Most of the injuries to the nerves that occur with blunt trauma such as car accidents, falls, lifting injuries, repetitive strain injuries, sports injuries occur to the nerve roots in the neck, mid back or lower back regions.
Nerve root injuries also occur gradually and insiduously with the aging process compounded by the activities of daily living. The subsequent course of the nerve injury will be dependent on (1) time lapsed since injury and (2) the degree of nerve injury.
When the nerve root injuries occur acutely as with blunt trauma or gradually as with aging, the nerve root injuries are partial. The common presentation is that of pain, stiffness or tightness rather than weakness.
When the patient presents with nerve related problems, the symptoms may be described as sharp, radiating, dull, throbbing, aching or burning. There may also be associated tingling and numbness or even itching.
The muscle symptoms due to nerve involvement may be described as tightness, stiffness, heaviness, swelling. The muscles will also be tender to touch with superficial or deep palpation.
Often, patients will complain of a deep feeling of coldness in the limbs. There may also be skin color changes such as blotching, deep redness or dusky hue to the skin or extreme pallor. These color changes are noted especially in the fingers or toes especially when dependent.
There may be patchy areas of hair loss in the distribution of the injured nerve root.
Patients may also complain of intolerance to heat and cold, humidity and weather changes.
They may have changes in bowel and bladder habits such that they may have frequency in urination or bowel movements.
Nerve related muscle symptoms may be constant or intermittent and usually made worse by movements and activities. Resting is usually helpful.
Nerve manifestations are manifold and unless one is aware of such diverse presentations, nerve root injuries as an underlying cause of the symptoms may be entirely unsuspected.