Pinched nerve diagnosis can be very difficult because symptoms often occur in a different part of the body from where the nerve compression has originated. A primary care physician can usually perform a series of basic tests to properly identify the source and location of pain and to determine if it’s due to a pinched nerve or another cause.
“Pinched nerve” is a general term that describes pressure placed on one of the many nerves running through the body. Causes range from an inflamed muscle or tendon to a swollen joint or bone spur. The symptoms of a pinched nerve are usually described as a burning or shooting pain, tingling, numbness and muscle weakness. Prompt treatment of pinched nerves is required to limit the potential for permanent nerve damage, making an accurate diagnosis from a doctor very important.
Pinched nerves in the spine
In addition to providing support for the upper body, the spine’s primary function is to protect the spinal cord. Due to the large amount of nervous tissue passing through such a narrow space, it is very common for nerve compression to occur in the spine and cause painful symptoms.
Some of the underlying causes of spinal pinched nerves include age-related, degenerative conditions like bulging or herniated discs, bone spurs and swollen joints. These conditions can make the already tight spinal canal even narrower, creating pressure on the central spinal cord or exiting nerve roots.
Identifying the location of a pinched nerve
While spinal nerve compression can cause local pain, it can also result in radiating symptoms, which can make a pinched nerve diagnosis difficult for many patients and doctors. However, it is possible to identify the source of the pinched nerve based on the location of symptoms.
The spine is divided into three sections: cervical (neck and upper back), thoracic (middle back), and lumbar (lower back). As nerve roots exit the spine in these areas, they travel to specific areas of the body, making it possible for a doctor to trace symptoms back to the location of the exiting nerve.
Here are the locations of symptoms as they correspond to regions of the spine:
- Cervical — causes symptoms in the neck, shoulders, arms and hands
- Thoracic — causes symptoms in the chest and abdomen
- Lumbar — causes symptoms in the hips, buttocks, legs and feet
One of the more well-known conditions resulting from a pinched nerve is sciatica. Sciatica is a group of symptoms related to the pinching or compression of the sciatic nerve. This nerve starts in the lower spine and travels all the way down both legs to the feet. If this nerve becomes compressed, symptoms like burning pain, a “pins and needles” sensation and muscle weakness can result throughout the lower body, especially in the hips and legs.
These symptoms are so commonly related to sciatica that many doctors, and even some patients, can make a preliminary diagnosis based on these symptoms alone. However, there is no substitute for thorough testing to make an accurate pinched nerve diagnosis.
Testing methods for diagnosis
Your primary care physician can start the diagnostic process by first reviewing your medical history and performing a physical examination to assess your current overall health. Your doctor will also usually perform a direct, hands-on test of the painful area to determine if the cause of pain is related to local muscle or connective tissue inflammation.
If a positive diagnosis cannot be made from basic testing, a doctor can then order more extensive testing. Here are some of the other testing methods for pinched nerve diagnosis:
- X-Ray — Basic imagery can detect displaced material in the spine that may be causing nerve compression.
- MRI — Magnetic resonance imaging (MRI) can give a more detailed picture of a problem area and can sometimes be necessary for an exact diagnosis.
- EMG — Also known as electromyography, an EMG looks for certain muscle responses that can be related to a pinched nerve.
- Nerve conduction — This test uses electrodes on the skin to measure the impulses from nerves and potentially detect a damaged or pinched nerve.
While it can be frustrating to go through rounds of testing for a pinched nerve diagnosis without receiving relief or treatment, it is important to find the exact cause of your painful symptoms. Treating the wrong condition can result in the continuation or worsening of pain and discomfort.
If you receive a pinched nerve diagnosis
If you have been told the source of your pain is a pinched nerve in the spine, most doctors will begin treatment with lighter methods of pain management. This can include over-the-counter pain medicine, physical therapy exercises and alternating hot/cold compresses. Back surgery isn’t considered in most cases unless symptoms are persisting after all conservative treatment options have been exhausted.
Surgical treatment options for a pinched nerve in the spine depend on the underlying cause, but the goal of pinched nerve surgery is to remove pressure on the pinched nerve in the spine. Specific methods can range from highly invasive traditional open back surgery to newer minimally invasive techniques that aim to reduce recovery times and hospital stays. While you should work closely with your doctor to find the best course of treatment, it is also important to stay informed about the full range of options available to you by researching the different types of pinched nerve treatments and surgeries.