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Nerve root impingement fairly rare, barely more common in car accident victims

PainSci » bibliography » Braddom et al 2009
Tags: neck, back pain, structuralism, head/neck, spine, pain problems, biomechanical vulnerability

Five pages on PainSci cite Braddom 2009: 1. The Complete Guide to Trigger Points & Myofascial Pain2. How to Treat Sciatic Nerve Pain3. The Complete Guide to Low Back Pain4. The Complete Guide to Neck Pain & Cricks5. Neuropathies Are Overdiagnosed

PainSci commentary on Braddom 2009: ?This page is one of thousands in the bibliography. It is not a general article: it is focused 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 wherever possible.

This fascinating study of almost 25,000 patients showed that “pinched nerves” (nerve root impingement, radiculopathy) are fairly rare — only 6% actually had it in the neck, and only 12% in the low back — and it’s barely any more common in people who’ve had car accidents. You would 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. That’s a counter-intuitive finding. If you polled health professionals and patients and asked them “Do people who’ve had car accidents have more nerve injury?” I think 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 not particularly fragile or prone to nerve injury; second, it’s good evidence that nerve root pinches are 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%!

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

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.

This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:

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