How pinched nerves are diagnosed and treated

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Ouch! If you’ve got a pinched nerve, you’re likely aware of it day and night because of the pain and numbness it produces. But many people with pinched nerves around the spine—a highly common problem—have no idea how they’re diagnosed or treated, according to Kaliq Chang, MD. 

A colloquial term that describes nerve compression, pinched nerves leading from the spine can trigger troublesome symptoms much farther away, such as in the arms and legs. That’s because these extremities are connected to nerves along the neck and back, Dr. Chang explains. 

If your pinched nerve is located in your neck, pain, tingling, numbness or even weakness can show up in your arms and hands. In your back, a pinched nerve can lead to similar symptoms in the buttocks, radiating down the back of the upper leg.

“These symptoms can be all over the map—brief or long-lasting, minor or terrible,” explains Dr. Chang, an interventional pain management specialist. “Many people feel pinched nerve symptoms for just a day or two before they quickly resolve, but if they’re long-lasting and severely impact your days, you’d be wise to get checked by a doctor.”

Risk factors and causes 

The first thing your doctor might determine is whether you’re predisposed to a pinched nerve due to various risk factors. Dr. Chang says these include:

Overweight or obesity

Pregnancy

Diabetes

Occupations requiring repetitive motions

Family history 

Beyond risk factors, certain habits or medical conditions can also lead directly to pinched nerves, Dr. Chang says. Your doctor is likely to observe and check for:

Injuries

Poor posture

Holding your body in one position for long time periods

Arthritis

Spinal bone spurs

Herniated or bulging discs in spinal vertebrae 

“Taking a comprehensive medical and personal history is the first and most important step toward accurately diagnosing and treating pinched nerves,” Dr. Chang explains. “Only after this step should your doctor decide which tests might unearth the cause and determine the best treatment approach.”

Diagnosis and treatment

A variety of diagnostic tests can point to the exact reason for your pinched nerve, Dr. Chang notes. These include:

Nerve conduction studies: These use electrodes to measure electrical nerve impulses, as well as muscle and nerve function.

Electromyography: This assesses the electrical activity in muscles both at rest and while contracting.

MRI imaging: These detailed images reveal possible nerve root compression. 

The best news possible involves pinched nerve treatment. “Most patients need only rest, temporarily avoiding any activities that worsen symptoms,” Dr. Chang says. 

Your doctor may also recommend other treatments that include: 

NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen or naproxen to soothe nerve pain and inflammation.

Physical therapy to stretch and strengthen muscles surrounding the pinched nerve site, relieving pressure on the nerve.

Epidural steroid injections

Surgery, a last resort if nonsurgical measures don’t work and your pain and other symptoms are severe and long-lasting. 

“For the vast majority of people with pinched nerves, this is a short-term bother,” Dr. Chang says. “This is one case where time (usually) does heal.” 

Kaliq Chang, MD, is an interventional pain management specialist board-certified in anesthesiology at Atlantic Spine Center. Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC. http://www.atlanticspinecenter.com, www.atlanticspinecenter.nyc 

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