The brain communicates with various body parts using a complex network of nerves. These nerves send instructions from the brain to the muscles, and they bring sensory information from the various body parts back to the brain. For these nerves to function properly, they must pass unobstructed from their origins in the brain and spinal cord, through the tissues and channels in the body, all the way to their end targets in muscles, joints, skin, and organs. A nerve traveling through any part of the body can become compressed, or “pinched”, whenever injured either acutely or chronically. An acute injury could be a motor vehicle accident, a traumatic injury, or a sports injury. A chronic condition that causes inflammation and structural alterations would be arthritis, a tumor, or an infection. When a nerve becomes physically compressed, electrical signals that normally travel through the nerve can be interrupted, resulting in numbness, tingling, or even weakness downstream from where the nerve is pinched. Pain may also be experienced. Whenever pain or neurological symptoms are felt, Centers for Neurosurgery, Spine & Orthopedics can offer patients a course of action which will ultimately result in a cure.
Where Can a Nerve Be Pinched?
A nerve, anywhere in the body, can become pinched by the surrounding anatomy. Certain nerves tend to be affected more commonly than all others. For example, carpal tunnel syndrome results from the median nerve in the wrist becoming pinched by inflammation that results in the swelling of the ligaments and joints due to trauma or repetitive use.
Similarly, sciatica is a pinched nerve syndrome that causes leg pain as a result of either the right or left sciatic nerve being pinched as it branches off the lumbar spine. The patient experiences pain down the back of the leg on the same side as the pinched nerve. Sciatica results from trauma or a degenerative process causing inflammation within the joints of the spine. Arthritis in the spine, called spondylosis , is a common cause of sciatica.
Trigeminal neuralgia is a common one-sided disabling facial pain caused by a pinched nerve. In this instance, the trigeminal nerve, which is the fifth cranial nerve, is compressed by a pulsating arterial blood vessel.
Symptoms of Pinched Nerves
The characteristic of most pinched nerves is that the pain, numbness, or weakness is felt from the point of where the nerve is being pinched as well as along the path of the nerve to it is most peripheral body part innervation. A pinched nerve in the lumbar spine can cause moderate to severe back pain but leg and foot pain may or may not be more prominent. A pinched nerve in the cervical spine can cause shoulder or hand pain, without causing much neck pain.
Because of this fact, the diagnosis of a pinched nerve in the spine may be delayed by patients or practitioners not familiar with neuroanatomy. Instead, they may focus on the painful body part, rather than the nerve that travels to that body part. At CNSO, the entire neuroanatomical structure and musculoskeletal structure is taken into account, as well as the patient’s entire past medical history, before a diagnosis is made.
Diagnosis for Pinched Nerves
When seeking medical attention for pain, it is important to find a provider who understands the difference between local pain and remote pain caused by a pinched nerve. The diagnosis is not always easy because pain, tingling sensations, and numbness cannot be measured. The provider must pay close attention to a patient’s descriptions of discomfort and ask detailed questions such as, “What makes the pain better or worse?”. Clearly, the provider must be an expert at nuanced musculoskeletal physical and neurological examination which, if done correctly, allows the doctor to localize the source of the pain.
Additional diagnostic tools include EMG studies, which use electrodes to test how well nerves and muscles are functioning in any extremity. Finally, X-rays, CT scans, and MRIs can provide additional anatomical information.
Treatment for Pinched Nerves
Fortunately, most cases of a pinched nerve, once diagnosed, can be treated without surgery. Activity modification, physical therapy, splints, and anti-inflammatory medications are enough to allow the majority of patients to get back to their normal lives. Occasionally, a nerve may become so inflamed that it requires a local injection of steroids in order to help the inflammation subside. Pain management doctors are the experts in diagnosing and performing steroid injections in joints, the spine, nerves that become pinched as they branch of the spine, as well as any other location of a pinched nerve. Pain management doctors are the specialists who provide epidural injections, transforaminal injections, and trigger point injections.
Rarely, surgery may be required to free or release the pinched nerve. These surgeries are typically performed by the surgeons at CNSO using minimally invasive techniques in an outpatient or inpatient setting.
When seeking treatment for a pinched nerve, look for experienced, qualified specialists who understand the complexities of diagnosing nerve ailments: many symptoms, such as pain or tingling, cannot be measured and may require investigation far away from the body part that hurts. The diagnosis of a symptomatic pinched nerve can never be made from MRIs alone because most adults have abnormal findings on MRI even if they do not have symptoms. Beware of providers who offer free MRI reviews.
A provider evaluating pinched nerve syndrome must be willing to spend a great deal of time listening to patients to gather clues about where their symptoms are coming from. He or she must also conduct a detailed physical and neurological examination. It is only then that the provider can make sense of a complicated MRI, with many possible abnormal findings, and determine whether these findings are related to specific symptoms and signs. This is an important point: If the initial diagnosis is incorrect, all treatment plans will fail, even if those treatments are performed well.
Up to 95% of pinched nerve patients will return to normal activity without surgery. The body has a remarkable capacity for healing, and the provider’s role is to guide patients through this process quickly and prevent future recurrences of symptoms.
However, for the rare patients who do need injections or surgery to regain normal function, the specialists must have a broad range of skills and a proven record of technical mastery to assure optimal outcomes. Patients owe it to themselves to get treatment from the best nerve specialists in the field.
Contact Centers for Neurosurgery, Spine & Orthopedics Today
The dedicated team at Centers for Neurosurgery, Spine, and Orthopedics (CNSO) understands how neck, back, joints, and nerve problems can impact someone’s daily life. By working with the CNSO team of renowned, board-certified neurosurgeons, orthopedic surgeons, pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists, patients will receive comprehensive and coordinated care, so they can quickly resume a healthy, less painful lifestyle free from disability. CNSO offers multiple convenient locations spanning northern New Jersey, including offices in Bergen, Passaic, Morris, Essex, and Hudson counties. Northern NJ patients can learn more about effectively treating pinched nerves by contacting CNSO today.