WHAT IS A PINCHED NERVE?
A pinched nerve may be caused by several conditions:
- A patient may have a tight or small canal for the nerves to pass through (spinal stenosis)
- There may be wear and tear resulting in changes to the facet or zygapophysial joints (small joints in the back of the spine)
- There may be wear and tear resulting in changes to the disc (the flexible section between the spine bones that allows our spines to twist and bend).
- Occasionally, the disc may have wear and tear on it causing the inside (nucleus pulposus) toothpaste-like substance to ooze outside of the outer walls of the disc (annulus fibrosus), causing a “disc herniation,” This disc herniation can irritate the nerve as it passes by, subsequently causing arm pain (if the disc problem is in the neck) or leg pain (if the disc problem is in the low back).
WHAT ARE THE SYMPTOMS?
- Typically, the pain is a shooting pain sensation that may also include numbness and tingling.
- If a patient is suffering from neck pain, that pain typically increases by turning the neck in certain directions.
- A patient suffering from lower back pain may report increased pain with prolonged sitting, prolonged standing, bending over, lifting or walking.
- If a patient has more severe nerve irritation, s/he may also experience weakness. A patient with progressive weakness or bowel/bladder incontinence (losing control of urine or stool) requires immediate medical evaluation.
WHAT DO OUR PROVIDERS DO TO DIAGNOSE A PINCHED NERVE?
- Dr. Tracy may obtain a history, physical examination and imaging to diagnose this problem.
- Occasionally, a patient may have biomechanical imbalances or other risk factors that can be identified that put their body at risk for developing a pinched nerve, such as poor posture or insufficient core muscle strength.
- A patient with a pinched nerve may require further evaluation with other tests, such as MRI’s, CT scans, or electrodiagnostic tests (electromyography and nerve conduction studies – EMG/NCS).
WHAT DOES INTEGRATED SPORTS & SPINE DO TO TREAT IT?
- A provider may prescribe combination of medications, modification of activity, ice/heat and/or exercise in order to properly rehabilitate a pinched nerve.
- It is important for a patient to rehabilitate a pinched nerve with posture exercises, strengthening the muscles that control the spine as well as addressing anything that might contribute to a poor posture like a poor chair at work.
- A provider may prescribe a guided, progressive, slow return of activity to prevent a relapse of the pinched nerve.
- Occasionally a provider may inject a steroid (corticosteroid or cortisone) into the epidural space (the tissues around the inflamed nerve), which typically alleviates pain so that a patient may advance their exercise program.
- Dr. Tracy may suggest surgery to ease the compression if the pinched nerve pain persists after conservative treatments.
- Because Dr. Tracy has a non-operative approach (common to physiatrists), surgery is often avoided. If surgery is indicated, Dr. Tracy will recognize it and direct you to a spine surgeon.