BY LUGA PODESTA, M.D.
(Originally Published in DRUM! Magazine’s July 2007 Issue)
Have you ever experienced a pain down your arm or leg that felt like an electrical shock? Or have you ever woken from a night’s sleep with numbness or tingling in your arm or leg? These are common symptoms of a pinched nerve, which is in fact a description of a number of injuries or conditions that can affect nerves in the neck, low back, or within the upper or lower extremities. Common names include sciatica for pain in the legs, neck (cervical), or lower back (lumbar), and radiculopathy in nerves exiting the cervical or lumbar spine. Nerves can also be pinched in the upper extremity, as in carpal tunnel syndrome in the wrist or cubital tunnel syndrome in the elbow. A “pinched nerve” is the term for pain or impaired function of a nerve that is under pressure. It happens to nerves that control muscle movements or relay sensations to the brain.
Commonly, the pains and/or abnormal sensations associated with pinched nerves are manifested away from the point of pressure. For example, the only symptom of a pinched nerve in the neck may be pain in the wrist or hand. When the nerve is being damaged from constant pressure, pain and numbness may increase, and weakness can develop in those muscles supplied by those particular nerves. There may be a loss of deep tendon reflexes, movement of a particular body part, sensation in the affected area, and shrinking (atrophy) of the affected muscles.
Nerves are extensions from the brain that reach out into the arms or legs and supply the electrical input and output to the muscles or skin. They are similar to insulated electrical wires that transfer the electrical impulses from the brain to the muscles (motor nerves) or skin (sensory nerves). A nerve is a microscopic cell, and its fibers may run several feet in length toward its destination.
If a nerve gets pinched, the flow up and down the inside of the nerve is reduced or blocked and the nutrients stop flowing. Eventually the membrane starts to lose its healthy ability to transmit the tiny electrical charges, and the nerve fiber may eventually die. When enough fibers stop working, the skin may feel numbness or a muscle may not contract.
Common causes of pinched nerves in the cervical or lumbar spine include herniated discs, bulging discs, or degenerative disc disease. Other causes include compression of a nerve in the arm, elbow, or wrist from repetitive movements, nerve instability or subluxation, maintaining a prolonged position or posture, arthritis, bone spurs, or a tumor or mass.
The treatment of a pinched nerve depends on which nerve is compromised and how it was actually damaged. Treatment can be as simple as changing the position of the body part where the nerve is pinched, or as complicated as surgically decompressing the nerve (relieving the mechanical pressure). When you suspect a nerve is injured or possibly being compressed, it is important that you seek a medical evaluation as soon as possible to determine the cause of the symptoms before permanent nerve injury occurs. Drummers are not immune to nerve injuries. In fact, I have treated an ever-increasing number of drummers with nerve-related injuries. It is imperative that we take proper precautions such as warming up and cooling down before and after playing, as well as maintaining an ergonomic setup of our drum kits. These simple procedures can help prevent these injuries from developing.
An avid drummer, Dr. Luga Podesta practices orthopedic sports medicine in Thousand Oaks, California, specializing in the nonsurgical treatment of the upper extremity, knee, and spine. He is a sports medicine consultant and team physician for the Los Angeles Angels, serves as head team physician for the Los Angeles Avengers of the Arena Football League, and the Los Angeles Riptide of Major League Lacrosse. Dr. Podesta can be reaches firstname.lastname@example.org.