Pinched Nerve

Pinched Nerve

Think you have a pinched nerve?

A pinched nerve is a common experience for most people over the age of 35.  Usually, it is associated with pain,  burning, or a tingling sensation to either the arms or legs.   While the pinching can occur out the spine, in conditions such as carpal tunnel syndrome, most of the time,  it is associated with a compression of a nerve within the spine.

In the Above diagram,  it demonstrates the effect of a disc herniation pinching a nerve in the neck.  The disc material physically compresses the nerve as it goes outside the canal.  The pinched nerve causes the associated pain,  burning, tingling and numbness.    In more severe situations,  the pinching will also impair the muscle movements associated with that particular nerve,  causing weakness.

While initially very painful,  a pinched nerve usually does improve and heal over time.

For mild situations,  your physician may recommend activities restrictions,  use of gentle massage and therapy, and an anti-inflammatory medication (if you can tolerate them).  For most patients,  the episode of the pinched nerve is often hard to pin point.  It may be caused by a certain activity.  It may be caused by a very innocent movement,  or a cough or a sneeze.  In some cases,  it may be secondary to a heavy lifting or a twisting event.  In these situations,  the nerve will initially become inflamed by the situation.  But,  gradually,  overtime,  the inflammation goes away.  Most recommendations are designed to reduce the inflammation.  That is why most physicians recommend anti-inflammation drugs (if you can tolerate them), ice, and time.    Fortunately,  this is the typical pattern of most pinched nerve events.

For more significant events,  there may be associated severe pain, and a history of a specific event such as a heavy lift,  or an accident. Usually,  the pinched nerve presents itself quickly, and there is a good history of the associated pain,  burning, numbness or tingling to a specific arm or leg.   Usually in the scenario,  as long as there is not significant weakness associated with the pain,  or no loss of bodily function of bladder or bowel control,  the same treatments above are recommended.  Even in the most severely pinched nerve, there still is a good chance the nerve will recover with time.

In a minority of pinched nerve events,  the situation becomes more progressive, with time.  If the pinched nerve is also associated with progressive increasing pain,  increasing weakness, or losing of bladder and bowel function,  this can become an emergent event.  If the physician has concerns that this is becoming a progressive problem,  the pinched nerve needs further diagnostic evaluations, and may ultimately require surgical intervention.  Fortunately,  the need for surgical intervention is necessary for only a small percent of all patients.

Citations

  • Cheng CH, Tsai LC, Chung HC, Hsu WL, Wang SF, Wang JL, Lai DM, Chien A. Exercise training for non-operative and post-operative patient with cervical radiculopathy: a literature review. J Phys Ther Sci. 2015 Sep;27(9):3011-8. PubMed PMID: 26504347

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