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Pinched nerve

Pinched nerve

Everything you need to know about a pinched nerve

A pinched nerve develops when surrounding tissues, such as bones, cartilage, muscles, or tendons, apply too much pressure to a nerve. Pain, tingling, numbness, and weakness can all be symptoms of this pressure.

Pinched nerves can occur in a variety of locations across the body. A herniated disc in the lower spine, for example, could place pressure on a nerve root. This could result in pain radiating down the back of your leg. Similarly, a pinched nerve in your wrist can cause numbness and pain in your hand and fingers (carpal tunnel syndrome).

Most people recover from a pinched nerve in a few days or weeks with rest and other conservative therapy. When a pinched nerve causes pain, surgery may be required.

Symptoms

Symptoms and indicators of a pinched nerve include:

  • Numbness or a loss of sensation in the nerve’s supply area
  • Sharp, agonising, or scorching pain radiating outward
  • Pins & needles, tingling feelings (paresthesia)
  • In the affected area, there is muscle weakness.
  • Frequently get the sensation that a foot or hand has “gone to sleep”
  • When you have a pinched nerve, the symptoms may be worse at night.

Diagnosis

Your doctor will ask you questions about your symptoms and perform a physical exam.

You may be subjected to tests if your doctor detects a pinched nerve. These tests may involve the following:

  • Blood tests. Tests to determine your fasting blood glucose or thyroid levels may be required.
  • Spinal tap (lumbar puncture).  A sample of cerebrospinal fluid (CSF) is taken from the area surrounding your spinal cord for this examination. The CSF could be sent to a lab to be tested for evidence of infection or inflammation.
  • X-rays. These images show how the bones are arranged and can reveal if there is any constriction or injury that could result in a pinched nerve.
  • Nerve conduction study. Through electrodes put on your skin, this test evaluates electrical nerve impulses and function in your muscles and nerves. When a little current flows through the nerve, the study detects the electrical impulses in your nerve signals. The results of your tests will tell your doctor if you have a damaged nerve.
  • Electromyography (EMG). During an EMG, your doctor inserts a needle electrode into numerous muscles through your skin. The test measures the electrical activity of your muscles during contraction and relaxation. The findings of the tests will tell your doctor if the nerves going to the muscles have been damaged.
  • Magnetic resonance imaging (MRI). This test produces precise pictures of your body in various planes using a high magnetic field and radio waves. If your doctor detects nerve root compression, this test may be used.
  • High-resolution ultrasound. An ultrasound produces images of body structures using high-frequency sound waves. It aids in the diagnosis of nerve compression diseases like carpal tunnel syndrome.

Causes

A pinched nerve arises when surrounding tissues apply too much pressure (compression) to a nerve.

This tissue can be bone or cartilage in some situations, such as when a herniated spinal disc compresses a nerve root. Muscles or tendons may be to blame in other circumstances.

Swollen tendon sheaths within the tunnel, the expanded bone that narrows the tunnel, or a thicker and deteriorated ligament could all be contributing to the compression of the carpal tunnel’s median nerve in carpal tunnel syndrome.

Tissue compression of a nerve or nerves can be caused by a number of factors, including:

  • Injury
  • Rheumatoid or wrist arthritis
  • Stress from repetitive work
  • Hobbies or sports activities
  • Obesity

When a nerve is pinched for a brief period of time, there is usually no long-term damage. Nerve function returns to normal once the pressure is released. If the pressure is not relieved, persistent discomfort and permanent nerve damage may result.

When to call a doctor

If the signs and symptoms of a pinched nerve persist for several days and do not respond to self-care treatments like rest and over-the-counter pain medications, see a doctor.

Your doctor will most likely ask you several questions. Some examples are:

  • What are your signs and symptoms? Do you have any pain, numbness, tingling, or weakness in your body?
  • Where exactly are you experiencing these symptoms?
  • How long have these symptoms been bothering you?
  • Have your symptoms been ongoing or sporadic?
  • Is there a particular activity or position that makes your discomfort worse?
  • Is there a particular exercise or position that helps you to feel better?
  • Do you have a profession or a pastime that involves repetitive motions?

Treatment

Rest for the affected area is the most commonly suggested treatment for a pinched nerve. Any actions that create or aggravate the compression will be prohibited by your doctor.

You may need a splint, collar, or brace to immobilise the area depending on where the pinched nerve is located. Because wrists flex and stretch regularly during sleep, your doctor may recommend wearing a splint during the day as well as at night if you have carpal tunnel syndrome.

 

Physiotherapy

To relieve pressure on the nerve, a physiotherapist will provide you with exercises that strengthen and stretch the muscles in the affected area. Activities that irritate the nerve may also be modified by the physiotherapist.

 

Medications

Ibuprofen and naproxen sodium are examples of nonsteroidal anti-inflammatory medications (NSAIDs). Nerve-related pain is commonly treated with anticonvulsants like gabapentin and tricyclic medicines like nortriptyline and amitriptyline.

Corticosteroids, administered orally or intravenously, may reduce pain and inflammation.

 

Surgery

If your pinched nerve doesn’t improve after a few weeks or months of conservative treatment, your doctor may suggest surgery to relieve the strain on the nerve. The type of surgery depends on where the pinched nerve is located.

For example, bone spurs or a portion of a herniated disc in the spine may be removed, or the carpal ligament may be severed to give greater room for the nerve to pass through the wrist.

Preparing for your appointment

You’ll almost certainly see a GP initially. It’s a good idea to prepare for your visit because there’s usually a lot to talk about and time is often limited. Here’s some information to help you prepare for your appointment and anticipate what your doctor may say.

What you can do

  • Be aware of any prerequisites for an appointment. If you have an imaging exam, ask if there is anything you need to do ahead of time, such as restrict your food or wear loose-fitting clothing.
  • Make a list of any symptoms you’re having, even if they don’t seem to be relevant to the reason you made the consultation.
  • Make a list of all of your medication, vitamins, and supplements.
  • If possible, bring a family member or friend with you. It’s not always easy to recall all of the information given to you during a visit. Someone accompanying you may recall something you overlooked or forgot.
  • Make a list of questions for your doctor.

Make the most of your time with your doctor by preparing a list of questions. Some fundamental questions to ask your doctor if you suspect a pinched nerve include:

  • Which of the following is the most likely source of my symptoms?
  • What types of exams do I require?
  • Is my illness likely to be transient or permanent?
  • What treatment would you suggest?
  • What are some alternatives to the major strategy you propose?
  • These are my additional health issues. How can I best manage both of these conditions?
  • Are there any activity limitations that I must adhere to?
  • Is there any written information or brochures that I can take home with me? What websites do you think people should go to?

Do not hesitate to ask your doctor additional questions at your appointment, in addition to the ones you’ve prepared.

Risk Factors

The following variables may make you more susceptible to a pinched nerve:

  • Sex. Carpal tunnel syndrome is more common in women, presumably because their carpal tunnels are smaller.
  • Bone Spurs. Bone spurs can be caused by trauma or a condition that promotes bone thickening, such as osteoarthritis. Bone spurs can harden the spine and narrow the space through which your nerves pass, squeezing them.
  • Rheumatoid arthritis. Inflammation can compress nerves, especially in the joints.

Other aspects to consider are:

  • Diabetes. Nerve compression is more likely in people with diabetes.
  • Overuse. Pinched nerves are more likely to occur in jobs or hobbies that involve the repetitive hand, wrist, or shoulder movements, such as assembly line labour.
  • Obesity. Nerves can be irritated by excess weight.
  • Pregnancy. Pregnancy-related water and weight increase can enlarge nerve pathways, squeezing your nerves.
  • Long-term bed rest. Nerve compression can be exacerbated by prolonged lying down.
  • Thyroid problems. Carpal tunnel syndrome is more common in people who have thyroid problems.

Prevention

The following precautions could help you avoid a pinched nerve:

  • Maintain proper alignment by not crossing your legs or lying in one position for an extended period of time.
  • Strength and flexibility activities should be incorporated into your daily workout routine.
  • Limit your time spent doing repetitive activities and take frequent breaks.
  • Keep your weight in check.
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