Pinched Nerve (cont.)

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How is a pinched nerve diagnosed?

The doctor will begin by asking the patient various questions about his or her pain, numbness, tingling, weakness, and other symptoms. The patient may also be asked about other medical conditions, work history, and family medical history. This information can often assist in identifying the nerve(s) affected.

The doctor will then examine the part of the body involved. This may include testing the patient's strength, sensation, and muscle tone in specific muscles. Depending on the results of the medical history and the physical examination, the patient may need additional tests.

If the doctor suspects the patient has a pinched nerve (compression of the nerves) in the neck or lower back, X-rays may be necessary to assess possible injury to the spine or arthritis of the spine. Depending on the severity and duration of the patient's symptoms, he or she may also need a CT scan or an MRI scan. These imaging studies provide additional information about a pinched nerve not seen on regular X-rays, and can provide additional information in preparation for surgical intervention if necessary.

The doctor may also recommend specific tests for the affected nerve including a nerve conduction study or an electromyography (EMG). In the nerve conduction study, the test stimulates the nerves with a mild electrical impulse and measures speed of the impulse traveling in the nerve. In the EMG, a small needle is placed into the muscle while the patient contracts the muscle to measure the electrical activity of the muscles.

How is a pinched nerve treated?

Support braces

In many cases a pinched nerve can be treated with rest and ice. If the pinched nerve is in the arm (carpal tunnel syndrome or cubital tunnel syndrome) the doctor may recommend a brace for a short period of time. The brace limits the amount of movement around the nerve, which allows it to rest and recover. The brace also prevents the patient from movements that may further compress or pinch the affected nerve. A brace used for carpal tunnel syndrome covers the wrist and and is extended slightly back. This is because during flexion (bending the wrist down) the median nerve in the wrist is further pinched. The brace for cubital tunnel syndrome in the elbow can be used to keep the elbow from bending too much which further stretches the ulnar nerve.

Medication

Various medications can also be used to treat a pinched nerve. Anti-inflammatory medications, for example, ibuprofen or naproxen can reduce the inflammation (swelling) around the affected nerve. Other medications used specifically for nerve related pain include gabapentin (Neurontin) or pregabalin (Lyrica.

Physical therapy

Physical therapy can assist to stretch and strengthen specific muscles in the body, which helps relieve the pressure on the pinched nerve.

Surgery

If the symptoms from a pinched nerve do not improve with the above treatments, surgery may be recommended. Surgery may also be recommended if the patient develops additional weakness in the muscles, or if the particular nerves being pinched cause loss of control of the bowel or bladder (cauda equina syndrome). These are signs of more severe nerve damage.

Surgery for a pinched nerve depends on the location of the nerve being pinched. If the pinched nerve is in the wrist (carpal tunnel syndrome) or elbow (cubital tunnel syndrome), the surgeon can release the tissues over the nerve in the wrist or elbow to free the nerve tissue pressure.

If the pinched nerve is in the neck or lower back a spine surgeon or neurosurgeon can remove a portion of the disc or bone spurs that are compressing the nerve in the spine. In some cases, if it is necessary to remove large portions of bone or disc, the surgery may require a spinal fusion to stabilize the spine after freeing the nerve.

In the MRI image below, the herniated disc is occluding the nerves in the spinal cord.

Picture of herniated disc pinching the nerves in the spinal cord
Picture of herniated disc pinching the nerves in the spinal cord
Medically Reviewed by a Doctor on 7/17/2014

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Pinched Nerve - Describe Your Experience Question: Please describe your experience with a pinched nerve.
Pinched Nerve - Treatments Question: What was the treatment for your pinched nerve?
Pinched Nerve - In Neck, Treatment Question: What was the treatment for your pinched nerve?
Pinched Nerve - In Neck Question: Did you have an X-ray, CT scan, or MRI to diagnose your pinched nerve in the neck?
Pinched Nerve - In Back Question: What symptoms did you experience with your pinched nerve in the back?