Advice for a (probably) pinched nerve? Good physiotherapist? (Tokyo)

February 22, 2013 6:17 AM

I've had a tingling/burning sensation in my left shoulder/hand for about a week. A doc that I saw in Tokyo thinks I have a pinched nerve and told to come back in a week, but was rather vague about what to do in the meantime. I have no health insurance so I would prefer to not go back, but I just noticed the tingling starting up in my right hand as well.

Hi all,

I posted last week regarding problems I was having regarding a tingling in the left shoulder. I stopped practicing piano for the time being and as the tingling didn't stop - it actually spread to my left hand - I decided to fork over the money for a doctor even though I don't have insurance (even without insurance, doctor visits are relatively cheap in Japan).

The doctor gave me a lookover (he bent my arms and head, asked of it hurt, never did), took an x-ray, and declared that I probably had a pinched nerve in the neck. He also said my neck was drooping forward because my posture sucks and told me to work on that. That makes sense - I always slouch when I walk + use the computer. He gave me some pain meds, sent me away, and told me to come back in a week if my situation doesn't improve.

I was told by a pharmacist that I should have gotten an mri as well to make sure that it is a pinched nerve, but that would mean forking out 350-plus dollars. The doctor didn't consult with me about that or give any other advice, just that a nerve was probably pinched and that I should "take it easy." He seemed pretty confident at the time, but looking on the internet there are plenty of illnesses that have tingling body parts as an illness.

That was yesterday. In between then and now, I have been working on sitting and standing straight, with my head further back (I think I am trying too hard, my lower back is getting sore). I also bought a better pillow and ordered an ergonomically correct chair for work. Before this I had been always using my laptop on my, well, lap. Besides that, I've been trying some stretches I found on youtube that are supposed to help (double chin + tennis in the sky) and doing some light jogging to try and get rid of some of this stress.

I also got an acupressure massage yesterday - it KILLED, especially in certain spots in the shoulder (where the pinched nerve is, I assume). I had to tell the therapist to take it easy more than once. I actually think the massage might have made the symptoms worse.

The therapist told me my shoulders/neck are super stiff. That makes sense, since I have been pretty stressed lately - I feel tension in my shoulders and jaw, which I am thinking might at least be one of the reasons I am having this pinched nerve problem now. my shoulders get really tired when typing, which usually doesn't happen.

Since I can't get on health insurance before April without paying a bunch of money, I am really hoping this goes away on its own and doesn't get worse. I am super worried though, and would like to get back to playing piano tingle-free. Someone recommended that I visit a physical/physiotherapist, but I don't know any good ones in my area (in or close to Tokyo).

TL;DR: Anyone suffer from a pinched nerve before? Anyone have any advice to help it heal on its own, or know of any physiotherapists to visit in Tokyo? What else could it be if not a pinched nerve?

posted by Thanquol180 to health & fitness (7 answers total)

I had a herniated disc in my lower back a few years ago, which I found out about because of sciatica in my leg. The problem came on slowly, over the course of months, and was at its worst for maybe 3 months or so (during which time I had a difficult time walking without being hunched over and having awful pain in my leg and my foot going knumb). I would say from the time that I noticed the issue to the time that it was more or less better it took approximately a year. After noticing the issue for a few months, I went to the doctor an initial time, when she took an x-ray and didn't find anything. After a month or so when it didn't get better, I went in again and she ordered an MRI, which is what uncovered the herniated disc. Following that I had numerous rounds of physical therapy. In retrospect, I might have opted out of some of the physical therapy, because most of the time I didn't feel like it did much, though it was nice to have someone knowledgeable about the problem to see on a regular basis (especially once I ditched the first physical therapist I went to, who I didn't like that much and changed to another who I did). I think what may have ended up making a difference was during the last round of physical therapy, they hooked me up to a machine that more or less kind of stretched my lower back out by pulling on my torso in both directions at the same time (I know there is a word for this method, I can't think of it right now). But it is hard to tell because this came at the end of a long saga of doctor's visits, faithfully doing PT exercises, and visiting the PT otherwise.

My impression with pinched nerves is that it is very much a case by case basis in terms of what ends up helping/resolving the problem. Some people seem to get over that issue within 4-5 weeks, some people like me manage to drag it on for ages, and some people will always have issues once they start. Even now, about three years after I had this issue, if I get lazy and don't go to the gym for a while I'll notice a bit of sciatica in my leg. I hesitate to try to give you advice on what to do next since I am not a medical professional of any kind and because it does seem like this problem is such a person-specific thing, but that was my experience with a pinched nerve.
posted by thesnowyslaps at 6:49 AM on February 22

Fish and or flax seed oil help with the pain (probably from anti-inflammatory properties), I avoid dairy and nightshade plants (causes inflammation for me), do you drive? are you gripping the steering wheel too tightly?

I recently started having acupuncture twice a week just for my general health and since then I have had no pain from my pinched nerve.

I'm also doing the exercises from this

how to fix neck pain

I keep my computer monitor high enough so that I am not looking down.
posted by cda at 7:03 AM on February 22

I've been through this exactly problem a few times. My best results have been from physical therapy combined with home exercises, hot-cold treatments, etc. As outlined in my answer to your prior question. Don't wait until April, because the tingling means your nerves are progressively being damaged, which means you will lose muscle strength, which means it just gets much harder to repair as you go along. Invest in at least a few sessions of PT and religiously do the recommended stretches and exercises.

Yes, you can't be sure without an MRI. But if your neck is stiff and there's tingling, you can put your money on pinched nerve. And PT/stretches/exercises for a pinched nerve is not going to do any damage if it's really something else.

I would avoid the jogging because of the impact for now. Walk, swim, cycle. Be patient, this is going to take quite a few weeks and day-to-day improvement may not be immediately apparent.
posted by beagle at 7:14 AM on February 22

I was diagnosed with a pinched nerve in my neck in 2007. Symptoms were quite scary -- severe numbness in my head, face, neck, both arms and upper back. My family doctor was concerned it something serious so I was sent to a neurologist and had an MRI and some other test with electrodes.

Turns out it was a pinched nerve. The treatment was exercises -- I got a printout-- and 'waiting' -- I was very worried, but was told it would take time -- perhaps months. I was not advised to get PT as my doctor was worried it would make things worse. (I have no idea if this advice was sound and certainly I'd do it if your doctor suggests it -- but I didn't do any PT.) The issue resolved itself very slowly over 3 or 4 months.

I did do acupuncture. I was a bit of a skeptic, but it really helped a lot. (Placebo?)
posted by Lescha at 9:40 AM on February 22

Top 3 Exercises for Thoracic Outlet Syndrome
posted by Manjusri at 3:16 PM on February 22

Hi there, thanks for the replies. I don't drive, but I think my computer habits are not helping.

Hmm, a lot of people are recommending acupuncture... maybe I'll take a look! Hope it gets better soon. Would love to hear other advice!
posted by Thanquol180 at 5:47 PM on February 22

You need to figure out what is causing the problem, and figure out how to fix it. I developed pretty severe carpal tunnel syndrome (a squashed ulnar nerve) and even was checked out by a neurologist. The solution? Change how I sit. Wait for six months.

Six months later, after switching to a standing desk, the difference was noticeable. A year later, the symptoms of carpal tunnel syndrome have not gone away, but muscle mass has returned to my hand, and I have regained 70% of feeling and about 85% of the mobility I lost in a couple of fingers.

But, like I said, there was no super-precise cure for my condition, which was similar, but much more severe, than your pinched nerve. It just took time, so waiting until you're on national health insurance in April will be fine.

So, switch how you sit. Don't lean when you sit.

Walk a lot. Swim. Do yoga or something.

Of course, an MRI (in my case it was a CT scan) will help doctors know definitely that it's a pinched nerve, rather than something more serious. After that, diagnostic test by a neurologist would also confirm the diagnosis.

But the treatment would be the same: change your habits, and give it six months.
posted by KokuRyu at 9:42 PM on February 23