If you have ever suffered from a pinched nerve you know how painful it can be. Chances are you experienced numbness or decreased sensation in the area supplied by the nerve or a tingling, “pins and needles” feeling. Some of my patients tell me they feel a sharp or burning pain which is aggravated by coughing or sneezing. Sometimes they may feel twitching in the affected area or like their foot or hand has “fallen asleep.”
I have to tell you that I sympathize with how my patients are feeling and congratulate them for seeing a doctor. So often people wait too long before seeing a specialist and suffer in silence before treatment relieves their symptoms. You should see your doctor if the signs of a pinched nerve last for several days and you do not respond to self-care measures. Before I go into detail regarding treatment and self-care remedies, let me elaborate on the definition of a pinched nerve.
Simply stated a pinched nerve is caused when a nerve is damaged or injured resulting from compression, constriction, or stretching. As a result the nerve is unable to properly conduct its signal which creates the symptoms described above. According to the most recent statistics, at some time, up to 40% of people experience pain, known as sciatica, which is the nerve most likely to be affected in low back pain.
What Do Nerves Have to Do With It?
Nerves are critical pathways that carry information from the brain to the extremities and are distributed throughout the entire body. There are two types of nerves, motor and sensory. Motor nerves carry information from the brain to the organs, muscles, and heart. Sensory nerves send information from the body back to the brain for processing, including pain, touch, taste, temperature and other sensations.
When a nerve is pinched, the signal is somehow interrupted along the way and is therefore unable to transmit. There are areas of the body that are more susceptible to nerve compression such as in the neck or lower back caused by a herniated disc, arthritis, bone spurs, or spinal stenoisis (narrowing of the spinal canal).
There are many causes of nerve pressure; injury, poor posture, osteoarthritis, sports activities, and obesity. These conditions may cause the tissue to compress resulting in inflammation. There is usually no permanent damage if the nerve is pinched for a short period of time but if the pressure continues there may be chronic pain and permanent damage.
What Can I Expect From My Doctor?
If you think you might have a pinched nerve, don’t hesitate to consult your doctor. He will begin by asking questions about your pain, numbness, tingling, weakness, or any other symptoms. Your medical conditions, family medical history, and other work related questions will be helpful in determining the best treatment for your specific condition.
The part of your body involved will be examined, including testing your strength, sensation, and muscle tone in certain muscles. If your doctor suspects a pinched nerve in the neck or lower back, X-rays may be needed to determine the extent of the injury. You may also need a CT scan or an MRI scan. These imaging studies provide information that cannot be seen on regular X-rays, and may be necessary to present a clear picture of your condition.
There are other tests that are helpful in determining the extent of nerve compression: a nerve conduction study or an electromyography (EMG). Both help to identify the electrical activity and speed of the impulse traveling in the nerve.
Will the Pain Ever Go Away?
You are probably asking the same question most of my patients ask…”Will the pain ever go away?” In most cases, patients with a pinched nerve are able to recover completely without any long lasting symptoms providing they follow a treatment that includes rest, modified activity, ice, physical therapy, and medications.
Listed below are some of the ways in which a pinched nerve can be treated depending on the location:
• Support Braces
There are times that I recommend a brace for a short period of time because it limits the amount of movement around the nerve allowing it to rest and recover. The brace also prevents my patients from moving the affected nerve which could further complicate the condition. For instance, a brace is used for carpal tunnel syndrome because when the wrist bends down, the median nerve in the wrist is further pinched.
Over the counter medications are often helpful in relieving the pain of a pinched nerve such as anti-inflammatory medications. For instance ibuprofen that can reduce swelling around the affected nerve.
• Physical therapy
By stretching and strengthening specific muscles in the body, pressure on pinched nerves is relieved.
•Self Care Measures
Alternating hot and cold packs to the affected area 2-3 times a day will help speed up the progress of regular massage and physical therapy. Stretching several times a day is important so make sure you follow the instructions given to you by your physical therapist.
• Natural Remedies
As mentioned earlier, anti-inflammatory medications are helpful in treating pinched nerves. There are herbal anti-inflammatories like turmeric, ginger, bromelain, and rosemary that have been known to help decrease pain. A combination of these should be taken 3-4 times a day for pain, or 1-2 for maintenance. Flax oil or fish oil supplements are also a good source of anti-inflammatory ingredients. Calcium and magnesium are important to muscle contraction and relaxation, and can help decrease tightness.
Certain foods provide anti-inflammatory benefits so if you are suffering from nerve pressure you might want to adjust your diet as well. Be sure to eat fruits, vegetables, whole grains, beans, moderate in fish, dairy, and good fats like olive or flax oil. Meat, sugar, white flour products, processed foods, and fried foods should be kept to a minimum.
Pinched nerves are common ailments and can occur anywhere in your body. Living with the pain and numbness of a pinched nerve is no fun. Fortunately with proper care and conservative treatments, most people recover from the condition within a few days or weeks.
Mark Bromson, M.D.
•University of Miami Graduate School-M.B.A (Health Administration)
•University of Pennsylvania School of Medicine
•Harvard College Biology-Graduated Magna cum laude
•Fellowship: Baylor University of Medical Center
•Residency and Internship: The Mount Sinai School of Orthopedic Surgery
•Fellow, American Academy of Orthopedic Surgeons
•Fellow, American Orthopedic Foot & Ankle Society
•Fellow, Florida Orthopedic Society