who had “sciatica.” Allegedly, her sciatic nerve was pinched by her piriformis muscle — a reasonably common scenario — and sending hot zaps of pain down her leg. She came to me with this diagnosis already in place. She also had some tingling in her feet. The description of her symptoms did, indeed, sound a lot like a nerve impingement problem. On the face of it, it did seem likely that her sciatic nerve was being pinched.
However, a couple things didn’t add up. For instance, she had no numbness at all — no dead patches of skin, which are highly characteristic of true nerve impingement. Instead, she had a lot of “dead heaviness” in the leg, a different kind of numb feeling that is much more closely associated with muscle knots than nerve pinches — and a lot more common.
I quizzed her carefully about the quality of her pain. She assured me it was “zappy” and “electrical” … just as you would expect of nerve pain. Yet something didn’t seem quite right. I couldn’t shake the impression that she was interpreting an intense non-neurological pain as a “zappy” pain simply due to her strong belief that she had a nerve problem. When you think a pain is nervy, you’re going to interpret, feel and describe it in nervy terms.
So I did some experimenting, and clinched the case:
This young woman’s “nerve” pain could be perfectly reproduced by poking muscle knots that were nowhere close to the sciatic nerve. Pressing on the side of her hip, on a gluteus medius trigger point several inches away from the sciatic nerve, she reported the same “electrical” pain flowing down her leg, even producing the weird, tingling sensations in her foot.
This virtually eliminates a diagnosis of sciatic nerve impingement.
In spite of spending most of my career trying to explain to people that this is common, I was surprised myself — fooled, really. Muscle knots are always fooling patients and professionals alike. Vastly more common than nerve problems, and often more painful, they nevertheless get upstaged and misdiagnosed.
Do you feel burning pain in your feet? Or uncomfortable tingling, numbness, stabbing, or shooting sensations? If so, you are more likely to have muscle knots than nerve pain.
For more information about muscle knots, see Save Yourself from Trigger Points & Myofascial Pain Syndrome! For a detailed discussion of nerve pain overdiagnosis in the context of neck pain, see Save Yourself from Neck Pain! Low back pain? I’ve written a book about that, too: Save Yourself from Low Back Pain!
Myofascial trigger points — muscle knots — are increasingly recognized by all health professionals as the cause of most of the world’s aches and pains. This detailed tutorial focuses on advanced troubleshooting for patients who have failed to get relief from basic tactics, but it’s also ideal for starting beginners on the right foot, and for pros who need to stay current. 231 sections grounded in the famous texts of Drs. Travell & Simons, as well as more recent science, this constantly updated tutorial is also offered as a free bonus (2-for-1) with the low back, neck, muscle strain, or iliotibial pain tutorials. Add it to your shopping cart now ($19.95) or read the first few sections for free!
