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Pinched Nerves

Nerves can be “pinched” or compressed in many ways. Common areas are in the wrist, the lower back, the neck, the leg and the elbow. Often the pinching is more of a compression. The most common nerve compression is in the wrist involving the median nerve, known as carpal tunnel syndrome. Nerve compressions can result from a number of causes, including disc herniation, soft tissue swelling, arthritic change with bony overgrowth, tumors, or they can occur without relating to a bodily structure.

Pinched nerves in the spine are called radiculopathy (pronounced “ra-dick-u-loputhy”). In a radiculopathy, the problem arises at or near the root of the nerve, just after it exits from the spinal cord.  Not only do they cause back and neck pain, but they frequently can cause pain that radiates down the leg or arm. They can cause weakness in the muscles with which they are associated. The pinched nerves are identified by the spinal location where they occur.

The most common radiculopathies are in the lumbar (lower back) region. Of these, S1 (first sacral) and L5 (fifth lumbar) are the most common. These are very low on the spine. The L5 and S1 nerves combine to form the sciatic nerve, and a problem with these can be referred to as sciatica (pronounced “sigh-at-ika”). The next higher vertebra is L4. It comes in 3rd in occurrence, and higher ones are relatively uncommon, although L3, the next one up the spine can be associated. It’s possible for problems with L5 and L4 to transfer loadbearing demands up to L3. Problems infrequently occur in the thoracic (pronounced “thor-as-ick”) spine.

The levels usually involved in the neck are C5 (5th cervical), C6, C7, C8 and T1 (1st thoracic). Nerves can also be compressed in areas distant from the neck, but that is another discussion.

The physicians at Rehabilitation Physicians PC are experts in evaluating patients for pain and possible nerve damage in the spine. The evaluation starts with a history and examination. From that point, diagnostic tests may be ordered to make a more exacting study to confirm or rule out a diagnosis. Further study may include testing, implementing an EMG (electrical nerve and muscle test), imaging studies (X-ray, MRI or such) or laboratory studies. Treatment may involve anything from a combination of a short period of rest, medications, physical therapy, or guided injections (epidurals) which are performed in our office. Most of these treatments are successful in treating painful conditions such as radiculopathies .

Call today to schedule an appointment with one our medical specialists to get started with your personalized diagnostic study and treatment plan.

For more information or to schedule an appointment, please call (248) 893-3200.