Pinched Nerve

Summary

Pinched = sharply squeezed or compressed
Nerve = one of the fibers that connects the body to the brain and spinal cord.

Nerves deliver sensory information from body to brain, and also carry movement instructions from brain to body. Compression (squeezing) of a nerve disrupts these functions and can result in tingling, numbness, or pain. This is called a pinched nerve.

At The Spine Hospital at The Neurological Institute of New York, we specialize in pinched spinal nerves. The spinal nerves branch off of the spinal cord, connecting it with the body.

Another name for a pinched spinal nerve is radiculopathy. Sciatica is one well-known kind of radiculopathy. It results from compression, or pinching, of the sciatic nerve–a large nerve that innervates the legs and feet.

Symptoms

Exact symptoms depend on the nerve affected. A pinched nerve root in the cervical spine (spine in the neck) may cause pain, numbness, or tingling in the arms and hands. A pinched nerve root in the lumbar (lower) spine may cause the same symptoms, but in the hips, buttocks, legs, or feet.

Causes and Risk Factors

The spinal nerves leave the spinal canal through small bony openings called foramen. They are adjacent to many other structures of the spine: ligaments, joints, vertebrae, and the flexible discs between vertebrae.

Any of these structures may impinge on a nerve, pinching it and producing symptoms. Conditions that may result in a pinched nerve include:

Tests and Diagnosis

In most cases, a detailed physical exam is enough to diagnose a pinched nerve. However, further testing may be necessary to determine the cause of the pinched nerve. The following studies may help:

  • X-ray (also known as plain films)– test that uses invisible electromagnetic energy beams (X-rays) to produce images of bones. Soft tissue structures such as the spinal cord, spinal nerves, the disc and ligaments are usually not seen on X-rays, nor on most tumors, vascular malformations, or cysts. X-rays provide an overall assessment of the bone anatomy as well as the curvature and alignment of the vertebral column. Spinal dislocation or slippage (also known as spondylolisthesis), kyphosis, scoliosis, as well as local and overall spine balance can be assessed with X-rays. Specific bony abnormalities such as bone spurs, disc space narrowing, vertebral body fracture, collapse or erosion can also be identified on plain film X-rays. Dynamic, or flexion/extension X-rays (X-rays that show the spine in motion) may be obtained to see if there is any abnormal or excessive movement or instability in the spine at the affected levels.
  • Magnetic resonance (MR) scans-  clearly show soft tissues like discs, spinal cord, and nerves.
  • Computed tomography (CT) scans- use X-rays and a computer to create detailed images of the spine and nearby structures.
  • CT plus myelogram (myelo-CT)- uses an injectable dye and CT scan to measure nerve function.

Treatments

Some cases of pinched nerve are best treated with non-operative measures such as medication and physical therapy. In other cases, surgery is the treatment of choice. Our neurosurgeons have extensive experience evaluating individual cases and patients, and tailoring the correct treatment to each patient.

Preparing for Your Appointment

Drs. Paul C.  McCormick, Michael G. Kaiser, Peter D. Angevine, Alfred T. OgdenChristopher E. Mandigo, Sheng-fu (Larry) Lo and Richard C.E. Anderson (Pediatric) are experts in treating conditions that cause pinched spinal nerves. Each can also offer you a second opinion.

For information about types of pinched nerves besides spinal nerves, visit the webpage of Dr. Christopher J. Winfree who is an expert in treating non-spine related pinched nerves.