Monday Medical: Finding relief from pinched nerves
For Steamboat Pilot & Today
Editor’s Note: This is Part 1 of a two-part series on diagnosing and treating pinched nerves in the neck. Part 2 covers surgical treatment options.
If you have sharp or aching pain in your neck or shoulders, or tingling and numbness that radiates out into your arms, you might be one of the 10% to 15% of Americans who experience a pinched nerve in the neck over the course of their lifetime.
Below, Dr. Alexis Tracy, a physiatrist in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center, outlines what pinched nerves are and nonsurgical treatment options.
What is a pinched nerve?
If a spinal disc herniates — a condition in which the softer, jelly-like portions of the disc bulge out through a tear in the tough exterior — or bony spurs build up on the vertebrae, nerves in the neck can get compressed and squeezed. That results in a pinched nerve or, in medical terms, cervical radiculopathy.
“While many people have degenerative changes, such as loss of disc height and bony spurring in the neck, not all people experience symptoms of a pinched nerve,” Tracy said. “But the condition can happen to any adult, at any age.”
Though a fall or other trauma may contribute to the issue, most cases come on gradually and are not the result of a traumatic event.
What does it feel like?
The most common symptoms of a pinched nerve in the neck are pain and numbness that radiates into the shoulder blade, arm or hand. Often, patients think the issue is with their shoulder or arm, not their neck.
“People who suffer from symptoms related to a pinched nerve do not typically have isolated neck pain,” Tracy said.
If you’re also experiencing weakness, the nerve could be losing function, and you should seek help quickly. “Weakness is the most concerning symptom,” Tracy said. “This should prompt an urgent visit to your doctor.”
During an appointment, your doctor will perform a neurologic exam to look for lack of sensation and gauge deep tendon reflexes and strength in the arms and hands.
How is it treated?
If pain is not severe and the neurologic exam is normal, physical therapy is often recommended to stretch muscles and relieve pressure on the nerve.
Helpful stretches can include a trapezius stretch, in which you place one hand behind you and bend your head in the other direction to loosen muscles in the back of your neck; the chin tuck, in which you gently push your chin toward your neck and hold for a few seconds to lengthen and release tension in the neck; and the head tilt, in which you slowly turn and tilt your head to either side, holding for five to 10 seconds in each position, to improve range of motion.
Use adjustable chairs, cushions and an ergonomic workstation to relieve pressure while sitting. Other treatments that may help include massage and yoga, alternating heat and ice packs and taking nonsteroidal, anti-inflammatory drugs like ibuprofen. Don’t underestimate the power of rest, which can help the nerve heal.
Remember that an improvement in pain is not a sign to stop your stretching and strength-building regimen.
“It’s important to continue the exercises from physical therapy after you’re discharged and even after your pain has resolved,” Tracy said. “That may help prevent future episodes of pain.”
What if conservative measures don’t work?
Though conservative treatments are often successful, further steps may be necessary.
“If the pain is severe enough to keep you from working or sleeping, does not improve with physical therapy over a few weeks or is getting worse over time, then we may try medications and steroid injections around the inflamed nerve root and, eventually, surgery,” Tracy said. “But in many cases, medications, rest and spinal injections are tried first and are successful.”
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.
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