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.
Common Pinched Nerve Areas
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.
Compressed Nerve Symptoms
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.
How Do You Treat a Pinched Nerve?
Treatment for a compressed nerve ranges from conservative treatment to surgery. These practices can include the following:
- Following a nutritious diet and exercising
- Practicing good posture
- Avoiding tobacco use
- Physical therapy
- Hot and cold therapy
In many cases, the patient may treat a pinched nerve with rest and ice. If the pinched nerve is in the arm, either at the elbow causing cubital tunnel syndrome or in the hand as carpal tunnel syndrome, the doctor may recommend a brace to limit the amount of movement around the nerve. The brace also prevents the patient from movements that may further compress or pinch the affected nerve.
The doctor may prescribe medications ranging from anti-inflammatories to nerve medications such as Lyrica or Neurontin. If the pinched nerve is in the areas around the back or neck, the doctor may recommend physical therapy to assist in strengthening the muscles.
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.
How is Sciatica Diagnosed?
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.
What Are the Treatment Options for Sciatica?
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.