Nerve is usually more burning & stinging. Can sometimes feel like there's a match burning against it. It can run up & down or cause numbness too. When it's excruciating there's nothing that really compares.

Muscle is deeper and localized to the area. If there's trigger points involved the pain can feel like its in one place but coming from another. Referred pain. The back is usually effected by TrPs the most. Can be sore and achy.

That's my experience anyway. Others may have a completely different opinion.

Take care.

Emerald

Yeah, nerve pain for me is more of a burning, like my leg is in a hot vat of oil. Sometimes it is like a fullness or squeezing feeling. But then again, sometimes it's hard to tell which pain is from what and where. It just blurs into one another in a big huge pot of pain stew. I hops you find out where your pain is coming from. I hope you feel better soon. Hugs!

This morning after exercising (not aerobic, just my PT stretches, etc) it burns and aches. However, typically it is a throbbing, heavy feeling. I would like for it to be muscular because then I think I may someday get relief, but it has been almost a year. Why is it so difficult for doctors to agree. I had an epidural steroid injection that was NO help. I am assuming if it was nerve related that would have given me at least some relief. I have had EMGs that showed no nerve damage. However, I do know that many people have told me that inflammation when I am hurting can pinch on nerves The degenerative disk disease is the only consistent diagnosis. Is this nerve or is this muscular?

Swelling can push on nerves. But muscles also spasm to protect the vertebrae from more damages with DDD and other spine damage.

Since I don't know what your pain feels like I really can't say. I have both but there's definitely a difference in how they feel. It's been yrs for me so maybe after awhile you just start to learn the difference??

E

I have been to a pain mgt doctor. He did epidural injections...no help. I have tried Neurontin...no help. MRIs are a year old....does that make a difference? They showed some mild herniation with DDD which my PCP said was facet arthrosis....arthritis is what he said. I went to a rheumatologist and she thought it was nerve more than arthritis, but that was based on a 5 minute evaluation. She ran tons of xrays, but that was three weeks ago and still no word from her and I have called back twice. Should I see a neurologist next? My EMG was normal too, I just want to live a normal life. Not being able to shop or work all day without pain is very depressing.

Hugs.. the answer is that there is no real answer. Even if the doctors can absolutely say this is muscle or that this is nerve pain, it won't change how they treat you, because the reality is that muscle pain causes nerve pain and vice verse.

I hope you can find relief. I wish this life on no one!

Hugs
yadlim

Thanks. I wish I knew the answers too.

I am using Neurontin more frequently at least 600 mg twice a day, I am trying to get an appointment for steroid injection. sleep alot due to neurontin and sleep apnea. Continue to work, and need to, as it keeps me active. Pain Pain Pain, but there is always someone worse off. At least I have a warm house and food.

doug15, I agree. The injections did not work for me, but I have had many friends who swear by them. I think I am going to try my Neurontin again. My doctor swears it will help me whether it is nerve or muscle pain. I just hate the side effects!

Neurontin/gabapentin usually takes awhile to build up in your system to reach a therapeutic level. The side effects were just about the end of me, at just 900mg/day, but the neuro talked me into sticking with it so I did. But it felt like forever getting adjusted to them. I still have weird twitches but the really strong jerking and grogginess has gone away. Most people do gain weight on it but I've been lucky not to have that. Fingers crossed. It's helps me more with nerve pain than muscle pain. Muscle relaxers work best but I do need them 5x a day to keep things manageable.

As for spinal steroid injections, did anyone see the new warnings the FDA issued over the last couple weeks? They're on the front page of their website. fda.gov Apparently they held hearings and the warnings were the result. Last Friday was also the deadline for filing personal complaints to them because they may issue more warnings later after reviewing the complaints.

The head of the trade organization for neurologists (sorry can't remember their official name) didn't have much good to say about them at all. Something to the effect about having "sludge" injected into your spine that is going to your brain. That's not a direct quote but pretty close. My neuro/PM refuses to do them but my last PM was an anesthesiologist and that was his primary treatment plan.

I know at the time of the meningitis outbreak a couple yrs ago the shots weren't FDA approved for the spine. They were being used off label. I'm not sure if that's still the case but I think so. I had them done in 2010 and had no benefit from them at all. They probably made things worse. Since I have other issues going on I can't be sure. But that was my experience and everyone is different. For some people they work great and for a long time.

Please read the info from the FDA and make an informed decision if you decide to have them done. So many drs do them now and some as their only method of treatment often threatening to withhold pain medication if you refuse them. That's what happened in my case & the only reason I consented. At $2500 +/- per injection theyre a big money maker for these docs. We're in enough pain without adding to it just to make someones vacation home pyt for them. Sorry that's my cynical side talking. I wish I knew then what I've learned since. It's one of the reasons I research so much now & don't just take a doctor's word for it anymore. Sometimes lessons have to be learned the hard way. For me that's usually how things go anyway.

Take care,
Emerald

I wouldn't know the difference if I hadn't had both at different times. To me, nerve pain, which is part of RSD, feels like a cold burning. Like ice but fire, too. I know, it makes no sense, and I am a writer! But if you ask me what the RSD in my foot feels like, my 1st answer will be a cold burning. My 2nd answer would be muscle spasms in my leg and lower back. Those feel like aching, sore muscles, as if you've worked out too hard or run too far.

Hopefully you're being treated for both. I have had this since 1997 and I can easily tell the difference now, but when I was 1st diagnosed, I really wasn't sure. I knew my back pain was muscle related but how does one know if there's also nerve pain? It's a different feeling.

Good Luck!

Thanks for all of the clarification! I appreciate it.

I think it's a mixture of both. When a nerve becomes compressed it causes the muscles to tighten up, and I think this results in the horrrible burning, tightness and numb sensations.

I've just had a C5/C6 ACDF and a carbon fibre cage inserted between the discs. I immediately regainged strength in the affected arm/hand, but the tightness, burning and numbness (all though the numbness is already less) still comes in waves. Apparently, it can take up to 2 years for a nerve to completely heal, and these symptoms can persist until it does.