A pinched nerve is a medical term used to describe the compression of a single nerve or group of nerves. When too much pressure is applied to the spinal nerves by surrounding bones, tissue, cartilage, or muscle, the nerve(s) will become impinged, which disrupts nerve function and can lead to chronic or acute pain, numbness, tingling and muscle weakness. Without proper and timely treatment, peripheral neuropathy may develop, a condition where the nerves that carry signals from the brain to the rest of the body become damaged. When the cervical nerve roots are compressed, the symptoms will radiate along the nerve pathways and can lead to cervical radiculopathy which usually affect the upper extremities; when the lumbar nerve roots are compressed as they exit the spine in the lumbar region, it can lead to lumbar radiculopathy which affects the lower extremities.
The body’s nerves are most vulnerable at places where they travel through narrow spaces. As a result, nerve compression often occurs when the nerve is pressed between ligament, bone, and tendons. Although a pinched nerve may not be a life-threatening issue, it can cause back or neck pain and other symptoms that affect a patient’s everyday life.
The nerves, which are part of the body’s peripheral nervous system, extend from the brain and spinal cord throughout the body sending messages to the muscles and skin. Nerves that leave the spine and go into the arms or legs are called peripheral nerves. A peripheral nerve has millions of nerve fibers that exit the spinal cord and branch out into muscles and skin.
The peripheral nervous system is divided into three systems, the somatic nervous system, sensory nervous system, and autonomic nervous system. The somatic nervous system transmits signals from the brain to end organs, such as muscles. The sensory nervous system transmits signals for senses like taste and touch to the spinal cord and brain. The autonomic nervous system is the self-regulating system of the body, which influences organ function.
When the sensory nervous system is interrupted due to a compressed nerve, patients will begin to receive warning signal, such as low back pain.
What is a Pinched Nerve?
Nerve impingement , or compressed nerve, is a term used to describe a nerve or group of nerves that have become impinged by bone, ligament, tendons, and soft tissue.
Though pinched nerves can occur anywhere throughout the body, they are most common in the lower back. The nerves in the spinal cord travel through the foramina, small openings between the vertebrae through which spinal nerve roots exit to other parts of the body. These small openings can become obstructed and pinch the nerves. Most cases of pinched nerves appear in the lower back.
Causes of a Pinched Nerve
There can be a wide variety of conditions and actions of pinched nerve causes. Some of the most common causes include:
Pinched nerve symptoms correlate with the location of the impingement. Nerve compression in the cervical spine or neck, will radiate along the cervical nerve pathways and lead to symptoms in the neck, arm, elbow, hand, wrist, and fingers.
A pinched nerve in the back can cause the following symptoms:
Shooting lower back pain
Pain that extends to the buttocks, legs, and feet
Pins-and-needles or tingling sensations
Numbness or weakness in the extremities
Aching or burning radicular pain
Frequent feeling of the feet or hands having fallen asleep
Some patients will find that the symptoms of their pinched nerves get worse when they are sleeping.
Beginning with a physical examination, the doctor will perform or request specific testing to determine if you are suffering from a compressed nerve. This along with a review of the patient’s symptoms and diagnostic imaging such as X-rays, CT and MRI studies will allow the doctor to provide an accurate diagnosis. Radiculopathy is a nerve disorder caused by a compressed nerve in the spine. Lumbar radiculopathy and cervical radiculopathy are the most common. A patient with a pinched nerve may be diagnosed with radiculopathy. Patients may also feel nerve compression in their neck which can lead to peripheral neuropathy.
Pinched Nerve and Herniated Disc
Each intervertebral disc has a gel-like center, the nucleus pulposus, which can break through the outer ligament, the annulus fibrosis. When the nucleus breaks through, it is known as a herniated disc. Herniated discs can lead to a pinched nerve as the bulging or extruded disc material puts pressure on the adjacent nerve root. Herniated disc are most common in the cervical and lumbar spine as these are the most flexible vertebrae and account for most of the motion of the spinal column.
If you have been diagnosed with a herniated disk, your physician may request diagnostic testing to determine if you are suffering from a pinched nerve as well. An individual who has previously been diagnosed with a herniated disc may need testing to determine if their pain is a result of a herniated disc or a combination of a herniated disc and pinched nerve.
Pinched Nerve and Sciatica
Sciatica is a term used to describe leg pain caused by the pinching of the sciatic nerve, which runs from the hip down through the leg. Pain from a pinched sciatic nerve can radiate down the leg and into the foot and toes.
Sciatica can be painful and debilitating at times. If you are experiencing sciatica symptoms, your physician will recommend diagnostic testing, such as an x-ray or CT scan, to pinpoint the precise location of the pinched nerve.
Although a pinched nerve is not a life-threatening condition, for many it can impede on their everyday life. There are many factors that can increase the risk of an individual suffering from nerve compression.
Some common risk factors include:
Jobs or hobbies that lead to repetitive hand, shoulder, or back movement
Exams & Tests
A nerve conduction study, also known as a nerve conduction velocity test, measures the electrical impulses the nerves are sending. During the test, a nerve is stimulated with a surface electrode patch attached to the skin while another electrode records the resulting electrical activity. Test results can reveal if you have a damaged nerve.
During an electromyography, the doctor will insert a needle electrode through the skin and into various muscles to evaluate the electrical activity of your muscles when they contract and when they are at rest.
A magnetic resonance imaging test, MRI, may also be completed in order to diagnose the issue.
Treatment for a Pinched Nerve
Rest is the most frequently recommended pinched nerve treatment option for those suffering from compressed nerves. A physician may also recommend that you discontinue any activities that can aggravate the condition. For many, the conservative treatment options, including rest, fail to stop the pain of the pinched nerve. When non-surgical options no longer work, surgery may be necessary.
Many non-surgical treatment options will be used first for patients who need pain relief. Some forms of treatment that may relieve pain include:
NSAIDs (nonsteroidal anti inflammatory drugs)
Epidural steroid injections
Patients may also turn to alternative therapies like chiropractic care, physical therapy or acupuncture for pain relief.
Over the past 35 years, the Bonati Spine Institute has been providing lasting relief for patients suffering from a pinched nerve using the Bonati Spine Procedures. These patented procedures offer an array of surgical techniques to treat pinched nerves.
A foraminotomy is a decompression surgery performed in order to increase the space of the foramen and hollow out the passageway where the nerve roots exit the spinal canal. The procedure involves the removal of bone or tissue that obstructs the neuroforamen and compresses the nerve roots leading to inflammation and radiating pain. The removal of part of the lamina is often necessary for the surgeon to gain access to the affected nerve roots in the neuroforamen. For this reason, the foraminotomy is often performed in conjunction with a laminectomy or laminotomy.
A laminectomy/laminotomy is a surgical procedure performed to relieve pressure (decompress) on the spinal cord or spinal nerve roots through the widening of the spinal canal. The procedure is carried out by removing or trimming part of the lamina (roof) of the vertebrae in the compressed area. The removal of part of the lamina creates an opening for the compressed nerves, relieving pressure on the nerve roots and reducing inflammation. The partial removal of the lamina may also allow the surgeon to remove any bone spurs or damaged tissue causing pain and inflammation in the patient.
Although a pinched nerve may be linked to genetics, there are many ways patients can prevent a pinched nerve.
Maintain good posture
Limit repetitive activities
Maintain a healthy weight
Eat a healthy diet
Incorporate strengthening and flexibility exercises into your exercise regimen can also prevent nerve compression.
The Bonati Spine Institute encourages patients with pinched nerves to contact us to request a no-obligation MRI review or discuss your conditions with our medical professionals. Find out why The Bonati Spine Procedures are considered to be among the world’s best solutions when it comes to advanced spine surgery. Your pain from pinched nerves can become a thing of the past.