Pinched Nerve

A pinched nerve, also known as radiculopathy, occurs when any mass or condition puts pressure upon the nerve. This mass may include a bone, cartilage, muscles, or tendons. That mass puts too

much pressure that disrupts the normal nerve function and results in pain, cramping, numbness, weakness, and tingling ¹. This condition can occur at any site of your body. Most people with this condition recover within a few days or weeks after taking some rest and other conservative treatments.

For example, a herniated disc in your lower spine may put pressure on the spinal nerve root and causes pain that radiates to the buttocks and legs. Similarly, a pinched nerve in your wrist can cause pain and tingle in your fingers and arm, known as carpal tunnel syndrome. A pinched nerve in the thoracic region, also known as thoracic radiculopathy, causes pain in your chest area.

The symptoms of pinched nerves depend on the severity and the location of the pressure. Depending upon the cause, symptoms can develop quickly or slowly. Typical symptoms include ²:

• Weakness and numbness in the affected area
• Sharp, burning, and radiating pain along the nerve area (sciatica)
• Numbness and tingling in the affected region
• Lack of coordination in the affected area

During sleep, the problems related to pinched nerves become worse. Sometimes, doctors prefer surgery to relieve pain from a pinched nerve.

A pinched nerve occurs when too much compression or pressure applied by surrounding tissues to the nerve. Pinched nerve induced by several conditions such as injury, rheumatoid or wrist arthritis, stress from repetitive work, trauma, heavy labor or sports activities, etc. Other risk factor includes diabetes, pregnancy, prolonged bed rest, obesity, etc. Usually, no permanent damage occurs during a short duration of a pinch on a nerve. Withdrawing the pressure will help to make your nerve become functional. But if left untreated, chronic pain and permanent nerve damage can occur.

How do Neurosurgeons Diagnose a Pinched Nerve?

This condition affects almost 85 peoples out of 100,000 in the United States ³. People of any age can experience this condition, but older look more susceptible to have it because of arthritis and degeneration of their spine and other parts of the body. Almost 60% of the pinched nerve occurs in the cervical region ³. The initial diagnosis of a pinched nerve includes a clinical presentation and pain patterns of patients. Your doctors may further confirm by manual muscle testing, sensory testing, Lasegue’s sign (for lumbar radiculopathy), and other imaging techniques. Imaging test may include ⁴:

• X-ray: To show the narrowing and changing alignment of the spinal cord.
• Electromyography (EMG): Uses electrical impulses to see whether the nerve functions normally.
• Computed tomography (CT) scan: Produces 3D images to show more detail of the spine.
• Magnetic resonance imaging (MRI): This shows the damages of soft tissues that cause nerve compression.

How do Neurosurgeons Treat Pinched Nerve?

Treatment of a pinched nerve depends on the cause and symptoms of the patients. The medical team should comprise orthopedics, nerve specialists, and physical therapists while treating a pinched nerve. Most patients with pinched nerves respond well to non-surgical and conservative treatment. Treatment protocol may include ⁵:

• Ice and heat therapy: Applying hot and cold therapy provides temporary relief from the pain and swelling.
• Medications: Medicines may include pain relievers, muscle relaxants, corticosteroids like prednisolone, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen to relieve pain and swelling.
• Physical therapy: This includes stretching and light exercises that can reduce pressure on your nerves and relieve minor pains.

Most of the time, only rest can relieve the patient from this condition. Sometimes doctors suggest splints and cervical collars for the wrist and hand or neck. If you still face some problems after following the above treatments, your doctor may advise to go for surgical options. Surgical treatment for this condition includes anterior cervical diskectomy and fusion, posterior cervical lamino-foraminotomy, and artificial disk replacement. Contact your doctor to select the best option for you.

References

1. Iyer, S. & Kim, H. J. Cervical radiculopathy. Curr. Rev. Musculoskelet. Med. 9, 272–280 (2016).
2. Baron, R. et al. Neuropathic low back pain in clinical practice. Eur. J. Pain (United Kingdom) 20, 861–873 (2016).
3. Caridi, J. M., Pumberger, M. & Hughes, A. P. Cervical Radiculopathy: A Review. HSS J. 7, 265–272 (2011).
4. Matz, P. G. et al. Indications for anterior cervical decompression for the treatment of cervical degenerative radiculopathy. J. Neurosurg. Spine 11, 174–182 (2009).
5. Trelle, S. Erratum: Improved effectiveness of partner notification for patients with sexually transmitted infections: Systematic review (British Medical Journal (2007) 334, (334-357) DOI: 10.1136/bmj.39079.460741.7C). Br. Med. J. 334, 1317 (2007).