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Pinched Nerve

Pinched Nerve

Nerves are like electrical cords that carry information from the brain to the rest of the body and vice-versa. They are distributed throughout the entire body.

 

  • Motor (efferent) nerves carry information from the brain out to the body. This allows the brain to send commands to the various organs of the body. For example, these commands are sent to the muscles causing them to contract and move, or sends information to the heart to either beat faster or slower. 
  • Sensory (afferent) nerves send information from the body back to the brain for processing, including information about pain, touch, taste, temperature, or other sensations.

 

The information travels along the nerve by an electrochemical signal, much like information traveling along an electrical cord. When a nerve is pinched, the signal is interrupted somewhere along its path.

Symptoms

The symptoms of a pinched nerve depend on what nerve is affected. Each nerve is responsible for sending information to or from specific parts of the body.

 

The most common symptoms of a pinched nerve are:

 

  • pain, 
  • numbness, 
  • tingling (pins and needles),
  • weakness of the muscles along the path of the nerve.

 

A pinched nerve sensation may feel like, for example, the sensation when a part of your body has "fallen asleep". A pinched nerve can cause symptoms at the site of damage, or any location further down the path from the affected nerve.

  • A pinched nerve in the neck can cause neck pain or stiffness, along with symptoms down the arm. 
  • A pinched nerve in the lower back causes back pain and stiffness with symptoms down the leg. A doctor can often identify which nerve is pinched in the neck or lower back based on what portion of the patient's arm or leg is affected.
  • A pinched nerve in the wrist from carpal tunnel syndrome typically affects the thumb, index, and middle fingers. It can also cause a weakness in the patient's grip strength, and atrophy of the muscle of the palm near the thumb. A pinched nerve in the elbow from cubital tunnel syndrome affects the forearm, the ring (fourth finger), and the small fingers of the hand.

Causes

What causes a pinched nerve?

 

A pinched nerve is caused when a nerve is somehow damaged or injured by direct pressure or compression and is unable to properly conduct its signal. There are many potential causes for a pinched nerve, depending on the location of the nerve.

 

Pinched nerve in the neck or lower back

 

A pinched nerve in the neck or lower back can be caused by a herniated disc, arthritis, bone spurs, or spinal stenosis.

 

Spinal stenosis is a narrowing of the spinal canal through which the nerves pass with the spine. A pinched nerve in the lower back or buttock can compress the sciatic nerve, which can cause sciatica.

 

Pinched nerve in the wrist or elbow

 

A pinched nerve in the wrist can be caused by carpal tunnel syndrome. This condition is caused by compression of the median nerve as it passes through confined tissues of the wrist. Cubital tunnel syndrome is a similar condition caused by compression of the ulnar nerve in the elbow. Both of these conditions are more common in people with diabetesand people who perform repetitive activitiessuch as a typist, using a computer keyboard for long periods of time, or assembly line workers.

 

Other causes of pinched nerve

 

Swelling around a nerve can be caused by an injury, bruise, or other conditions, including the swelling of the extremities that can occur with pregnancy. An inherited tendency, as manifested by a family history of a similar condition, can also increase an individual's chance of developing a pinched nerve.

Treatment

Support braces

 

In many cases a pinched nerve can be treated with rest and ice. If the pinched nerve is in the arm (carpal tunnel syndrome or cubital tunnel syndrome) the doctor may recommend a brace for a short period of time. The brace limits the amount of movement around the nerve, which allows it to rest and recover. The brace also prevents the patient from movements that may further compress or pinch the affected nerve. A brace used for carpal tunnel syndrome covers the wrist and and is extended slightly back.

 

This is because during flexion (bending the wrist down) the median nerve in the wrist is further pinched. The brace for cubital tunnel syndrome in the elbow can be used to keep the elbow from bending too much which further stretches the ulnar nerve.

 

Medication

 

Various medications can also be used to treat a pinched nerve. Anti-inflammatory medications, for example, ibuprofen or naproxen can reduce the inflammation (swelling) around the affected nerve. Other medications used specifically for nerve related pain include gabapentin (Neurontin) orpregabalin (Lyrica).

 

Physical therapy

 

Physical therapy can assist to stretch and strengthen specific muscles in the body, which helps relieve the pressure on the pinched nerve.

 

Surgery

 

If the symptoms from a pinched nerve do not improve with the above treatments, surgery may be recommended. Surgery may also be recommended if the patient develops additional weakness in the muscles, or if the particular nerves being pinched cause loss of control of the bowel or bladder (cauda equina syndrome). These are signs of more severe nerve damage.

 

Surgery for a pinched nerve depends on the location of the nerve being pinched. If the pinched nerve is in the wrist (carpal tunnel syndrome) or elbow (cubital tunnel syndrome), the surgeon can release the tissues over the nerve in the wrist or elbow to free the nerve tissue pressure.

 

If the pinched nerve is in the neck or lower back a spine surgeon or neurosurgeon can remove a portion of the disc or bone spurs that are compressing the nerve in the spine. In some cases, if it is necessary to remove large portions of bone or disc, the surgery may require a spinal fusion to stabilize the spine after freeing the nerve.

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