What is actually happening when we talk about a ‘pinched nerve’

by May 20, 2019

Cervical or lumbar radiculopathy or also referred to as a ‘pinched nerve’ refers to when a nerve is irritated or compressed as it passes through the tunnel of the spine in either the neck or back. This tunnel is very small in nature and gets smaller as we age and therefore much more common in ages 40+.

It’s very common for people to present to a physiotherapist with a self-diagnosed ‘pinched nerve’, but this is much less common than you think. In most cases, the pain is arising from the joints in the neck and there is an inflammatory response around the nerve, however, it is not being pushed on.

Signs & Symptoms (what you may experience)

  • Referred pain down either the arms or legs
  • Altered sensations down the arms or legs such as pins and needles or burning.
  • Muscle weakness
  • Diminished reflexes

What causes a trapped nerve?

A nerve can become ‘pinched’ by the surrounding tissue that irritates or compresses the nerve.

These tissues include:

  • Disc herniation or protrusion
  • Injury to ligaments
  • Injury to muscles
  • Arthritic spurs (bone spurs)
  • Inflammation from a different injury

How do we diagnose this?

The first step is a thorough neck and/or back assessment by your Doctor or Physiotherapist to assess whether further imaging is necessary. Once we have diagnosed your problem, we are able to decide whether an Orthopaedic review is required, or whether physiotherapy should be prescribed. 

How can physiotherapy help?

  • Soft tissue massage and dry needling to decrease muscle spasm around the compressed nerve.
  • Mobilisation of the spine to decrease joint stiffness and take pressure off the nerve by allowing more space for it to pass through.
  • Strengthening exercises for weak muscles to prevent the injury from returning.
  • Education & advice about which positions to avoid, and which positions will help.
  • Corticosteroid injections can be organised by referring to a Medical Specialist (if necessary).

How Long until I’m better?

The time to recovery varies between individuals. This ranges from several weeks to months.

What can I do at home?

The first thing to is follow-up with your general practitioner for advice on medication that can help both with the pain and any inflammation that may be occurring. The next thing to do is find comfortable positions that won’t irritate the nerve further. Your physiotherapist will show you these positions and some gentle exercises to get you going again.

Reece Jones

Principal Physiotherapist

Set in Motion Physiotherapy

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