How Physical Therapists Find the Cause of Numbness and Pain
Have you ever experienced unexplained numbness, tingling, or deep aching pain? These symptoms can be frustrating, especially when they don’t seem to have an obvious cause. That’s why a thorough evaluation is key to pinpointing the source of your symptoms.
I’m Lauren Masi, Doctor of Physical Therapy and Board Certified Orthopedic Clinical Specialist. I’m also the owner and Clinical Services Director of Bay Area Physical Therapy and Lafayette Physical Therapy. Today, we’re going to talk about how physical therapists find the cause of numbness and pain.
What Typically Causes Numbness and Tingling?
When you come into my office, the first thing to know is that I can’t feel what you’re feeling. I can’t jump into your body and know, so I’m going to ask you to describe your pain to me. What does it feel like? And as soon as I start to hear words like “numbness,” “tingling,” or sometimes even “burning” or “a deep ache,” I know that we’re talking about pain that’s coming from a nerve.
The most obvious descriptors are “numbness and tingling.” If you have a compressed nerve, you might end up having numbness and tingling. It’s not a guarantee, but it usually does indicate that a nerve is involved. Also, if a nerve is involved, sometimes you might even notice weakness of the muscles which that nerve innervates (or supplies pieces of itself to).
Why It’s Important to Look Above and Below the Area of Pain
As a physical therapist, my job is to figure out where’s it coming from. We get to the root cause so that we can make sure that we can treat that area as effectively and efficiently as possible. When it comes to nerves, sometimes symptoms can travel. They might not be exactly where the compressed area is. It can even be patchy or very localized to a different area. And sometimes you might be able to draw a line where it connects from its origin to the part that’s affected or the end part of that nerve, but it doesn’t have to follow a specific trend.
For example, I’ve had a patient who came in complaining of pain only in her big toe, and she was trying to rack her brain on what it could have been caused by. She thought maybe she bumped her toe into the bottom of a clothing rack when she was shopping one day, but she really couldn’t figure it out. After I looked at her toe, nothing seemed to match up with her symptoms. So, I had to follow the chain back up and look at the rest of her body.
We have talked in prior blogs about how the whole body is interconnected. As a physical therapist, I do know where certain nerve roots from your spine innervate and the typical distributions where those can trace back to. There’s also something called peripheral nerves where nerves that branch off out in the arms and legs might be entrapped local to that area. It’s my job to figure out where that is.
Numbness, Tingling & Pain Symptoms Can Originate from the Spine
Some people will use the word sciatica when they’re talking about pain down the back of their leg, and that is a catch-all term. Sciatica can be caused by multiple different origins of pain. It might be something compressed up in the spine at one of the nerve root levels that eventually becomes the sciatic nerve. It could be compressed a little bit under your piriformis muscle in your buttock. We have to figure out exactly where the compression is so we can take the pain away from the rest of your leg.
When it comes to the hand, hand numbness and tingling can be caused by carpal tunnel, a very local issue from the wrist down. But it can also be caused from your neck. Different nerve levels in your neck can cause pain down into your hand. And as I mentioned a moment ago, it might not be pain going all the way down your arm. You might not even have pain in your neck. You’re just feeling it in certain distributions within your hand. And again, it’s our job—based on what you describe to us and where you mention the symptoms are in your hand—to trace it back.
How an EMG Nerve Conduction Study Can Help
We want to make sure that we look above and below the affected area, that we look at the whole body. We do the tests and measures that we have learned in school and through our experiences to help figure that out.
If we are unsure or we want to get a more clean-cut diagnosis of where it’s coming from, we also have nerve conduction studies and electromyography (EMG), which can help us to get to that root cause and pinpoint the area of your nerve trouble.
Reach Out to Bay Area Physical Therapy for a Consultation
If you have not seen our prior vlogs on diagnostics or carpal tunnel, please take a peek so you can see how we can help get to the root cause of your numbness and tingling and then provide treatment. And if you need anything, please reach out to Bay Area Physical Therapy today for a complimentary consultation.