When Muscle Pain Signals a Nerve Problem: Insights on Diagnosis and Non-Surgical Treatments

[medi K / HEALTH IN NEWS] Pain mistaken for simple muscle soreness often stems from nerve-related issues, a phenomenon more common than many realize. Radiculopathy, where a spinal disc compresses a nerve root, can produce pain that feels like it originates in the muscle itself, sometimes in unexpected areas. This makes accurate diagnosis critical to distinguish between routine muscle pain and nerve-related conditions.

Prolonged pain can lead to muscle imbalance and atrophy, triggering additional pain and complications. Restricted muscle use due to chronic discomfort may cause posture changes and reduced strength, affecting overall physical health. Moreover, pain-induced emotional stress can influence the nervous system, creating a vicious cycle of worsening symptoms, underscoring the need for early intervention.

Dr. Sangwon Jung, director of Misa Wontop Neurosurgery Clinic in South Korea, emphasizes that surgery is not always necessary. “A range of non-surgical treatments can effectively alleviate pain,” he says.

“Strengthening exercises and lifestyle adjustments are key to preventing recurrence, and since the painful area may not be the root cause, precise diagnosis is essential.”

When Muscle Pain Points to Nerve Issues

From a neurosurgical perspective, radiculopathy—where a disc presses on a nerve root—is a common culprit. Nerve roots contain both motor and sensory nerves, which can manifest as muscle pain when compressed. Unlike typical muscle soreness, this pain often feels like a deep, localized ache in the muscle mass. For instance, what seems like a tight shoulder might actually result from pressure on the cervical sixth nerve root.

The challenge lies in the atypical presentation of many neurosurgical conditions. At a recent medical conference, a case was discussed where a patient with sole pain in the foot experienced relief after a nerve root block for a disc issue. Such unexpected pain locations highlight the complex connection between nerves and symptoms.

Is Surgery the First Step?

The notion that neurosurgery equates to immediate surgery is a common misconception. “Every patient’s condition is unique, requiring careful evaluation,” Dr. Jung explains. Surgery may be warranted if muscle weakness is present, but the cause—whether disc compression, muscle tears, nerve root pressure, or peripheral nerve issues—must be pinpointed. Severe cases requiring emergency care, such as those arriving via ambulance, may need surgery at larger hospitals. However, for common complaints like back pain or leg numbness, surgery is rarely the first option.

Modern advancements have reduced the need for invasive procedures. “The days of large incisions, as seen in older surgical training, are gone,” Dr. Jung notes. Minimally invasive techniques, such as nerve blocks or other procedures, offer effective relief with lower costs, less recovery time, and reduced physical strain, making them viable alternatives.

The Ripple Effects of Chronic Pain

Persistent pain often leads to avoidance of the affected muscle, causing overuse of opposing muscles. Over time, this imbalance weakens unused muscles while overdeveloping others, potentially locking the body into abnormal postures. “This can spark a chain reaction of new issues,” Dr. Jung warns. The body’s muscles rely on balanced tension, and disruptions can strain other areas, leading to atrophy and further pain.

Emotional stress from chronic pain complicates matters further. Pain can activate the sympathetic and parasympathetic nervous systems, increasing muscle tension and exacerbating discomfort. This interplay resembles the classic chicken-or-egg dilemma, where emotional and physical factors amplify each other. Dr. Jung advises against delaying treatment in hopes of spontaneous recovery. “Visiting a specialist promptly to identify the pain’s cause is crucial,” he says.

Non-Surgical Options for Pain Relief

For weakened ligaments, treatments like prolotherapy, DNA injections, collagen-based injections, and platelet-rich plasma (PRP) therapy—a topic of growing interest in medical circles—have proven effective for pain and inflammation control. For spinal issues, procedures like neuroplasty, which widens the space between the disc and nerve, or nucleoplasty, which reduces disc volume, can relieve pressure. Dr. Jung cites a case where a patient with lingering pain from shingles a year prior found relief after six months of weekly injection treatments.

Are Growing Pains and Varicose Veins Nerve-Related?

Dr. Jung’s interest in treating varicose veins stemmed from their connection to nerve-related pain. Some patients with persistent back or leg pain despite spinal treatments were found to have varicose veins. One theory suggests that venous issues lead to waste buildup, irritating nearby nerves and causing inflammation and pain. Similarly, growing pains in children are thought to arise from nerve irritation in the periosteum, the membrane surrounding bones, during rapid growth. Both conditions, rooted in nerve irritation, fall within the scope of neurosurgical care.

Preventing Recurrence and Managing Pain Post-Treatment

Chronic pain can lead to muscle atrophy, reducing strength and increasing the likelihood of recurrence. To counter this, Dr. Jung recommends combining treatments with rehabilitation, strength training, or manual therapy. Regular stretching of the affected area, especially in cases of prolonged pain where muscles are weakened, is essential.

“Pain control is not the end of treatment,” Dr. Jung stresses. “True recovery occurs when muscles regain proper function.” Without lifestyle changes, such as correcting posture or movement habits, recurrence is likely. The brain’s “default settings” for muscle use must be retrained, a process that can take time and requires consistent effort. Dr. Jung also notes that the painful area may not always be the source. For example, a patient with pelvic pain was recently relieved by treating back muscles, highlighting the importance of identifying the root cause.

In South Korea, where long work hours (often 9 a.m. to 6 p.m. or longer) and sedentary lifestyles are common, addressing chronic pain through early diagnosis and comprehensive care is particularly vital. By combining precise diagnostics with modern non-surgical treatments and proactive rehabilitation, patients can break the cycle of pain and reclaim their quality of life.

Kim Kuk Ju / press@themedik.kr

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