A Pinched Nerve After a Procedure That Did Not Work

Some of the hardest cases we see are not the people who have tried nothing. They are the people who have already tried something and it failed.

By then they are not just in pain. They have stopped believing anything is going to help.

Defeated, and out of options

We had one patient with such a severe pinched nerve. They had already tried to do a nerve ablation. They wanted to do another surgery, which the patient was just fed up with because of the one that had failed. Injections, pain medications, nothing worked. The next operation was wanting to fuse it together, and the patient just was defeated and lost all hope.

By doing shockwave, decompression, and the corrective therapies at home, not only did they feel better and the pain went away, but they had hope back in their life again for the first time. They were not dependent on their spouse taking care of them, and they were able to return to work.

Not dependent on their spouse. That is the line that tells you what a pinched nerve actually costs somebody. It is not the pain score. It is what your husband or wife has been quietly absorbing for a year.

What a pinched nerve is

A nerve leaves the spine through a small opening between two vertebrae. Anything that narrows that opening can irritate it. A disc that has lost height, a joint that has degenerated, inflammation in the surrounding tissue, or a segment that has locked down and thrown load onto its neighbors.

The nerve reports it wherever it travels, which is why the pain often shows up nowhere near the actual problem. Down an arm. Down a leg. Into a hand that goes numb at night.

Treating where you feel it usually disappoints, because that is not where it is coming from.

Why a procedure can fail and the problem can remain

An ablation interrupts a nerve's ability to report pain. That is a real tool and sometimes it is the right one.

But it addresses the signal rather than the space. If the opening the nerve travels through is still narrowed, the mechanical situation is unchanged, and people are often surprised when things return or move somewhere new.

That is not a criticism of anybody's care. It is just a different question, and it is the one we ask: can the space be changed.

Reactive care and proactive care

There is a kind of medicine that exists to save your life when something has gone wrong, and it is absolutely amazing at that. Emergency medicine saves people every single day.

But it is reactive by design. It waits for the crisis and then answers it.

What we do sits on the other side of that. It is about figuring out what is causing the problem and fixing the cause, so that the crisis has less reason to happen at all, and so you can keep living the life you want to live without needing drugs or surgery to do it.

A pinched nerve is a good example of the difference. The reactive answer is to quiet the signal. The proactive answer is to ask why the space closed down in the first place.

What we do about it

We start with an exam and imaging so we can see which level is involved and what stage it is at.

Then spinal decompression to open the space the nerve travels through. Specific adjusting to restore motion where segments have stopped moving, which you can read about on our chiropractic adjustments page. SoftWave therapy for the soft tissue that has been irritated and guarding, often for years.

And then the corrective therapies at home, which is where physical rehabilitation comes in and where most of the durable change actually happens.

If the nerve involved is the sciatic, our sciatica page covers that specifically, and if a disc is the driver, start with herniated disc.

What the first few weeks usually look like

The nerve symptoms tend to change before the mechanics do.

Numbness and tingling often settle first, and they often move before they leave, retreating up the limb back toward the spine. That sounds alarming and it is usually a good sign, because it means the nerve is being irritated across a shorter distance than it was.

Then the pain goes from constant to intermittent. Then it becomes situational, showing up after a long drive or a bad night of sleep instead of all day.

That last stage is where people stop, and it is exactly where they should not, because nothing has been built yet. The symptoms went quiet before the structure caught up, and a nerve that has room today can lose it again if nothing around it changed.

Common questions about pinched nerves

How do I know if it is a nerve and not a muscle?

Nerve symptoms travel and muscle symptoms usually stay put. Pain that runs down a limb in a line, numbness, tingling, or weakness in one specific movement all point at a nerve. An exam sorts it out quickly.

Can a pinched nerve heal on its own?

Sometimes, if whatever narrowed the space settles down by itself. What does not resolve on its own is the mechanical situation underneath it, which is why people often get better and then get the same thing back a year later.

I already had a procedure and it did not work. Is there any point in coming in?

There often is. A procedure that addressed the signal may have left the space unchanged, and that is a different question with different answers.

If you have already been through something

You are allowed to ask what else exists. Having had a procedure that did not work does not mean you are out of options, and it does not mean the next step has to be a bigger operation.

If your problem is something we cannot help you with, we will get you to someone who can. But we would rather look first.

Learn more about pinched nerve care at Element Wellness Center, or call our Point Loma office at (619) 523-9355.