What Is a Pinched Nerve?

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A pinched nerve is when pressure on a nerve from surrounding tissue, muscle, etc. is so much that it disrupts the nerve's functioning. This can involve the spinal nerves or peripheral nerves (of the limbs) and cause symptoms such as pain, tingling, numbness, sensory loss, and weakness. Arthritis and trauma are among the leading causes. While pinched nerves do not typically cause permanent nerve dysfunction, these consequences can occur.

Pinched Nerve Symptoms

Each nerve in the body is dedicated to detecting sensation in specific regions of the skin or internal organs and/or stimulating certain muscles/organs. For nerves that serve the skin and musculoskeletal system, the symptoms of a pinched nerve correspond with the sensory and motor function that is normally supplied by the compressed nerve.

Common symptoms of a pinched nerve, which can occur in combination, include:

  • A burning sensation
  • Tingling sensations that feel like pins and needles or electric shocks
  • Pain that typically radiates away from the pinched nerve
  • Pain in a seemingly unrelated location (e.g., in your elbow or arm due to a pinched nerve in your neck)
  • An area of numbness on the skin
  • The feeling of your hand or foot falling asleep
  • Diminished sensation to pain, temperature, or touch on an area of the skin
  • Weakness of affected muscle(s)

A pinched nerve generally affects only one side of the body, and its effects can range from mild to severe. You can, however, have more than one pinched nerve, which could cause symptoms in several locations.

The symptoms of a pinched nerve usually come on gradually and may frequently fluctuate. The intensity of your symptoms often varies with your physical position.

Most nerves detect sensation of an area on the skin and may control muscle movement of a nearby (but slightly different) area. With that in mind, know that your weakness and sensory changes might not match up perfectly on one area of your body.

Impaired Physical Functions

Sometimes, a pinched nerve can affect specific physical functions. This is usually associated with pinched nerves of the lower spine.

Physical functions that can be affected by a pinched nerve include:

  • Bladder control
  • Bowel control
  • Sexual function

A pinched nerve is usually uncomfortable, but it can cause permanent sensory damage or weakness if the nerve is severely compressed or under pressure for too long. Be sure to get medical attention if you develop any of the symptoms of a pinched nerve.

Causes

Your nerves can become pinched when the passages through which they travel become inflamed or compressed.

Inflammation causes swelling that can crowd the area around a nerve, impinging on it. Trauma can disrupt the structures around a nerve (bones, cartilage, and soft tissue), causing physical pressure in addition to inflammation.

There is a wide variety of possible causes (and risk factors) for this, including:

Your spinal nerves pass from your spinal cord through small holes (intervertebral foramina) before reaching their destination in your extremities. These foramina are located in your vertebrae, which are the bones of your spine. The narrow passage of the spinal foramen is a common location for nerve compression.

When a spinal nerve is compressed as it leaves the foramen, the condition is called radiculopathy.

Nerve passageways throughout your body can also become inflamed, placing pressure on a nerve. For example, carpal tunnel syndrome, ulnar nerve entrapment, and cubital tunnel syndrome are all examples of peripheral nerve compression.

Diagnosis

The diagnosis of a pinched nerve begins with a careful history and physical exam. Your doctor will ask you about your medical history, your physical activity, and any injuries you may have had.

Your physical examination will include an assessment of your sensation, reflexes, and motor strength. A pinched nerve in the spine can cause sensory changes that correspond to the nerve dermatome and muscle weakness or reflex changes that correspond to the nerve's myotome.

Symptom Evaluation

Some nerves are susceptible to compression due to their location. Certain repetitive actions or medical conditions also predispose to a pinched nerve in certain locations.

Your doctor will likely recognize a pattern of sensory changes, pain, or weakness corresponding to these nerves.

Nerve(s) Location Results of Compression
Cervical nerve roots Upper spine •Sensory changes and/or weakness in the shoulder, arm, and/or hand
Headaches
Femoral Hip to knee

Weakness and/or sensory changes in the thigh

Lateral femoral cutaneous Brim of pelvis to front thigh

Pain along the front and outside of the thigh
(A condition known as meralgia paresthetica.)

Median Mid-region of arm and wrist •Diminished sensation in the thumb, first two fingers, and palm of the hand
•Carpal tunnel syndrome
Peroneal Side of leg Foot drop
Plantar In the feet Pins and needles sensation in the sole of the foot
Radial Medial side (toward thumb) of arm and hand

Pain of the back of the hand

 

Sciatic Lower back, hip, buttocks, legs (large nerve formed by spinal nerves of the lumbosacral region)

•Leg pain and weakness
•Bowel and bladder dysfunction
(Compression of this nerve is known as sciatica.)

 

Tibial Along the tibia (largest bone in lower leg) past knee and down toward ankle Pain down the back of the leg and the foot
Ulnar Medial (inner) side of elbow

Altered sensation along little finger half of hand and wrist (like when you hit your "funny bone")

Diagnostic Tests

A number of tests can help verify the location of a pinched nerve, assess the extent of nerve damage, and determine whether there are structural problems that need to be addressed.

Electromyography (EMG) and nerve conduction study (NCV) are tests that involve placing needles and electric shocks on the extremities to help your medical team determine whether you have nerve damage and help define the severity of it, if so.

These tests are mildly uncomfortable, but they aren't painful and only take a few minutes.

Imaging studies, such as an X-ray or a spine magnetic resonance imaging (MRI), can be helpful in evaluating bone fractures, joint injuries, or tumors—all of which can cause a pinched nerve.

Differential Diagnoses

"Pinched nerve" is often casually used as a catch-all phrase for muscle pain, neck pain, or pain of an arm or leg. An injury resulting from compression, constriction, or stretching of a nerve may not always be defined as a pinched nerve.

Other conditions that can be confused with a pinched nerve include:

Your physical examination and diagnostic tests can help your medical team differentiate a pinched nerve from these other conditions, which helps in directing your treatment plan.

Treatment

The treatment of a pinched nerve is focused on reducing the effects and preventing it from worsening. There are several treatment strategies, and you will probably need to use a few of them to get the best effect.

Treatment options for a pinched nerve include:

Lifestyle Adjustments

Avoiding the movements that exacerbate your pinched nerve is usually recommended. For example, for a repetitive motion based injury such as carpal tunnel syndrome, a mild case can be relieved by resting your hand and arm.

If weight gain is the cause of your pinched nerve, losing weight may alleviate the symptoms. (Note: A pregnancy-associated pinched nerve is often relieved after delivery.)

Medications

Non-steroidal anti-inflammatory (NSAIDs) medications such as Advil (ibuprofen) are often used for the management of inflammatory pain.

Steroids may be used orally (by mouth) or by injection to reduce inflammation around a compressed nerve.

Physical Therapy

Physical therapy—including safe exercises and learning optimal ways to move to prevent repetitive motion injuries—is often used as an initial treatment along with pain management to help reduce the effects of a pinched nerve.

Cervical traction, guided by your therapist, may be used for a pinched cervical nerve to open up space where the nerves exit the spinal cord.

Splinting

Splints may be used to reduce motion and decrease inflammation around the nerve. This can be an especially effective treatment for ulnar nerve compression.

Complementary and Alternative Options

Therapies such as acupuncture or massage therapy may be helpful for some people in controlling the pain associated with a pinched nerve. TENS—a form of electrostimulation—may also help reduce pain.

These therapies are used primarily to reduce pain and do not appear to have a significant role in reducing nerve compression on their own.

Surgery

Surgery may be needed to remove scar tissue, which exacerbates nerve compression. Surgery can also alleviate the source of nerve compression, such as a herniated disc, a bone fracture, or a tumor.

Often, the effects of a pinched nerve worsen with time, but sometimes they can improve if the cause (inflammation or weight gain for example) is alleviated.

A Word From Verywell

Early diagnosis and treatment are important strategies for reducing the harm from a pinched nerve. If you notice symptoms of a pinched nerve, it is important to get medical attention so your doctor can identify any concerning causes sooner rather than later.

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Article Sources
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