The term “pinched nerve” describes the compression of any nervous tissue in the body by another part of the anatomy like a muscle, bone, tendon or ligament. This is a wide-ranging condition that can happen anywhere in the body and be caused by a variety of factors.
One of the simplest examples of nerve compression is waking up with numbness in your arm from sleeping in the wrong position. However, a pinched nerve related to traumatic or repetitive injury can be far more chronic and debilitating. It is important for pinched nerves to be treated as quickly as possible to avoid any long term nerve damage that could lead to an even more serious condition.
The spine is a common location for nerve compression to occur, because it houses the central spinal cord in a tightly confined space. This means that if any part of the spinal column becomes displaced, the spinal cord or any of the exiting nerve roots can easily become pinched. The following spinal pinched nerve overview provides more information about the specific causes and symptoms, as well as the diagnosis and treatment of this condition.
Causes of a pinched nerve in the spine
A major underlying cause of a pinched nerve in the spine is breakdown of the spine due to age. As we get older, decreasing circulation causes important connective tissue like spinal discs and joint linings to dry out and shrink. This, combined with years of wear from supporting the upper body, leads to conditions like herniated discs or arthritis, which can narrow the already limited space in the spinal column.
Spinal narrowing can potentially cause compression on the tightly packed spinal cord or spinal nerve roots. In addition to age-related conditions, a pinched nerve in the spine can also be caused by injury, either from trauma like an accident, or repetitive motion from work or exercise.
Common symptoms of pinched nerves
In conjunction with local pain and irritation, a pinched nerve in the spine can cause radiating symptoms to travel out to different areas of the body. This is because the central nervous system is responsible for transmitting information to and from the brain, meaning nerve compression in the spine can interfere with sensation and movement in the lower body or arms. The following symptoms are commonly experienced by patients with a pinched nerve in the spine:
- Tingling and numbness
- Burning pain
- Muscle weakness
- Impaired motor skills
The location of symptoms will usually correspond to the location of the pinched nerve, so interference in the upper spine will affect the neck, shoulders, arms and hands. Nerve compression in the lower spine can cause symptoms in the hips, buttocks legs and feet. These lower body symptoms are called sciatica if the nerve being pinched is the long and wide sciatic nerve.
Diagnosis and treatment of pinched nerves
Your primary care physician is usually the first to diagnose and treat a pinched nerve. Nerve compression related to inflammation from a minor injury should go away in a few days to a week, but if symptoms remain after that you should make an appointment with your doctor for an accurate diagnosis and treatment plan.
A physician will go over your medical history, give you a physical examination and possibly use diagnostic imagery like an X-ray or MRI to positively identify the source of your symptoms.
In many cases of nerve compression, patients find successful and lasting pain relief with a conservative treatment plan as recommended by a doctor. These are some of the most commonly prescribed methods of treatment for a pinched nerve:
- Low-impact strengthening and stretching exercises
- Over-the-counter anti-inflammatory medication
- Hot and cold compression therapy
- Massage therapy
- Lifestyle changes, like losing weight or quitting smoking
More extensive treatments for pinched nerves can also include prescription pain medication, physical therapy and epidural steroid injections. If pinched nerve symptoms continue after a full course of treatment — usually lasting several weeks or months — your doctor may refer you to a spinal surgeon for nerve decompression surgery.
Surgery for a pinched nerve
The goal of surgical treatment for a pinched nerve in the spine is the removal of any part of the spine that is compressing the nerve, like the herniated portion of a disc or an arthritic bone spur. Many patients do experience positive outcomes from spine surgery as long as postoperative and recovery instructions are followed.
However, there are some risks and difficulties associated with open back surgery, as with any type of surgery. The large incision and associated muscle disruption required to access the spine often means overnight hospitalization followed by a long recovery period.
Advances in medical technology and surgical technique have made a more minimally invasive approach to spine surgery possible. The aim of these minimally invasive surgeries is to reduce the recovery time and some of the risks associated with more traditional open back procedures by using smaller incisions to access the pinched nerve. If you are considering surgery for a pinched nerve, ask your doctor about a referral to a surgeon who performs minimally invasive spine surgery.