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Wednesday, 29 November 2017 | Author : Flex Free

Pinched Nerve

A pinched nerve is the name given to the uncomfortable sensation, pain, or numbness caused when increased pressure leads to irritation or damage to a peripheral nerve (A peripheral nerve is one that is outside the brain and spinal cord.). Although this condition is often associated with back pain or a neck injury, almost any nerve is susceptible. A herniated disk in your lower spine, for example, may put pressure on a nerve root, causing pain that radiates down the back of your leg. Likewise, a pinched nerve in your wrist can lead to pain and numbness in your hand and fingers (carpal tunnel syndrome).

Damage from a pinched nerve may be minor or severe. It may cause temporary or long-lasting problems. The earlier you get a diagnosis and treatment for nerve compression, the more quickly you'll find relief. In some cases, you can't reverse the damage from a pinched nerve.

Pinched Nerve Causes

A pinched nerve occurs when too much pressure (compression) is applied to a nerve by surrounding tissues. In some cases, this tissue might be bone or cartilage. In other cases, muscle or tendons may cause the condition. The pressure may be the result of repetitive motions. Or it may happen from holding your body in one position for long periods, such as keeping elbows bent while sleeping. Nerves are most vulnerable at places in your body where they travel through narrow spaces but have little soft tissue to protect them.

Source: www.sjchs.org

In the case of carpal tunnel syndrome, a variety of tissues may be responsible for compression of the carpal tunnel's median nerve, including swollen tendon sheaths within the tunnel, enlarged bone that narrows the tunnel, or a thickened and degenerated ligament.

A number of conditions may cause tissue to compress a nerve or nerves, including:

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

Pinched Nerve Symptoms

Pressure on a peripheral nerve can irritate the nerve itself, its protective covering, or both. When this occurs, the nerve is unable to conduct sensory impulses to the brain appropriately, leading to a sense of numbness. This inflammation associated with the damage or injury can also cause pain or paresthesia (a tingling or prickling sensation) signals to be sent to the brain.

Inflammation or pressure on a nerve root exiting the spine may cause neck or low back pain and may also cause pain to radiate from the neck into the shoulder and arm. Or pain may radiate into the leg and foot (sciatica). Nerve compression in your neck or arm may also cause symptoms in areas such as elbow, hand, wrist and fingers.

If a nerve is pinched for only a short time, there's usually no permanent damage. Once the pressure is relieved, nerve function returns to normal. However, if the pressure continues, chronic pain and permanent nerve damage can occur.

Pinched nerve signs and symptoms include:

  • Numbness or decreased sensation in the area supplied by the nerve. This may initially come and go, but over time becomes persistent.
  • Sharp, aching or burning pain, which may radiate outward
  • Tingling, pins and needles sensations (paresthesia)
  • Muscle weakness in the affected area
  • Frequent feeling that a foot or hand has "fallen asleep"

The problems related to a pinched nerve may be worse when you're sleeping. Sometimes symptoms worsen when you try certain movements, such as turning your head or straining your neck.

Common areas where nerves are pinched include the following:

  • Carpal tunnel.
  • Ulnar nerve at the elbow. Frequently caused by leaning on elbows while sitting or driving.
  • Lateral femoral cutaneous nerve. Caused by compression of the sensory nerve leading to the upper thigh. This may also be seen in pregnancy, when the enlarging uterus can also cause nerve compression.
  • Common peroneal nerve injury. Associated with crossing the legs at the knee.
  • Sciatic nerve problems or sciatica. Pain which travels from the low back into the leg or hip.
  • Cervical spine. A pinched nerve in the neck can cause pain or tingling to travel into the arm or shoulder blade region.

Source: www.completepaincare.com

Of note, although tennis elbow is a painful condition often associated with repetitive activities, the pain is caused by inflammation of the tendons of the elbow, not a pinched nerve.

Pinched Nerve Risk Factors

The following factors may increase your risk of experiencing a pinched nerve:

  • Sex. Women are more likely to develop carpal tunnel syndrome, possibly due to having smaller carpal tunnels.
  • Bone spurs. Trauma or a condition that causes bone thickening, such as osteoarthritis, can cause bone spurs. Bone spurs can stiffen the spine as well as narrow the space where your nerves travel, pinching nerves.
  • Rheumatoid arthritis.
  • Thyroid disease. People with thyroid disease are at higher risk of carpal tunnel syndrome.

Other risk factors include:

  • Diabetes.
  • Overuse. Jobs or hobbies that require repetitive hand, wrist or shoulder movements, such as assembly line work, increase your likelihood of a pinched nerve.
  • Obesity. Excess weight can add pressure to nerves.
  • Pregnancy. Water and weight gain associated with pregnancy can swell nerve pathways, compressing your nerves.
  • Prolonged bed rest. Long periods of lying down can increase the risk of nerve compression.

Pinched Nerve Diagnosis

The diagnosis of pinched nerve is made by taking a history of symptoms and performing a careful physical examination. Depending on the findings, the diagnosis may be made clinically or further testing may be required.

Source: www.healthline.com

Electromyography (EMG) is a nerve conduction study to help confirm the diagnosis of a pinched nerve and to determine the extent of nerve damage.

If the pinched nerve is in the neck or back, an MRI or CT scan may be considered to make the diagnosis and look for the cause (bulging disc, arthritis, or fracture).

When to see a doctor

See your doctor if the signs and symptoms of a pinched nerve last for several days and don't respond to self-care measures, such as rest and over-the-counter pain relievers.

Pinched Nerve Treatment

Treatment varies, depending on the severity and cause of the nerve compression.

  1. Resting the affected area is often very effective, especially in cases of injury caused by repetitive activities. Physical therapy is frequently beneficial when a pinched nerve is caused by problems in the neck or low back. Exercises may strengthen the back or core muscles and decrease or eliminate pressure on a nerve root. Over-the-counter anti-inflammatory medications like ibuprofen may be helpful. Injections of corticosteroids may also be beneficial for many types of pinched nerves.
  2. For cases of carpal tunnel syndrome, splinting or bracing the wrist is often used. In cases of ulnar neuropathy or common peroneal neuropathy, learning to change body positions may be required to achieve the best outcome.
  3. Weight loss can be of benefit for many types of pinched nerves.
  4. Surgery may be required to release pressure on the nerve if it fails to respond to medication, splinting, physical therapy, or injections. The specific type of surgery depends upon the nerve involved. However, the goal of the surgery is the same, to eliminate or relieve the pressure on the affected nerve. In more severe cases, it may be necessary to remove material that's pressing on a nerve, such as scar tissue, disc material, or pieces of bone.

Pinched Nerve Prognosis

In many cases, once a pinched nerve has been identified, the symptoms can be resolved when treatment allows the nerve to recover. There are instances where the nerve damage is permanent, and a patient may be left with permanent numbness or pain in the affected area. Because nerves can regenerate (regrow) very slowly over time, it's important to seek evaluation for symptoms which persist or recur over a number of days or weeks.

Pinched Nerve Prevention

The following measures may help you prevent a pinched nerve:

  • Maintain good positioning, don't cross your legs, don’t lean on elbows, or lie in any one position for a long time. Use ergonomic principles at work and at home.
  • Incorporate strength and flexibility exercises into your regular exercise program.
  • Limit repetitive activities and take frequent breaks when engaging in these activities.
  • Maintain a healthy weight.

 

 

 

 

 

References:

  • https://www.mayoclinic.org/diseases-conditions/pinched-nerve/symptoms-causes/syc-20354746
  • https://www.medicinenet.com/pinched_nerve_overview/article.htm
  • https://www.webmd.com/pain-management/guide/compressed-nerves#1

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