Definition

Nerves, cordlike bundles of fibers made up of neurons, use chemical and electrical signals to transmit sensory and motor information from one body part to another. The term pinched nerve describes damage or injury to a nerve or set of nerves caused by compression to those nerves. The pressure causes pain, abnormal sensations and/or impaired function of the affected nerves. The pains or sensations may be distant from the point of pressure.

Causes

Poor posture is one cause that sufferers from pinched nerves can try to improve without medical intervention; degenerative changes are harder to modify.

  • Poor posture
  • Spinal stenosis, or bone spurs
  • Herniated, prolapsed or slipped disk
  • Degenerative disk disease
  • Arthritis, osteoporosis

Risks

Risk factors are things associated with an increased chance of developing a disease or condition. Risk factors for a pinched nerve are:

  • Overuse caused by repetitive movements from job, sports or leisure activities
  • Obesity
  • Heredity
  • Age
  • Trauma

Symptoms

Muscle weakness, numbness and tingling are common symptoms. The part of the body experiencing symptoms depends on which nerve is being pinched.

General:

  • Sharp or burning pain, or a dull ache
  • Pain frequently radiates from the low back or neck into the leg or arm
  • Numbness, tingling, "pins and needles" sensations
  • Feeling that a foot, hand, or limb has "fallen asleep"
  • Diminished reflexes
  • Muscle weakness, decreased coordination, heaviness, or clumsiness of the extremity
  • Twitching or spasms in affected extremity
  • Muscle atrophy is sometimes a late symptom

Pinched nerve in cervical (neck) region of the spine:

  • Neck and/or shoulder pain
  • Arm and/or hand weakness
  • Pain, numbness and tingling that run down the arm to some or all fingers

Pinched nerve in lumbar (lower back) region of the spine:

  • Sciatic pain running from lower back to buttocks, down back of thigh to toes
  • Numbness of leg, feet and/or toes
  • Weakness of the foot and toe(s)
  • Difficulty with foot push off
  • Foot and/or ankle drop
  • Difficulty walking

Diagnosis

After a thorough physical examination, your physician will decide which tests should be administered.

  • MRI
  • CT scan can be helpful in viewing bony involvement
  • Nerve conduction studies and electromyography may be useful in determining if there is a peripheral problem and if it is a nerve or muscle abnormality.

Treatment

Your physician will prescribe treatment which may include one or more of the following:

  • Rest for the affected area
  • Stop activities that cause or aggravate the injury to the nerve
  • Splint or brace to immobilize the affected area
  • Alternating between heat and ice on affected area
  • Physical therapy after the acute phase
  • Massage
  • Hot shower
  • Stretches
  • Anti-inflammatory medication
  • Cortisone injections
  • Surgery

Prevention

There are some steps you can take to prevent developing a pinched nerve.

  • Decrease risk factors
  • Proper workplace ergonomics
  • Maintain good posture, standing and sitting
  • Limit repetitive activities
  • Take breaks during long stretches of the same activity
  • Maintain healthy weight

If you want to learn more about pinched nerve and associated conditions call the Mount Sinai Department of Neurosurgery at 212-241-2377.