healing a pinched nerve

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

A pinched nerve can be a very annoying and painful condition.

The nerve consists of one long cell from the low back or neck down to the foot or hand, so the nerves tend to heal slowly. The nerves heal from the top down, and depending on how much damage is done at the time the nerve becomes impinged (pinched), it may take weeks to months for the nerve to fully to heal.

Treatment of neural impingement is directed at relieving the pain and then allowing the nerve to heal on its own. Nerves need both inflammation and pressure to be painful, so either relieving the inflammation or the pressure can relieve the pain.

A pinched nerve often needs no additional treatment other than rest. That’s because simply not using the area of the body affected by the pinched nerve can help promote healing. When the nerve is not given a chance to recover the troubling symptoms may persist or possibly worsen.

While there are no shortcuts to speed your body's natural healing process, there is a lot you can do to give yourself the best chance of a quick recovery. Learn proper sitting and lifting methods. Proper rest is a critical factor in the healing process too. Proper nutrition is also of great importance, so eat right.

Stay active!

Your heart is a pump. It pumps the blood through the arteries to the nerves. If you stay inactive, sit still, stand still, or lay in bed, you are reducing the ability of the heart to maintain circulation. The heart is deconditioned and so are the muscles. Toned muscles help with circulation. Deconditioned muscles don not. By doing aerobic exercises and getting the pump going, you get that blood to the pinched nerve and nutrition to the discs so they can heal. If you are inactive, not only do you stop the muscle pump, but also you begin to get weak.

Estimates are that you lose 1% of your muscle strength for each day of inactivity. Bed rest also affects other body functions, such as the ability to think, see, and hear clearly. Inactivity leads to all these bad side effects, and begins to make the problem worse.

Estimates are that when we are forty-five years old we need 45% of our normal strength/power to get through a normal day, but by age seventy-five, we need 90%. So the effects of inactivity/bed rest are worsened with age. One day of bed rest is okay while you begin other parts of the program (i.e. ice, anti-inflammatory drugs), but any more leads to problems.

Most anti-inflammatory drugs work systemically, and all have side effects. Ice will increase the blood flow to the deep structures (nerves, muscles, and ligaments), and help reduce swelling.

Both help to relieve pain and improve healing. The best method is to use an ice pack twenty to twenty-five minutes and no more. This can be repeated every two hours. Watch your skin so that you don't get frostbite, but with the new form of packaged reusable soft ice this rarely occurs.

Heat does not work. While it makes it may feel better temporarily by relaxing the muscles, it also makes the blood supply go to the skin and takes it away from the deep structures that really need it. This makes the problem worse.

Anti-inflammatory drugs need to be taken regularly and at advised dosages. Some people respond to these; others do not. Many people get side effects from these drugs. Upset stomach, bleeding, eye damage, kidney damage, and other toxic side effects may occur, so you should use them under the care of a physician. Anti inflammatory drugs are better at keeping the swelling down than at getting the swelling down. So, start their use early. Once the pain is gone, it is rarely necessary to continue use of the medication.

Muscle relaxants are useful for a brief time, but usually cause sleepiness and depression. You should not operate a car while using them. They do not relax the muscles in a direct way, but have a more central effect. They are especially useful in getting some relief for sleeping at night. Muscle relaxants can be habit forming.

Narcotics are not very useful. When you take a narcotic, you block the pain, but you are not improving the blood flow or strengthening the muscle. They may be useful if they allow you to undertake an exercise program to improve blood flow/nutrition and muscle strength.

Narcotics allow you to ignore the pain warning, so they may allow you to do things that are potentially damaging, such as sitting or lying too long in one position. They also cause sleepiness, depression, constipation, upset stomach, and are habit forming.

Physical therapy and chiropractic can be useful if it decreases the muscle spasm or tightness of the muscle. If you are then able to undertake an active exercise program and improve the blood flow, this is very useful.

If you feel improvement, it is useful to have repeated manipulations. If a manipulation increases the pain it may be actually pinching the nerve more. If numbness or weakness worsens, you need to try something else.

As with physical therapy and chiropractic, massage can temporarily decrease muscle spasm and increase blood flow, but it will only be effective if you start an exercise program and continue the blood flow.

Epidural steroid injection can be quite helpful to relieve pain. It should be administered only with ultrasound or fluoroscopic guidance.

Surgery is always a last ditch type of intervention. It often improves the anatomic problem by removing what is pinching the nerve or limiting the blood flow, but it does not make you normal. It allows you to resume activity and improve the blood supply so your body can heal and get back towards normal. It can do about 10% but you still need to do your 90%. It is not like carpentry where you can go in and connect two things and you are done. It's more like gardening.

Surgery can prepare the area but it is the daily activity that restores the blood flow and restrengthens the muscles. Just like gardening it takes a season to get the results you want. If you plant your garden, but never water it or care for it or worse yet poison it (by smoking) you wouldn't expect much of a crop. However, if you take care of it everyday, at the end of a season you could expect a prize-winning result.

There is intense interest in a type of treatment known as internal disc decompression therapy. This is a non-invasive, non-surgical type of treatment that has up to an 86 per cent response rate. For more information, contact the Arthritis and Osteoporosis Center of Maryland at (301) 694-5800.

Healing a pinched nerve