Pinched Nerves - How They're Diagnosed and Treated

Pinched NeveDiagnosisTreatment

If you’ve got a pinched nerve, you’re likely aware of it day and night because of the pain and numbness it produces. But many people with pinched nerves around the spine, a highly common problem, have no idea how to have them diagnosed or treated, according to Kaliq Chang, MD, of Atlantic Spine Center.

A colloquial term that describes nerve compression, pinched nerves leading from the spine can trigger troublesome symptoms much farther away, such as in the arms and legs. That’s because these extremities are connected to nerves along the neck and back, Dr. Chang explains.

If your pinched nerve is located in your neck, pain, tingling, numbness or even weakness can show up in your arms and hands. In your back, a pinched nerve can lead to similar symptoms in the buttocks, radiating down the back of the upper leg.

“These symptoms can be all over the map – brief or long-lasting, minor or terrible,” explains Dr. Chang, an interventional pain management specialist. “Many people feel pinched nerve symptoms for just a day or two before they quickly resolve, but if they’re long-lasting and severely impact your days, you’d be wise to get checked by a doctor.”

Risk factors and causes

The first thing your doctor might determine is whether you’re predisposed to a pinched nerve due to various risk factors. Dr. Chang says these include:

  • Overweight or obesity
  • Pregnancy
  • Diabetes
  • Occupations requiring repetitive motions
  • Family history

Beyond risk factors, certain habits or medical conditions can also lead directly to pinched nerves, Dr. Chang says. Your doctor is likely to observe and check for:

  • Injuries
  • Poor posture
  • Holding your body in one position for long time periods
  • Arthritis
  • Spinal bone spurs
  • Herniated or bulging discs in spinal vertebrae

“Taking a comprehensive medical and personal history is the first and most important step toward accurately diagnosing and treating pinched nerves,” Dr. Chang explains. “Only after this step should your doctor decide which tests might unearth the cause and determine the best treatment approach.”

Diagnosis and treatment

A pinched nerve occurs when there is pressure on a nerve that interferes with the nerve's function. This can cause pain, numbness, tingling, or weakness in the affected area. Pinched nerves can occur in any part of the body, but they are most common in the neck, shoulder, elbow, wrist, and lower back.

A variety of diagnostic tests can point to the exact reason for your pinched nerve, Dr. Chang notes. These include:

  • Nerve conduction studies: These use electrodes to measure electrical nerve impulses, as well as muscle and nerve function.
  • Electromyography: This assesses the electrical activity in muscles, both at rest and while contracting.
  • MRI imaging: These detailed images reveal possible nerve root compression.

The best news possible involves pinched nerve treatment. “Most patients need only rest, temporarily avoiding any activities that worsen symptoms,” Dr. Chang says.

Your doctor may also recommend other treatments that include:

  • NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen or naproxen to soothe nerve pain and inflammation.
  • Physical therapy to stretch and strengthen muscles surrounding the pinched nerve site, relieving pressure on the nerve.
  • Epidural steroid injections
  • Surgery, a last resort if nonsurgical measures don’t work and your pain and other symptoms are severe and long-lasting.

There are several treatment options for a pinched nerve, including:

One of the first steps in treating a pinched nerve is to rest the affected area. This will help reduce inflammation and allow the nerve to heal. Applying ice or heat to the affected area can help reduce pain and swelling. Ice should be applied for the first 48 to 72 hours, followed by heat therapy to promote healing.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or acetaminophen can help reduce pain and inflammation.

Gentle stretches and strengthening exercises can help improve flexibility and mobility in the affected area and reduce pressure on the nerve.

Physical therapy can help improve range of motion, strength, and flexibility in the affected area and reduce pressure on the nerve.

“For the vast majority of people with pinched nerves, this is a short-term bother,” Dr. Chang says. “This is one case where time (usually) does heal.”