Pinched nerve

The term "pinched nerve" describes one type of damage or injury to a nerve or set of nerves.

A nerve is a cell which is microscopic in size, and its fibers may run several feet in length. A nerve cell that originates in the brain or within the spinal cord is called a central nerve, and a nerve that leaves the spine to go into the arms or legs are called peripheral nerves. These peripheral nerves are actually bundles of millions of nerve fibers that leave the spinal cord and branch to target muscles to make them move or go to the skin to provide feeling.

The injury may result from compression, constriction, or stretching. Symptoms include numbness, "pins and needles" or burning sensations, and pain radiating outward from the injured area. One of the most common examples of a single compressed nerve is the feeling of having a foot or hand "fall asleep." Pinched nerves can sometimes lead to other conditions such as peripheral neuropathy, carpal tunnel syndrome, and tennis elbow. The extent of such injuries may vary from minor, temporary damage to a more permanent condition. Early diagnosis is important to prevent further damage or complications. Pinched nerve is a common cause of on-the-job injury.

A nerve can be pinched as it leaves the spine by a herniated disc or by bone spurs that form from spinal arthritis. Some examples of terms used to describe spinal disc abnormalities include:

• Pinched nerve
• Sciatica
• Herniated disc (or herniated disk)
• Bulging disc
• Ruptured disc
• Slipped disc
• Disc protrusion
• Disc degeneration
• Degenerative disc disease


Another common place for nerves to get pinched is in the carpal tunnel. This is a bottle-neck area in the wrist through which all of the finger flexor tendons and the median nerve must pass to get to the hand. When one has a pinched nerve in the low back, pain is usually perceived as radiating down the leg. Here again, the symptoms the person experiences seem to them to be traveling into the leg along the distribution that the nerve usually travels. This is the basis of “referred pain”. Muscle spasm in the back commonly accompanies pinched nerves and can be quite painful. Sometimes, nerves can be pinched and the only symptoms may be numbness and weakness in the arm or leg without any pain whatsoever.

In assessing “pinched nerve” symptoms, a physician’s medical diagnosis focuses on determining the source of a patient’s pain. For this reason, the medical diagnosis of a patient’s low back pain, leg pain, or other symptoms is based on more than just the findings from a diagnostic test, such as an MRI scan or CT scan. Instead, the physician arrives at a clinical diagnosis of the cause of the patient’s pain through a combination of findings from a thorough medical history, conducting a complete physical exam, and, if appropriate, conducting one or more diagnostic tests.

• History. The physician will take the patient’s medical history, such as a description of when the low back pain, sciatica or other symptoms occur, a description of how the pain feels, and what activities, positions or treatments make the pain feel better, and more.
• Physical exam. The physician will conduct a thorough physical exam of the patient, such as testing nerve function and muscle strength in certain parts of the leg or arm, testing for pain in certain positions, and more. Usually, this series of physical tests will give the physician a good idea of the type of back problem or neck problem that the patient has.
• Diagnostic tests. After the physician has a good idea of the source of the patient’s pain, a diagnostic test, such as a CT scan or an MRI scan, is often ordered to confirm the presence of an anatomical lesion in the spine. The tests can give a detailed picture of the problem, such as the location of the herniated disc and impinged nerve roots.


Although the anatomic findings on an imaging study have certain significance, they are not necessarily diagnostic. There can be lesions present on an imaging study that are not symptomatic. A patient’s physical exam findings and symptoms need to match the anatomic findings to arrive at an accurate medical diagnosis.

The key factor in the clinical diagnosis is to determine if the patient has a pinched nerve originating in the spine or if the disc space itself is generating the pain. These two common conditions produce a different type of pain.

• Pinched nerve: When a patient has a symptomatic herniated disc, it is not the disc space itself that hurts, but rather the disc herniation is pinching a nerve in the spine. This produces pain that is called radicular pain (e.g., nerve root pain, or sciatica from a lumbar herniated disc, or arm pain from a cervical herniated disc).
• Disc pain: When a patient has a symptomatic degenerated disc (one that causes low back pain or other symptoms), it is the disc space itself that is painful and is the source of pain. This type of pain is typically called axial pain.


It's critical to accurately diagnose the site of pain origination, because the type of pain created by the offending disc dictates the type of treatment, and the treatments for the different diagnoses vary considerably. For example, treating a lumbar herniated disc will not do the patient much good if it is a muscle strain or other soft tissue injury rather than the disc herniation that is the cause of the patient’s pain.

The most frequently recommended treatment for pinched nerve is rest for the affected area. Corticosteroids help alleviate pain. In some cases, surgery is recommended. Physical therapy may be recommended, and splints or collars may be used.

With treatment, most people recover from pinched nerve. However, in some cases, the damage is irreversible.




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