Is a Pinched Nerve a Permanent Problem?

Is a Pinched Nerve a Permanent Problem?

As a Spine Surgeon,  I see people with pinched nerves almost everyday.  Fortunately,  most pinched nerves do not become a permanent problem.  That is why greater than 98% of pinched nerves can be treated without an operation.

Pinched nerves are commonly caused by herniated nucleus pulposus (disk herniation), cervical and lumbar spondylosis  (bone spurs).  The more rare reasons include  fracture, infection,  tumor,  and fat collection (epidural lipomatosis).  For some,  the pinching comes and goes secondary to loosening of the bones and shifting of the bones on one another (spondylolithesis).  Fortunately,  the great majority of the pinched nerves are from the disk herniation or bone spurs.

In the disk herniation,  or bone spur situation,  there is often a temporary,  but significant pain response to the pinching.  Like any tissue that is pinched,  there is a swelling or inflammation process that paradoxically can increase the pain for a certain duration.  Over time,  the swelling goes away,  and the nerve shrinks back to normal.  That shrinking of the nerve is part of the  “unpinching process”.  Science can explain all these points in a most detailed and microscopic description.  The simplest way is to say “the nerve swelling goes away,  and nerve returns back to a normal size”.

In relationship to a disk herniation,  Spine Surgeons now know that the larger disk herniations are often the ones that naturally shrink in size.  The body actually considers the disk herniation as a foreign material,  and attacks the disk fragment,  and it does get degraded down in size.  In addition,  the larger disk herniations are often originally full of water.  Over time,  the water is absorbed,  and the disk herniation fragment will dry up,  thus further shrinking in size.  This contributes to the  “unpinching of the nerve”.

Bone spurs do not go away,  and can and do grow in size.  The nerve usually gets pinched secondary to a combination of the bone spur squeezing the  nerve when the nerve is stretched or pulled.  In the arm,  the nerve bundles from the spine can be stretched when the arm is placed in the extremes of motion,  or when the arm is being stressed by certain activities.  Likewise,  the nerves to the legs are also stretched when the leg is moved in a certain manner.  There was a recent fascinating research performed looking at the location of the nerves in the spinal canal when the extremities are positioned in certain fashion.  There was definite movement of the nerves within the spinal canal,  depending on the position.  If the nerve was then slightly pinched by a bone spur,  it is not hard to understand how that movement will cause further pinching,  and subsequent pain.

Even in the Bone spur scenario,  the pinch is usually temporary,  and the nerve recovers.

As a Spine Surgeon, I know  most pinches do get better with time,  activities modifications,  and medications.  Occasionally,  steriod injections on the nerves are also required to help decrease the inflammation.   While the initial pain can be severe,  there is a good chance that the pinched nerve pain will be a temporary situation.  Unfortunately,  some pinches caused by fractures,  tumors,  infections,  hematoma’s etc may require urgent surgical care to prevent a permanent situation.   Thank goodness,  that situation is less common.

If you have a severe pinched nerve,  there is still a good possibility that may be only a temporary problem.  At the same time,  a Spine Specialist will be the best Physician to determine the best treatment options.  Sometimes Surgery is still a good choice,  if the pinching is severe,  and prolonged.

Citations

  • AANEM.. AANEM's top five choosing wisely recommendations. Muscle Nerve. 2015 Apr;51(4):617-9. PubMed PMID: 25789931

7 thoughts on “Is a Pinched Nerve a Permanent Problem?

  1. This made me feel like my pinched nerve wasn’t the end of the world. ive recently started weightlifting and i ended up pinching a nerve in my outer thigh and its numb now.Constantly. its been like this for a week now and I dont have any back pain, i walk fine, and have minor tingling/ pins and needles. does this mean im recovering and my leg will become un-numb at one point?

    1. Hi Marjorie. Only you know if you are getting better or not. Anti-inflammatories and ice can often settle down the pain when a nerve is inflamed. Numbness in your outer thigh is often from a pinched nerve in the back. Simple stretching may be all you need but if it continues for any amount of time or weakness develops, get it checked!

  2. I’ve been feeling muscle spasms underneath my left shoulder blade near where you would see “bra bulge” and I’m wondering what might be causing it? I actually lifted my shirt and looked in the mirror and could see the muscles visibly twitching. I am obese but I’ve never felt muscle spasms like this before. I am on day two of starting a ketogenic diet in attempt to lose some weight and am wondering if this could be the cause? I’m trying to drink more water; I’ve had about 7-8 glasses today which is more than I usually drink. Any info would be helpful.

  3. Hello, I have had what I believe to be is a pinched nerve for going on 2 years plus, in my left side c6/7 region. I went into a Chiro after minor neck pain and it got worse so I decided to see a pain doc who does steroidal injections, and ablations.The only thing is my doctor thinks its muscular, but a recent ER visit that doctor told me he also thought it was a pinched nerve in the same cervical area. My last MRI was a year ago and did not show a pinched nerve, and the pain was tolerable with heat NSAIDs and Biofreeze. Recently I have begun to lose the use of my left arm. Especially at the top part bicep, and tricep, the trapizious muscles are spastic and I have been given Roboxin and Gaba, as I refuse to take any narcotics because in my opinion they make it worse. The doctor I am seeing now is a pain doc. Should I ask for a referral for a Neurosurgeon? I have some really odd symptoms as well other than shooting pain down my arm and to shoulder blade. I have to sleep straight as a pencil on my back with no pillow, if it’s real bad I have to sleep on our hardwood floor, in order to get any sleep. I cant be touched on the left side or it hurts while laying down. If my neck is turned to any degree of angle, and I fall asleep it sends shooting sharp pain from my neck to my temporal are in my head and wakes me up instantly in number 10 pain. It goes away right away after i straighten my neck and stretch but it is scary. The first time it happened i thought i was having a stroke. Thanks for your time.

    1. Definitely see someone regarding the muscle wasting and the positional neck problems. Often a normal MRI can miss instability in the spine that a simple flexion/extension x-ray could diagnose. You could be putting pressure on the nerve or the spinal cord only in certain positions.

  4. Thank you for this, I found this very useful! If someone feels that they have a pinched nerve in the neck, What can they do at home as far as stretches exercises to recover/unpinch the nerve?

    1. Hi! It is all going to depend what is causing the compression on the nerve. If it is a herniated disc or if the nerve itself is swollen, mild neck stretches, anti-inflammatories, ice, and time are all going to be beneficial. If this doesn’t work, oral steroids or injections could be appropriate. If the pressure is caused by bone, we try to shrink the nerve back to normal first but if that doesn’t work, surgery is usually indicated. Please look on the website under conditions and hit the “non surgical spine care”. There are safe exercises there to get you started.

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