Nerve root impingement fairly rare, barely more common in car accident victims
PainSci summary of Braddom 2009?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focussed on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★★?5-star ratings are for sentinel studies, excellent experiments with meaningful results. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
This fascinating study of almost 25,000 patients showed that “pinched nerves” (nerve root impingement, radiculopathy) are fairly rare in the general population — only 6% actually had it in the neck, and only 12% in the low back — and barely any more common in people who’ve had car accidents. You would certainly think that car accidents would cause more nerve root injuries, especially in the neck, but that is precisely what this study did not find. It identified only a small (2%) increase in the neck, and no difference at all in the low back. This is quite a counter-intuitive finding. I think that if you polled health professionals and patients and asked them “Do people who’ve had car accidents have more nerve injury?” you would get a much larger number.
So I get two interesting things out of this straightforward study: first, it’s yet another great example of how the spine is just not particularly fragile or prone to nerve injury; second, it’s terrific evidence that nerve pinches are really pretty rare overall, certainly relatively to what people fear. Yes, 12% is more than 1 in 10 people — hardly rare — but if you believe every patient who says “I have a pinched nerve,” the rate would be about 80%!
This retrospective study compared the frequency of electrodiagnostically confirmed cervical and lumbar radiculopathies in a motor vehicle accident (MVA) population to that of a non-MVA population in 24,651 consecutive initial electrodiagnostic reports. The frequency of cervical radiculopathy was slightly but significantly increased in 8% of the MVA compared to 6% of the non-MVA patients. The frequency of plexopathy was significantly increased in the MVA (3%) compared to the non-MVA patients (2%). The frequency of lumbar radiculopathy was not significantly increased (12% for both groups). Nineteen percent of the MVA patients and 18% of the non-MVA patients had cervical and/or lumbar radiculopathy. This shows that the frequency of cervical and lumbar radiculopathies is low after MVAs. MVA appears to cause a small but significant increase in the frequency of cervical radiculopathy and plexopathy.
These four articles on PainScience.com cite Braddom 2009 as a source:
- PS Sciatica Science & Solutions — A guide to buttock and leg pain (which may or may not involve the sciatic nerve)
- PS Save Yourself from Low Back Pain! — Low back pain myths debunked and all your treatment options reviewed
- PS Save Yourself from Neck Pain! — All your treatment and self-help options for a crick in the neck explained and reviewed
- PS Nerve Pain Is Overdiagnosed — A story about nerve pain that wasn’t really nerve pain