Do I Have a Pinched Nerve?
September 17, 2024
A patient complaining about burning, tingling, numbness, maybe even unusual sensations that feel like “pins and needles” pricking the skin, may have a pinched nerve. Neurosurgeon Giorgio Rotoli, D.O., sees patients of all ages who have pinched nerves in their neck, mid- to upper back or low back.
“This is quite a common condition,” he says. “It’s encouraging, however, that approximately 80 percent of people can avoid any surgical intervention when treating it.”
How to Manage a Pinched Nerve
Peripheral nerves exit the spinal cord through narrow gaps between vertebrae, Dr. Rotoli says, and can be pinched “in a multitude of areas.” That pinching can be caused by connective tissues such as muscles, tendons and ligaments, along with bones.
Nerves can be compromised by conditions such as a herniated spinal disk or osteoarthritis with a bony spur—two of the most common causes—along with muscles that contract due to nerve entrapment, or by an injury or a tumor.
Sometimes, with a condition called claudication, pinched nerves causing discomfort or fatigue in the legs or hip area don’t occur while resting, but when a person walks or stands.
Diagnosing a Pinched Nerve
Dr. Rotoli starts his evaluation with a comprehensive physical exam to determine the extent of a patient’s pain. Then if he suspects a pinched nerve, he may order any of these noninvasive tests:
- X-ray: A dynamic X-ray may be used, allowing a patient to move during the diagnostic process.
- CT scan: This evaluates the patient’s bony anatomy.
- MRI: This test evaluates soft tissue, such as nerves, disks and the spinal cord.
Treating a Pinched Nerve
It’s appropriate to start with conservative treatment that might include:
- Oral anti-inflammatory medications (NSAIDs)
- Physical therapy
- Epidural steroid injections
Most pinched nerves, also called nerve compression, can be managed with conservative treatments, but sometimes surgery is recommended, Dr. Rotoli says. That may be the case when a patient can no longer tolerate pain despite heavy medication, if they develop extreme weakness in extremities, or experience loss of bowel or bladder control.
“Advances in surgical technology have actually allowed many same-day procedures that provide significant pain relief immediately following surgery and the ability to lead a normal life again more quickly,” he says.
The most common minimally invasive procedures for pinched nerves are:
- Microdiscectomy: This corrects a herniated disc that’s ruptured or protruding. The surgeon removes tissue that compresses the nerve.
- Foraminotomy: The procedure creates more space in the area where the compressed nerve exits the vertebrae.
Can I ‘Prevent’ a Pinched Nerve?
Sometimes, a pinched nerve is inevitable, but there are precautions you can take to try to prevent this from happening, says Dr. Rotoli. They’ll also help contribute to your overall spine health.
- Strengthen your core or trunk muscles. You hear a lot about the core, the center part of your body, because it has a big job in stabilizing the body. Learn more about these exercises that do just that, and don’t be discouraged if they’re challenging at first: plank, superman, bird dog, dead bug, cat-cow and bridge.
- Consider your workouts. If you walk or run, you know about “pounding the pavement.” That’s hard on your spine and joints overall. “Choose more natural and even surfaces, such as beaches, or even flat grass to lessen the impact,” Dr. Rotoli recommends.
It’s also important to use leg and other muscles correctly when you lift weights—and don’t make your spine do all the work. Check with a professional, if necessary, to ensure you are using good form. Oh, and don’t forget to exercise regularly for greater benefits.
- Mind your posture. When your posture isn’t “right,” you put stress on your body. The idea is to keep your back correctly aligned when you stand or sit, and especially when you lift something or bend over.
- Maintain a healthy weight. Excess weight puts extra stress on your joints and bones. Studies have found an association between obesity and back pain.
- Eat a balanced diet. What you eat matters to your body, and to your bone and spine health. Your bones do best with vitamins and minerals such as calcium, vitamin D, magnesium, vitamin K and omega-3 fatty acids. Of course, fruits and vegetables, whole grains, leafy greens and protein are necessary for good health in general. Ask your doctor what supplements you might need to take, if any, and always do so with your doctor’s approval.
Next Steps & Resources:
- Meet our source: Giorgio Rotoli, D.O.
- To make an appointment with a neurosurgeon near you, call 888-973-4674.
- Learn more about spine care at Hackensack Meridian Health.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.
