For patients affected by a pinched nerve in the neck or back, treatment is top priority. While some pinched nerves can go away in a short period of time with minimal treatment, some spinal conditions are more chronic.
Conditions like spinal osteoarthritis and degenerative disc disease can pinch nerves and cause debilitating symptoms like shooting pains, tingling, numbness and muscle weakness for months or years at a time. While most of the underlying causes of pinched nerves in the spine are not reversible, it is possible to manage symptoms and make decisions that allow for nerve decompression.
When looking for meaningful and effective medical care, knowing who treats a pinched nerve can help narrow your search to find someone who can offer the best chance of finding pain relief.
A primary care doctor
For someone dealing with neck or back pain, whether they have been diagnosed with a pinched nerve or not, it is recommended to first seek treatment from a primary care physician. This doctor should have the medical background and knowledge of your medical history to diagnose and prescribe an initial care plan.
The first round of conservative treatments usually consist of rest, heat and ice therapy, light exercise and over-the-counter pain medicine. Your doctor can also advise you to make lifestyle changes — like quitting smoking or losing weight — to improve your overall health and potentially take pressure off pinched nerves.
If these treatments prove ineffective after a period of time, a primary care physician should still be able to refer you to a specialist for more advanced treatment.
There are many doctors with specialized backgrounds in the spine and have the knowledge to give a more detailed diagnosis and recommend more involved treatment methods.
Here are some common types of specialists who can treat a pinched nerve in the spine:
- Physiatrist — A physiatrist is a doctor specializing in physical medicine, which treats the body from a functional and mechanical perspective. Treatment from a physiatrist usually involves physical therapy to strengthen core muscles and improve posture. This can result in less pressure being placed on a pinched nerve.
- Neurologist — Neurologists study the nervous system and the various disorders that affect it, so one specializing in the spine would have detailed knowledge of a pinched nerve in this region. One method of pain relief that some neurologists recommend is transcutaneous electrical nerve stimulation. This noninvasive treatment uses electrical pulses to stimulate nerves and reduce pain.
- Anesthesiologist — An anesthesiologist can administer epidural injections that are useful for a variety reasons. For example, epidural steroid injections can reduce inflammation around a pinched nerve and provide pain relief that can allow a patient to complete physical therapy that would not be possible otherwise. An epidural nerve block can have important diagnostic value. It can tell doctors important information about the location of nerve compression when radiating symptoms make it harder to pinpoint.
Many patients report finding effective relief from alternative therapies — and there is a growing trend for some methods to be incorporated into a holistic care plan by primary care physicians.
Someone seeking these treatments independently should still keep their doctor informed of any alternative therapies they decide to undergo.
Here are two types of alternative therapists that a patient with a pinched nerve could research:
- Acupuncturist — Acupuncture is a practice that originated in ancient China. A licensed and trained acupuncturist will know how to safely insert thin needles along specific pathways on the body to improve the body’s flow of energy. There is evidence that it can be an effective pain reliever by stimulating nerves and muscles and increasing blood flow to problem areas.
- Chiropractor — A doctor of chiropractic is a practitioner who has received a doctorate from an accredited chiropractic school. A chiropractor has a detailed knowledge of musculoskeletal anatomy — especially the spine. They are able to make an accurate diagnosis using imagery like an X-ray or MRI. Many pinched nerve patients report feeling pain relief after a session of chiropractic adjustment and realignment.
Doctors and patients will usually wait until conservative options have been exhausted before surgery is considered. The advantage of surgical treatment for a spinal pinched nerve is that it decompresses the nerve at the source and is possibly the most direct form of treatment.
The downside of open back surgery is that accessing the spine has requires a large, muscle tearing incision that results in a long recovery period for patients. Another risk of open spine surgery is known as failed back surgery syndrome (FBSS), which occurs when symptoms return or even worsen after surgery. A leading cause of FBSS is misdiagnosis of a spine condition, so it is extremely important that the correct diagnosis has been made before electing surgery.
Minimally invasive spine surgery is an alternative to traditional procedures, allowing surgeons to access the spine for decompression and stabilization procedures using a smaller incision. This approach to spine surgery still offers a chance for meaningful relief with a reduced recovery time when compared to more invasive procedures. Patients considering surgery for a pinched nerve should ask their doctor or spine specialist if they are a likely candidate for this type of treatment.