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Pinched Nerve

A pinched nerve occurs when too much pressure is applied to a nerve by surrounding tissues, such as cartilage, muscles or tendons, or by surrounding bones. This pressure disrupts the nerve’s function, typically causing pain, tingling, numbness or weakness.

While pinched nerves can occur throughout the body, the spine (including the back and neck) is one of the most common places. The nerve roots surrounded by the vertebral column are particularly vulnerable to becoming pinched because they are tightly crowded in the spinal canal.

Nerves of the brain and spinal cord comprise the central nervous system. These nerves branch out and deliver impulses and instructions throughout the body. A spinal pinched nerve occurs when any of these nerves are put under pressure or become compressed. The compression results in pain and other symptoms that can limit the crucial functioning of these nerves. This can disrupt the appropriate signals to control the muscles of the body.

Symptoms

In addition to pain, pinched nerves may cause a number of other common symptoms. Symptoms will vary according to the area in which the pinched nerve(s) occur. These areas are:

  • Cervical (upper) spine, where symptoms present in the neck, upper back, shoulders and arms
  • Thoracic (middle) spine, where symptoms present in the mid back, ribs, torso and internal organs
  • Lumbar (lower) spine, where symptoms present in the lower back, buttocks, hips and legs

General symptoms include any of the following:

  • Radiating pain through the neck or lower back
  • Radiating pain through the leg or foot, often called sciatica
  • Radiating pain through the shoulder blade or arm
  • Muscle spasms
  • “Pins and needles” or tingling sensations
  • Arm or leg weakness or numbness

Causes

The typical causes and conditions listed below don’t necessarily result in symptoms. However, when these conditions also cause a pinched nerve, people will likely experience symptoms. Many of these are common features of the aging process and/or of wear and tear on the relevant parts of the body:

  • Herniated discs
  • Bulging discs
  • Bone spurs
  • Spinal stenosis
  • Osteoarthritis/spinal arthritis
  • Facet disease
  • Trauma (injury/accident)
  • Repetitive motion (sports or physical labor)

Diagnosis

In the event of a suspected pinched nerve, a thorough examination is conducted by a neurosurgical spine specialist. The doctor will discuss the patient’s general health and medical history and review symptoms. The doctor will also perform a physical examination of the neck/back, examining for reflexes, muscle weakness or diminished sensation.

Additional tests for a pinched nerve may include:

Magnetic resonance imaging (MRI)–An MRI is used to detect a herniated disc or spinal stenosis, which are conditions that can cause a pinched nerve. It can also show pinched or inflamed nerves and/or spinal cord or nerve root compression.

Nerve conduction study–This test can locate the exact area of the pain, tingling or numbness, thus indicating a pinched nerve. A nerve conduction study is usually done in conjunction with electromyography (EMG).

Electromyography (EMG)–EMG tests the function of nerve roots that emanate from the spine. If abnormal electrical signals in the muscles are detected, this may indicate that a nerve exiting the spine is being pinched.

Treatment

In some cases, a pinched nerve can resolve on its own. There are also a variety of nonsurgical options available to treat pain and other symptoms of a pinched nerve. Pain relief can allow patients to undertake other rehabilitation measures, such as special exercises. Conservative care is initially recommended. This includes the following:

  • Rest
  • Anti-inflammatory medications
  • Hot/cold therapy
  • Physical therapy
  • Corticosteroid injections (sometimes referred to as epidural steroid injections)

However, in other cases, surgery is clearly indicated. In the event that surgery is recommended, patients benefit from the advances and advantages of minimally invasive surgical techniques. These techniques include much smaller incisions, quicker surgical procedures, less trauma and less scarring to the surgical area, less surgical risk, fewer potential complications and shorter recovery times.

A full explanation of diagnostic testing and spinal surgical procedures for pinched nerves and other conditions is available here.

At Advanced Neurosurgery Associates, our spine expert Dr. Vivek Ramakrishnan is widely experienced in the diagnosis and treatment of cervical and lumbar pinched nerves. Dr. Ramakrishnan works individually with each patient to customize care. If all nonsurgical methods are exhausted, and surgery is indicated, he utilizes minimally invasive techniques whenever possible.