Pinched Nerve

By Jay Herrera, DPT
Categories: , ,

unhappy woman suffering from pinched nerve and neck pain

The term “pinched nerve” is a general term used In musculoskeletal medicine used to describe a condition where a component of a nerve is compromised is some manner by way of excessive pressure which can be from surrounding structures, inflammation, abnormal growths like tumors etc.

In this article, we will narrow the discussion of pinched nerve to the two most common sites often seen in clinical practice ie most often experienced by people.

  1. Neck (cervical spine)
  2. Low back (lumbar spine)

The cervical spine is designed to positioned your head so that you can function in an upright posture. The cervical vertebrae are made up of 7 segments. When stacked on top of each other it a natural curvature, there is normally enough room for the nerves branches that come off the spinal cord (spinal nerves) to exit from structures called the Foramen. Motions allows are rotation right/left, bending forward/backward, side bending right/left.

The lumbar spine is comprised of 5 spinal segments and helps support the upper body’s weight and connects upper body to lower body. Allows spine motions: bending forward/backward, rotation right/left, side bend right/left. The lumbar segments when stacked also has a normal curvature and foramen for spinal nerve outlets.

When you have poor posture, trauma from a fall, whiplash, sprain/strain from lifting an object too heavy,  the muscles around the cervical/lumbar spine can become excessively tight and compress on these stacked vertebrae decreasing the natural healthy curvature of the cervical / lumbar spine and even decrease space between the vertebral segments themselves. The opening for the spinal nerves, the foramen, can become smaller and more easily compressed. The spinal nerve at this point is called the spinal nerve root which can no longer have enough space to exit the foramen. The foramen, essentially a bony structure can then compress this areas of the spinal nerve and “pinch” the nerve.

Symptoms of a Pinched Nerve

  • Pain at the segments where the pinched nerve is present. as well as radiating pain away from the pinched nerve.
  • Muscle tightness as the body is attempting to help the pinched nerve site
  • Sharp pain
  • Full ache
  • Possible sensory loss where numbness and tingling can be experienced
  • Loss in muscle strength as decreased nerve signal to the muscle group associated to the nerve level as well as decreased use of the muscle due to pain
  • Deceased overall functionality of the associated muscle groups : cervical spine pinched nerve = often can be arm function; Lumbar spine pinched nerve =  can lead to decreased  leg function.

Pinched Nerve Treatment Options

  1. Rest: allowing the body to rest if the pinched nerve is due to a trauma or simply excessive postural stress can often help to bring comfort quickly.
  2. Therapeutic Exercise: Gentle stretching to alleviate the muscle guarding around the compromises spinal segments can be helpful to relieve the excessive pressure that can be compressing the spinal nerve root. Corrective exercise to help with poor posture or joint instability can help to ensure muscles of the region are healthy and strong enough to support function spine motion.
  3. Manual Therapy: research demonstrates that gentle spinal manipulation (which can be delivered by a Licensed Physical Therapist) of the compressed segments can help to relieve pressure at the vertebral opening and even allow tight muscles in the area to relax.
  4. Heat: can help to calm excessively tight muscles.
  5. Ice: to the painful spine segment can help to alleviate an inflammatory response that can cause nerve and joint irritation.
  6. Cold Laser: a class 3 cold laser -> the Microlight- ML 830(R) (the laser is not actually cold but rather this is the classification of laser to indicate it is not a burning class 4 laser) which has been FDA approached for joint and muscle pain/discomfort is a powerful therapeutic tool to help calm the inflammatory process and actually induce the cells to regenerate and heal faster by stimulating the cells ATP processes causing a cascade of chemical processes to help heal damaged tissue.
  7. Soft Tissue Massage: helps relieve muscle tension allowing increased blood flow to the area for healing as well as decreasing any fibrotic scar tissue (adhesions) that may be present.
  8. NSAIDS: if your Physician has approved you to use this, non-steroidal anti inflammatory drugs can help mitigate the excessive inflammation experience at the problem site. Can be useful in the short term.

What to Expect

Incorporating all or several of the common treatment procedures can usually help bring about relief within days or weeks depending on the nature of the underlying condition’s cause.