Nerves play a major role in our bodies. They are ‘phone lines’ from the brain to different parts of the body to move that part of the body and also for you to feel changes in the environment.
If you want to bend your elbow, for example, the brain makes a ‘phone call’ through the nerves to the muscles responsible for bending the elbow and the action is performed.
Without our nerves, our bodies will not be able to function.
What Is A Pinched Nerve?
To have a pinched nerve means to have a compressed nerve. Bones, muscles or tendons can compress the nerves.
The spinal column protects the spinal cord. The spinal column is divided into five sections:
- Cervical or neck region
- The thoracic or upper back region
- Lumbar or lower back region
- Sacral region
Each region has a particular number of vertebral bones. The cervical has 7 bones while the lumbar has 5 bones.
Spinal nerves originate from the spinal cord, go through a hole in the vertebral bones, and then to the muscles and organs, they supply.
A pinched nerve can also be called radiculopathy or nerve impingement.
What Causes A Pinched Nerve?
1. Herniated discs
Discs are found between our vertebrae. This allows for easy movement of the bones on each other. A disc has 2 portions; an outer ring and an inner ring. As we mentioned earlier, nerves go through a hole in the vertebral bones from the spinal cord. In a herniated disc, the inner ring “pops” out and compresses the nerve as it passes its route.
This places pressure on the nerves and can cause a break in the transmission of impulses.
Any external force to the neck and back such as a blow or an accident can affect the alignment of the spine and lead to a compression of the nerves. Imagine, a car rear-end collision which may cause a whiplash injury to the neck, this may lead to a shift of the vertebrae causing a compression of the nerves.
3. Bony spurs
As we grow older, the discs between our vertebrae begin to dry out and shrink in size and height. As they shrink, it reduces the space between the vertebrae and bone begins to grow to protect or assist the discs. The bones that grow out are called bony spurs and these spurs can pinch the nerves around the neck and lower back.
4. Tight Muscles
Nerves supply muscles. Due to our consistent bad posture and poor lifting techniques, there is a tendency to develop tight muscles. As muscles get tight, they may compress the nerves that pass through them.
5. Poor Posture
Sitting in the front of a laptop with your upper back hunched and your face to close to the screen places your spine under a lot of stress. This may lead to tight muscles, herniated discs and strain on muscles and ligaments that can compress the nerves.
Due to the weight of the baby during pregnancy on the back and the posture a pregnant woman assumes, there may be pinching on the nerve.
Pinched Nerve Symptoms
Because of the nerve compression, there is a break in transmission of sensation and your extremities may feel like there is “no blood” flowing through them. Pinched nerves at the neck cause numbness in the arms and sometimes chest while a pinched nerve in the back cause numbness in the legs.
2. Tingling Sensations
These feel like crawling or pin and needle sensation in your arms or legs.
3. Sharp pain
There is usually a sharp hooking pain at either the neck or the back. The pain may be felt when trying to stand from sitting or trying to turn your neck.
Nerves pass information to muscles to move. When a transmission problem occurs, there tends to be muscle weakness in the arms and legs due to pain and discomfort.
5. Referred Pain
The spinal nerves from the cervical spine (around the neck) supply the muscles of the arm, some parts of the chest and shoulder while the nerves of the back supply the legs.
When there is a compression of the nerves at these sites, there is a referred pain to where the nerve supplies. Someone with a pinched nerve at the waist will feel pain down the entire leg to the feet while that of the neck can get to the fingers.
6. Muscle Spasms
A muscle goes into spasm when it contracts at its own will which means the nerve cannot control the muscle due to the pinching. Muscle spasms can be very painful.
Other symptoms in serious cases may include:
- Difficulty passing out urine
How Is A Pinched Nerve Diagnosed?
An x-ray is usually recommended to check for bony spurs and any other bony alignment that may pinch the nerve. It can also detect muscle spasm by reporting a straightening of the normal curve of the spine.
An MRI is a more penetrating radiographic tool that can show if there are herniated discs and the extent of the nerve compression.
Nerve Conduction Test
A nerve conduction test assesses nerve damage and measures how fast an electric impulse is transmitted through the nerves.
This test measures the electrical activity of the muscles. It assesses the health state of the muscles and nerves and also rules out any other condition that may have the same presentations as a pinched nerve.
Physiotherapists carry out assessment and tests to identify the root cause of the pinched nerve.
Pinched Nerve Treatment
From using medications, physiotherapy, and surgery to treatments that can be done at home, there are many ways a pinched nerve is relieved. Although, it is always best to discuss with your doctor if you have any health challenges.
Non – Steroidal Anti Inflammatory drugs (NSAIDs) are usually prescribed orally or topically. Some of these oral NSAIDs are ibuprofen, diclofenac, and naproxen. Topical gels usually have ibuprofen and diclofenac as their active ingredient. They are usually referred to as cold gels.
After carrying out the assessment, the physiotherapist will draw up goals with you using a time frame depending on the cause and severity of the pinched nerve. The goals are mainly to:
- Relieve pain
- Strengthen weak muscles
- Stretch out tight muscles
- Correct postures
- Prevent any deformities that may come up due to the pain
The goals change as you improve and exercises are gradually added to suit your body’s demands.
Some modalities that may be used by a physiotherapist are:
- Transcutaneous Electric Nerve Stimulator (TENS)
- Electrical Muscle Stimulator (EMS)
Modified Lumbar Traction
Traction helps to temporary take off anything that may be pinching the nerve.
- Lie on a hard floor on your back
- Bend your legs on a chair
- Ensure your knee and hip joint are bent at 90 degrees
- Stay in this position for 10 – 15 minutes
Instead of using a chair,
- Lie on the floor on your back at the edge of the wall
- Straighten your legs on the wall so you form an “L-shape” on the wall
- Stay for 10 – 15 minutes
Use of Orthotic Devices
Neck collars and lumbar supports are suggested to people with pinched nerves at the neck and back.
They provide mild traction to relieve the pressure off the pinched nerve and also prevent unnecessary movements at the neck that may cause more harm to the nerve.
They both have a role to play in correcting posture as well.
The use of ice or heat can be used to relieve pain and also calm down any stained muscle or ligament that may pinch the nerve. Ice and heat can also be alternated to help relieve pain. Ice can be used first for 20 minutes and then heat after for 20 minutes as well.
Exercises For A Pinched Nerve In The Neck
Exercises are recommended to relieve the pressure on the pinched nerve. Some of these exercises are:
Side Neck Stretches
- Take your right ear to your right shoulder
- Hold for 5 seconds
- Repeat on the left side
- Do this 5 times
Neck Flexion Stretches
- Slowly bend your neck forward
- Hold for 5 seconds
- Return to starting position
Neck Rotation Stretches
- Take your chin towards your right shoulder
- Hold for 5 seconds
- Repeat on the left side
- Place your fingers on your chin
- Push your chin towards your neck while moving your head back
- Hold for 5 seconds
Exercises For A Pinched Nerve In The Back
The major nerve that is usually pinched from the back is the sciatic nerve. The sciatic nerve has its nerve roots from the lumbar and sacral region.
The piriformis muscle is a flat muscle at the buttock that can pinch the nerve coming from the back especially when it is tight. This stretch will stretch out the piriformis and the pinched nerve.
- Lie on your back with your legs bent
- Place your right ankle on your left knee
- Place your two hands behind your left thigh
- Pull the left thigh towards your chest with the right ankle still on your knee
- Hold for 20 seconds
- Release and repeat on the other leg
Sitting Hamstring Stretch
The hamstrings are another group of muscles that can become tight and pinch the nerve coming from the back.
- Sit on the edge of the chair
- Bend your right leg to 45 degrees and the left leg at 90 degrees
- Bend at your waist and place your hands on the toes of the right leg
- This stretches the back muscles, the hamstrings, and the nerves.
Surgery is always a last resort if other forms of treatment do not work. The type of surgery depends on what is pinching the nerve.
The prognosis depends on how soon the pinched nerve is identified and how soon treatment starts. If treatment does not start on time, it may lead to nerve damage, which may get worse.
Also, avoiding whatever activity caused the pain in the first place is a good way to have a quick recovery.
How Can I Prevent it?
Maintain a good posture
When sleeping, you use firm pillows that can support your neck. When using a pillow, ensure your head and neck are well supported on the pillow not only your head.
While sitting, ensure your work station is comfortable so it does not put your muscles under stress.
Lift properly. Bend at your legs when you want to lift and not with your back.
Go on stretch breaks
Reduce your sitting time at work. Stand up and do some of the stretches mentioned earlier. Have a 5 minutes stretch break after every one hour of sitting to prevent muscle tightness which may pinch the nerves.