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A pinched nerve occurs when surrounding tissues, such as bones, cartilage, muscles, or tendons, compress a nerve. This compression can cause symptoms like pain, tingling, numbness, or weakness in various parts of the body. Commonly, this condition originates in the neck (cervical radiculopathy), the upper middle back (thoracic radiculopathy), or the lower back (lumbar radiculopathy). Pinched nerves can also happen in the hand, elbow, and wrist, with carpal tunnel syndrome being a notable example that affects the wrist.
Pinched nerves can lead to various symptoms across different parts of the body. For example, a pinched nerve in the cervical spine might result in a stiff neck, accompanied by pain and numbness that can radiate to the shoulder and arm. Similarly, when a lumbar nerve in the lower back is compressed, it can cause pain that extends to the back, hips, buttocks, and legs. Furthermore, thoracic radiculopathy, another manifestation of a pinched nerve, can lead to pain in the chest area—a symptom that demands serious attention. In cases of severe chest pain, it is imperative to promptly contact a healthcare provider.
Many individuals recover from a pinched nerve with rest and conservative treatment methods within a few days to weeks. However, some cases may require surgery to relieve the pain caused by the nerve compression.
Symptoms
Symptoms of a pinched nerve can include:
- A feeling of tingling, similar to pins and needles.
- Decreased sensation or numbness in the area the nerve serves.
- Weakness in the muscles of the affected area.
- Pain that is sharp, aching, or burning, which might spread outwards.
- A common sensation that a foot or hand is “asleep.”
- Symptoms might worsen during sleep.
While symptoms of a pinched nerve can often be alleviated with rest and over-the-counter pain medication, you should consider seeking medical advice if your symptoms persist for several days without improvement despite self-care measures.
Cause
A pinched nerve occurs when excessive pressure, also known as compression, is exerted on a nerve by surrounding tissues. These tissues can include bone or cartilage, as seen in cases where a herniated spinal disk compresses a nerve root. Additionally, muscles or tendons may also contribute to nerve compression.
In conditions like carpal tunnel syndrome, various tissues can be responsible for compressing the median nerve within the wrist’s carpal tunnel. This compression may result from swollen tendon sheaths within the tunnel, enlarged bone narrowing the tunnel, or a thickened and degenerated ligament.
Several conditions can lead to tissue compression of a nerve or nerves, including:
- Damage.
- Overweight.
- Pastimes or sports.
- Wrist arthritis or rheumatoid arthritis.
- Anxiety brought on by tedious labor.
When a nerve experiences brief pinching, there is typically no lasting damage. Once the pressure is alleviated, nerve function typically resumes. However, if the pressure persists, it can lead to chronic pain and permanent nerve damage.
Risk factors
Several factors may elevate the likelihood of developing a pinched nerve:
- Attributed sex at birth. Perhaps because their carpal tunnels are smaller, women are more likely to acquire carpal tunnel syndrome.
- Bone spurs. Bone spurs can result from trauma or diseases like osteoarthritis that thicken the bone. Bone spurs have the ability to pinch nerves and stiffen the spine by constricting the area where your nerves pass.
- Rheumatoid arthritis. Particularly in your joints, rheumatoid arthritis-related inflammation can compress nerves.
- Diseases of the thyroid. The risk of carpal tunnel syndrome is increased in those with thyroid dysfunction.
Other risk factors include:
- Diabetes. Diabetics are more likely to experience nerve compression.
- Excessive utilization. The risk of developing a pinched nerve is higher in occupations or pastimes that demand repetitive hand, wrist, or shoulder movements. Work on assembly lines is included in this.
- Being overweight. Nerves might become more compressed by excess weight.
- Being pregnant. Pregnancy-related weight gain and water retention can expand nerve pathways and pinch your nerves.
- Extended rest in bed. When asleep, symptoms of a pinched nerve may exacerbate. Utilizing self-care methods such as rest and over-the-counter pain relievers often help alleviate these symptoms. Nonetheless, if the symptoms persist despite these measures for several days, seeking medical advice for further evaluation and guidance is recommended.
Diagnosis
To identify a pinched nerve, your doctor will inquire about your symptoms and perform a physical examination.
If a pinched nerve is suspected, further tests may be required, which could include:
- Blood tests. Tests to check your thyroid function or fasting blood glucose may be necessary.
- The lumbar puncture, also referred to as a spinal tap. Cerebrospinal fluid (CSF) is taken from the region around your spinal cord during this test. A lab may get the CSF to check for infection or inflammation.
- Radiology images. The positions of the bones are displayed in these photos. They can show whether there is injury or narrowing that might result in a pinched nerve.
- Nerve conduction study. Using electrodes applied to your skin, this test assesses the electrical nerve impulses and functionality in your muscles and nerves. Your nerve signals’ electrical impulses are measured in the study when a tiny current flows through the nerve. Test findings can indicate whether you have nerve damage.
- Electromyography (EMG) is one. An electrode needle is placed under your skin into many different muscles to record an EMG. Your muscles’ electrical activity during contractions and at rest is assessed by this test. The findings of the tests indicate to your healthcare provider whether there is injury to the nerves that supply the muscles.
- Computed tomography (CT) scan. A CT scan provides three-dimensional images and offers greater detail of the spine compared to an X-ray. (2)
- Magnetic resonance imaging (MRI). This test creates precise pictures of your body in various planes using radio waves and a strong magnetic field. If a medical expert believes you may have nerve root compression, they may use this test.
- Ultrasound with high resolution. High-frequency sound waves are used in ultrasound to create images of the body’s internal structures. It is useful in the diagnosis of carpal tunnel syndrome and other conditions involving nerve compression.
Treatment
Resting the affected area is typically the initial treatment suggestion for a pinched nerve. It’s important to avoid activities that worsen compression or aggravate symptoms. Depending on the nerve’s location, immobilization with a splint, collar, or brace may be necessary. For example, individuals with carpal tunnel syndrome might need to wear a splint both day and night since wrist movement commonly happens during sleep.
Physical therapy
A physical therapist can instruct you in exercises designed to strengthen and stretch muscles, thereby alleviating pressure on the nerve. Additionally, they may suggest modifications to activities that exacerbate nerve irritation.
Medications
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen or naproxen sodium are effective in alleviating pain associated with a pinched nerve. Additionally, anti-seizure medications such as gabapentin can help manage nerve-related pain. Tricyclic antidepressants like nortriptyline and amitriptyline are also utilized for pain relief. Corticosteroids, administered orally or via injection, may aid in reducing both pain and inflammation.
Surgery
If symptoms persist despite several weeks to a few months of conservative treatments, surgery may be necessary. Surgery aims to alleviate pressure on the nerve, and the specific type of procedure depends on the location of the pinched nerve.
Surgical interventions may entail the removal of bone spurs or a portion of a herniated disk in the spine. In cases of carpal tunnel syndrome, surgery involves cutting the carpal ligament to create additional space for the nerve to pass through the wrist.
