What Is a Nerve?
A nerve is a collection of individual cells called neurons. Nerves span throughout the body, from the skin to the muscles and organs. The nervous system is comprised of the central nervous system, which includes the brain and the spine, and the peripheral nervous system, which includes the rest of the body.
What Are Pinched Nerves?
Compressed nerves are also known as pinched nerves. Nerves become pinched when pressure is applied to them by surrounding tissues, such as bones, cartilage, discs, muscles, tendons or bone spurs. This pressure disrupts the function of the nerve and can produce pain in the local and surrounding area. Certain pinched nerves can even project pain into unrelated parts of the body.
What Causes Pinched Nerves?
Peripheral nerves travel from the brain into the spinal column. From here, these nerves travel through the spine out into the body. A nerve may become pinched or compressed when the space through which that nerve travels narrows. The space may narrow as a result of disc deflation, bone spurs, or inflammation in the surrounding tissue that places pressure on the nerve itself.
The staff at DFW Center for Spinal Disorders is wonderful. They answered all of my questions, calmed my nerves, and left me feeling “warm and fuzzy”. Dr. Happ took so much time to sit and explain my condition to my husband and me. I have never had so much respect for a doctor. Kathy C
How Are Pinched Nerve Diagnosed At DFW Center For Spinal Disorders?
A pinched nerve can often be diagnosed by symptoms and a physical examination. However, our doctor may order tests such as ultrasound, MRI, nerve conduction study, or Electromyography.
Preventing Future Pinched Nerves
Pinched nerves may result from poor posture and spinal misalignment related to body mechanics and overall physical resilience. People who are interested in avoiding pinched nerves are advised to live a healthy lifestyle that includes routine physical exercise. In particular, a strong and flexible back and core can reduce the risk of spinal injury, stenosis, and deterioration. Stress on the spine and the muscles of the back can be reduced by maintaining a healthy weight. Furthermore, limiting alcohol intake and avoiding tobacco is recommended, as these habits inhibit the proper flow of nutrients to the spine and its nerves.
What Areas Are Pinched Nerves Usually Located?
Pinched nerves can occur throughout the body. The most common locations include the spine, specifically the neck and lower back, along with the hand in a common condition known as carpal tunnel syndrome.
Symptoms Of Compressed Nerves
The untoward pressure can disrupt the nerve’s function, causing the following symptoms of a pinched nerve:
- Muscle weakness in the affected area
- Aching, sharp or burning pain that radiates to the surrounding areas.
- Tingling or pins and needles
- Numbness and/or decreased sensation in the nerve target area.
Signs Of A Pinched Nerve In Your Neck Or Shoulder
A pinched nerve in the neck is referred to as cervical radiculopathy. Signs of nerve compression follow the path of the affected nerve. Most of the nerves in the neck and shoulder travel either toward the head and face or down the arms. Symptoms may include frequent or chronic head and neck pain, shoulder tension or pain, and pain and weakness down the arms. Additional signs of a cervical pinched nerve include a “pins and needles” sensation down the arms, numbness, or general muscle weakness along the nerve path.
Indications Of Pinched Nerves In The Spine
The symptoms of a pinched nerve in the spine may include:
- Muscle pain
- Limited range of motion in the part of the spine that is affected.
Symptoms such as pain, numbness, tingling, and weakness may also follow the nerve path. For example, if a nerve in the lower back is compressed, pain may shoot down the leg.
Pinched Nerve Treatment Options
Treatment for pinched nerves is typically conservative.. Common treatment options include:
Physical therapy involves the performance of specific therapeutic exercises that stretch and strengthen the muscles that support nerve function. As muscles reach optimal condition, the pressure on the nerve should decrease. Physical therapy is an ongoing routine that may need to continue for months to achieve the desired outcome.
The role of drug therapy in the treatment of a pinched nerve is to reduce inflammation. Some patients may achieve improved comfort and range of motion taking a non-prescription nonsteroidal anti-inflammatory. Some patients need prescription medication or injections of a corticosteroid to reduce significant inflammation.
What Are The Surgical Options For A Pinched Nerve?
If the condition fails to improve with conservative measures, the patient could benefit from surgery. This can range from a simple procedure to open the space for the nerves to a fusion if too much of the disc or facet joint is needed to be resected to properly free up the pinched nerve. We conduct a thorough examination and testing process to determine the cause and appropriate treatment for symptoms of a pinched nerve.
When Would I Need Surgery For A Pinched Nerve?
Patients with compressed nerves from pressure on either the nerve roots or the spinal canal could be suffering from stenosis. The patient could be recommended to undergo a series of epidural injections in which a licensed medical provider places steroid medications near the area where the nerves are compressed or irritated.
If the condition fails to improve with conservative measures, the patient could benefit from surgery. These could range from a simple procedure to open space for the nerves or spinal nerves to potentially involving a fusion if too much of the disc or facet joint is needed to be resected to properly free up the pinched nerve.
The office staff are always so friendly and helpful and I like that I am able to be seen at an office so close to my home. I would recommend Dr. Tinley to anybody who needed a spine specialist. – Virginia G.
Pinched Nerve vs. Herniated Disk?
A herniated disc and pinched nerve may go hand in hand. The spinal column consists of several bones (vertebrae) and discs. The discs between vertebrae act as cushions. Discs create space that provides openings for nerves to exit the spinal column. A herniated disc occurs when the disc suffers too much stress and has developed a tear in its outer chamber. This tear allows the gel-like center to leak out.
A herniated disc may not press on the nerve right away. If it doesn’t, there may not be any symptoms of the disc problem. The more the gel within the disc leaks, the more likely it is that the nerve will be compressed. This may result from pressure placed on the gel-like substance or decrease in the space between vertebrae.
If you have sciatica, certain behaviors will cause pain. So, when you’re with your one of our spine specialists, you may be asked to walk on your toes or heels. He may also ask you to rise from a squatting position or lift your legs one at a time when lying down.
We can usually get a good idea of your sciatica from our physical exam and listening to descriptions of your pain. However, if the pain is severe or isn’t improving with other treatments, we may order imaging tests.
- X-ray — A spinal x-ray can show bone spurs that are pressing on nerves.
- MRI — An MRI produces detailed images of bone and soft tissues such as herniated discs.
- CT Scan — For a CT scan of your spine, a contrast dye is usually injected into your spinal canal before the scan is made. The dye circulates around the spinal cord and the spinal nerves, which appear white on the scan.
- Electromyography (EMG) — This measures the electrical impulses produced by the nerves and the responses of your muscles. This can confirm nerve compression.
What Are The Risk Factors For Sciatica?
These conditions make it more likely that you may develop sciatica.
- Age — Age-related changes in the spine (issues such as herniated discs and bone spurs) are the most common causes of sciatica.
- Obesity — Excess weight places more stress on the spine.
- Occupation — There is some thinking that jobs that require you to twist your back, carry heavy loads, or drive a vehicle for long periods of time contribute to sciatica.
- Prolonged sitting — If you have a sedentary lifestyle or have to sit for prolonged periods of time, you’re more likely to develop sciatica.
- Diabetes — Because diabetes affects the way your body uses blood sugar, this increases your risk for nerve damage.
Sciatica Treatment Options
Most cases of acute sciatica respond well to self-care measures such as these:
- Over-the-counter painkillers
- Cold packs — An ice pack placed on the painful area for up to 20 minutes several times daily.
- Hot packs — After two or three days of pain, apply heat to the painful areas. If the pain continues, alternate hot and cold.
- Walking stretches the legs and back.
- Light Stretching exercises for the low back. Try to not bounce or jerk, but hold stretches for at least 30 seconds.
These are treatment options we use for sciatica at DFW Center for Spinal Disorders:
- Medications — We may prescribe these medications: anti-inflammatories, muscle relaxants, narcotics, tricyclic antidepressants, and anti-seizure medications.
- Physical therapy — When acute sciatica improves, physical therapy can help you strengthen the muscles supporting your back, improve your flexibility, and correct your posture.
- Steroid injections — Injections of corticosteroid medication into the area around the irritate nerve root can be very effective. These injections can last for a number of months. They can only be given periodically, however, as overuse can lead to serious side effects.
- Surgery — Surgery is definitely a last resort for sciatica, which usually will clear up on its own. But if the patient has a compressed nerve that is creating muscle weakness, loss of bowel or bladder control, or pain that is not responding to any other therapy, surgery can be a good option. These surgeries are usually done with minimally invasive methods to access the area of the spine affected, and remove the bone spur or herniated disc that is compressing the nerve.
How Long Does It Take for Sciatica To Heal?
It’s estimated that up to 40 percent of people will experience sciatica at least once in their life. The good news is that for most people, surgery is not necessary and the pain will resolve within about 6 weeks. These cases are usually relatively mild and are probably “acute sciatica.”
However, if your symptoms and pain persist for more than 4-8 weeks, you could have chronic sciatica. The duration of this more involved sciatica is highly variable.