What Is a Pinched Nerve?

A pinched nerve occurs when the tissue and muscle that surrounds a nerve presses on the nerve itself. This disrupts the nerve's ability to function properly. Spinal nerves and peripheral nerves (in the limbs) are prone to being pinched. Typical symptoms are pain, tingling, numbness, and weakness.

This article will explain the symptoms of pinched nerves, what causes them, and how they are diagnosed. It will also discuss possible complications and treatment options.

Pinched Nerve Symptoms

Each nerve in the body detects sensations in specific areas of the skin or the internal organs. Nerves also stimulate certain muscles and organs so they function properly. For nerves that serve the skin and musculoskeletal system, the symptoms of a pinched nerve affect the nerve's normal function.

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
• Reduced 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. Its effects can range from mild to severe. You can, however, have more than one pinched nerve, which could cause symptoms in several locations. It is also possible to have symptoms of weakness as well as a reduced sensation to pain in different areas of the body.

The symptoms of a pinched nerve usually come on gradually and may come and go. Symptoms may be milder or more severe depending on your physical position.

Impaired Physical Functions

Sometimes, a pinched nerve can affect specific body 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

Causes

Your nerves can become pinched when surrounding tissues become inflamed or compressed.

Inflammation causes swelling that can crowd the area around a nerve. Physical trauma (such as an injury) to the area can also disrupt the bones, cartilage, and soft tissue around a nerve.

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

• Osteoarthritis
• Rheumatoid arthritis
• Repetitive movements/overuse
• Degenerative joint disease
• Injuries to the neck, back, arms, or legs
• Bone fractures
• Burns
• Pregnancy
• Weight gain/obesity
• Hypothyroidism
• Cancer and tumors
  

Your spinal nerves pass from your spinal cord through small holes called intervertebral foramina before reaching their destination in your extremities (hands and feet). These foramina are located in your vertebrae, which are the bones that make up 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 healthcare provider will ask you about your medical history, your physical activity, and any injuries you may have had.

Your physical examination will include assessments of your sensation, reflexes, and motor strength. A pinched nerve in the spine can cause sensory changes that correspond to the nerve dermatome (an area of skin that gets its sensation from a specific spinal nerve root).

Symptom Evaluation

Some nerves are prone to compression due to their location. Certain repetitive actions or medical conditions often cause a pinched nerve in

Your healthcare provider will likely recognize a pattern of sensory changes, pain, or weakness corresponding to these nerves, listed in the table below:

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. This helps your medical team determine whether you have nerve damage and if so, how severe it is.

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:

• Muscle spasm
• Peripheral neuropathy
• Traumatic injury of a nerve or muscle
• Multiple sclerosis

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

Treatment

The treatment of a pinched nerve is focused on reducing symptoms 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 results.

Treatment options for a pinched nerve include:

Lifestyle Adjustments

Avoiding the movements that aggravate 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 and/or wearing a temporary brace.

If weight gain is the cause of your pinched nerve, losing weight may relieve 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 pain caused by inflammation around the nerve.

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

Physical Therapy

Physical therapy—including specific exercises and strategies 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 is a technique in which the head is gently pulled in order to stretch the neck. This is can be done by a physical therapist, either using their hands or a special device. Cervical traction can 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 (transcutaneous electrical nerve stimulation) may also reduce pain. A TENS unit is a small device with electrodes that apply mild electrical impulses to the painful area.

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

Surgery

Surgery may be needed to remove scar tissue if it is playing a role in nerve compression. Surgery can also treat a herniated disc, a bone fracture, or a tumor, if any of these is causing the pinched nerve.

Summary

A pinched nerve can be painful, but usually temporary. Symptoms include tingling, numbness, and weakness. In some cases, however, a pinched nerve can cause permanent sensory damage or weakness if the nerve is severely compressed or under pressure for too long.

Early diagnosis and treatment are important for reducing the risk of permanent damage. If you notice symptoms of a pinched nerve, especially if the pain is severe and is lasting for more than a few days, it is important to get medical attention so your healthcare provider can identify any concerning causes sooner rather than later. Treatment can include physical therapy, rest, and anti-inflammatory medications.