Question
Well I'm only 16 and i been having really odd/bad back problems. I'm not 100% how it start but theres two times that stand out in my mined, the first was in like 6th grade in wrestling i was only bout 98 pounds and i throw am 210 pound dad over my head and i got this like shock in my lower-mid back. That never when away really i get odd discomfort still in my lower and mid back. Then football last year is when it got really bad i went head to head with a kid and i felt another shock in my upper back and neck, this hurt really bad. i toke a break for awhile thinking i pinched a nerve but the discomfort and pain still after a year hasn't gone away. i have spasms,weird twitches,times when its hard to control my arms and hands,discomfort,weakness sometimes,pressure, and random burst of pain or a pain that last a awhile. this year my right arm has been affected the worse  i wake up at night with weird discomfort that never was there and stuff. I just don't know what is wrong or could be wrong people keep telling my its pinched or trapped nerves but they don't last so long or get worse over time. ideas?

Answer
Dear Erin,

Well, I have to assume that you have not had any of these symptoms explored by a physician, and you really need to. Much of what you have described are neurological in nature, this should be followed up on.

The history of the head to head football trauma is very significant, and is often referred to as a stinger.  The more appropriate medical terminology is called neuropraxia.  This basically means that the nerve roots of the lower neck and upper back had a jolt in which damage occurred to the actual nerve structure without internal destruction.  This represents a significant but recoverable injury.  Below I have listed the range of nerve injury for you to appreciate 1-3.

1)  NEUROPRAXIA: represents a local conduction block with axons (inner nerve fibers) remaining intact. Weeks or months may pass before the discontinuity of the myelin sheath (outer covering) is repaired.

2)  AXONOTMESIS: implies a more advanced compression or traction injury in which axons are disrupted.

3)  NEUROTMESIS: implies a complete severance of the nerve, in which a nerve lesion preserves its appearance of integrity but is, in fact, totally disorganized.

Now, how can this be documented?  Clinical diagnosis is the most common, meaning that your symptoms and history are used along with a functional examination to figure out what nerve roots and nerves are affected.  On the other hand, an electrodiagnostic study (NCV study) is the best way to determine this, but often the test will not be able to concretely diagnose a nerve problem until it has become more severe.  An NCV study also requires the use of needles and hurts, so it is often put off.

Bottom line is that you need to be examined, and this issue needs to be addressed professionally to render a concrete diagnosis.  A chiropractic physician or an orthopedist would be the best doctors to determine this...preferably these doctors would have additional training in sports injuries.

Good Luck Erin.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net