Pinched nerves can cause symptoms of tingling, numbness, muscle weakness and shooting pains for those who are affected. Doctors will generally refer to this condition as nerve compression that can happen at any location of the body where nerves travel.
A pinched nerve can occur as a result of minor muscle strains, bone fractures, repetitive motion, traumatic injury and degenerative conditions like arthritis. Pinched nerves caused by minor injuries can go away on their own with minimal treatment, with symptoms subsiding once the nerve is decompressed. However, conditions that are more chronic and irreversible will cause debilitating symptoms that persist for months and seriously interfere with a patient’s life.
The spine is particularly prone to injury or degeneration and because there are so many nerves packed into it, pinched nerves commonly happen in this region. Conservative treatments for a pinched nerve in the spine can be effective, allowing many people to return to normal activity and live in relief.
However, if you have been through a course of nonsurgical treatment without getting the relief to live a full and active life, you might be wondering if a surgical procedure can bring relief from pain and other symptoms.
How to know if you need a surgical pinched nerve procedure
Patients diagnosed with nerve compression in the spine should make important treatment decisions with their primary care physician, or in some cases, a specialist that has provided long-term care. A doctor with detailed knowledge of your medical history and treatment record will be the most qualified to make recommendations about treatment.
Due to the highly invasive nature of many open back surgical procedures, open spine surgery is usually viewed as a treatment of last resort by medical professionals and patients. Before considering spine surgery to treat a pinched nerve, most surgeons would want a potential candidate to meet the following criteria:
- Experiences chronic pain that has lasted at least three months.
- Has exhausted conservative treatment options like physical therapy, epidural steroid injections and over-the-counter and/or prescription pain medication.
- Meets weight requirements.
- Has been clearly diagnosed with an anatomical lesion that is causing nerve compression and can be safely removed.
Traditional open back procedures for a pinched nerve require the surgeon to use a large incision to access the spine. This means cutting through supporting muscles and connective tissue, resulting in blood loss, scarring and a long — and sometimes painful — rehabilitation process for a patient. Because of these risks, minimally invasive nerve decompression surgery can be a more effective treatment for many patients.
Are there pinched nerve procedures that don’t involve surgery?
There are some advanced nonsurgical pinched nerve procedures that can treat symptoms and provide pain relief for patients. A spine specialist, like a neurologist or an anesthesiologist, may recommend or perform procedures like the following:
- Epidural steroid injection — This is an injection of an anti-inflammatory corticosteroid right outside the protective sac that surrounds the spinal cord, called the dura. These injections can reduce the compression on a pinched nerve and provide pain relief for long periods of time. This is not a permanent solution, but it can provide a patient with enough functionality to complete physical therapy and make other lifestyle changes that can help with long-term pain management.
- Selective nerve root block — This is another type of injection that can serve both a diagnostic and pain relief function. When a nerve root exiting the spinal canal becomes compressed, there are times when even advanced imagery like an MRI doesn’t reveal the precise location of the pinched nerve. An anesthesiologist can inject a numbing agent into the suspected location, and if symptoms disappear, it can confirm that this was the correct nerve and that decompression surgery would provide effective relief.
Minimally invasive spine surgery
If you are considering traditional open neck or back surgery to treat a pinched nerve, a safer and effective alternative is minimally invasive spine surgery. These procedures use precision instruments and a small incision to access the spine and decompress a pinched nerve. A small incision means the surgeon can avoid severing muscles, leading to a shorter recovery period and less scarring for patients. Talk to your primary care doctor or spine care specialist about this type of procedure to see if you are a potential candidate.