Is This Pain in My Neck … or Back … or Shoulder … a Pinched Nerve?
A pinched nerve is a common source of pain among the elderly, people who perform a lot of repetitive movements, those with arthritis and anyone struggling with obesity. Although they sometimes heal on their own, pinched nerves can cause significant disability and sometimes even permanent nerve damage when left untreated.
Determining how many people actually have pinched nerves is very difficult, since many people report symptoms that could be caused by another injury, and some people don’t experience any symptoms at all. Many different factors can contribute to a pinched nerve, including past injuries, someone’s level of exercise, age, gender and bodyweight. While there isn’t just one single cause of pinched nerves, prevention seems to be very important.
Conventional methods of treating pinched nerves usually include medications and surgery. However, research shows that non-surgical, more conservative treatments, including physical therapy, exercise, chiropractic adjustments, supplements and rest, can also greatly help reduce pinched nerve pain.
What Is a Pinched Nerve?
Pinched nerves (also called compressed nerves) are deep root nerves that have become inflamed and irritated due to experiencing an abnormal amount of pressure. Pressure can accumulate around a deep root nerve from surrounding tissues, bones, cartilage, muscles or tendons that protrude outward or are damaged due to an injury or inflammatory condition. (1)
Nerves are responsible for sending important sensory information regarding pain, well-being and perceived threats from our bodies to our brains, and vice versa. Major nerves travel from your brain through your spinal cord and down the center of your back, connecting to small series of nerves that stem off into your limbs and elsewhere. A pinched nerve causes painful sensations in addition to things like “pins or needles” and swelling because increased pressure changes the way nerves communicate.
What are some common conditions that might cause a pinched nerve? These can include a herniated disc in the lower back or a pinched near the neck. One of the most troubling things about pinched nerves is that they usually don’t just cause pain in one location — the pain often spreads, for example, extending down the legs, to the hands and into the shoulders.
Compression (increased pressure and stress) placed on a root nerve is the primary cause of a pinched nerve, which interferes with normal signals regarding pain.
There are several locations in the body where pinched nerves are common and numerous reasons that someone might develop a pinched nerve. The causes of a pinched nerve can include: (2)
- Herniated disc, caused from a disc tearing or weakening
- Wear and tear associated with aging and inflammation
- Poor posture, such as forward head posture
- Repetitive movements that wear down or irritate tissue
- Staying in one position for long periods of time, such as those related to someone’s job or hobbies
- Injuries, such as trauma, tears and sprains
- Bone spurs, which narrow the spaces where nerves travel
- Recovering from conditions or treatments that cause neuropathy, including breast cancer and diabetes (3)
- Arthritis and degenerative joint diseases
What makes a pinched nerve different than a herniated disc or slipped disc?
For the most part, people use the terms herniated disc, bulging disc, slipped disc, and pinched or compressed nerve interchangeably. (4) It can be hard to tell if a pinched nerve versus a herniated disc is the exact cause of your pain, numbness or tingling, but the good news is that both types of conditions are usually treated in similar ways.
Although they’re closely related, herniated discs are not exactly the same as pinched nerves. Herniated discs and slipped discs can contribute to pinch nerves because they cause tissue to protrude into a nearby nerve. Usually they’re the result of aging/degeneration, injuries or various diseases that affect the nerves in the spine. These conditions cause spinal discs to open and expand, which can lead to fluid leaking out, worsened inflammation and increased pressure.
That being said, it’s important to understand the real causes of your pain in order to know how best to treat it. Because there are various reasons you might have disc or nerve pain, it’s important to work with your doctor to identify if pain is at the site of the disc location itself or if it’s coming from a nearby irritated pinched nerve. Prior to taking medications or receiving adjustments, and definitely before undergoing surgery, getting an accurate diagnoses is crucial.
What does a pinched nerve feel like? Pain, nerve damage and irritation caused by a pinched nerve can sometimes be minor but other times severe. It’s possible for symptoms of a pinched nerve, such as tingling or shooting pains, to come and go temporarily or to become chronic problems. Pain can occur in the cervical (neck) region, thoracic (upper) region or lumbar (lower) spine. While in some cases pinched nerve pain goes away relatively quickly, in other rare cases that are left untreated, it can lead to permanent nerve damage and chronic pain.
Although the location of a pinched nerve determines the types of symptoms you feel, most pinched nerves have the following in common: tenderness and pain, swelling, feelings of extra pressure, and some degree of scarring. Increased pain when moving and trouble exercising are also common pinched nerve symptoms.
Pinched nerve symptoms aren’t usually located to one area; rather they cause “radicular pain” (nerve root pain) that tends to spread from one body part to another. The word “radiculopathy” refers to a variety of symptoms, including traveling pain, numbness and weakness. (4)
Symptoms of a pinched nerve in your neck or shoulder include: (5)
- Pain, numbness and tingling that radiates from your neck down your upper back, shoulders or arms.
- Symptoms might affect your elbow, hand, wrist or fingers.
- It’s common for pain to get worse when you move, type on a computer or lift things.
- You might experience “pins or needles,” inflammation, weakness, and pain associated with conditions like carpal tunnel syndrome, golfer’s elbow or tennis elbow. Your grip may become weak, and your arm or hand might become stiff.
Symptoms of a pinched nerve in your back include: (6)
- Back pain radiating from your lower back running down your legs. Pinched nerves are most common in the lower back because the lower back bears a high percentage of pressure and force.
- Burning sensations, tingling, heat and weakness might be felt in the thighs, low back or buttocks. Sometimes the pain might spread upward to your chest and neck.
- Pain likely gets worse if you exercise, after waking up from sleeping, or when you’re bending and walking.
To help make a diagnosis of a pinched nerve, your doctor will likely perform:
- A physical exam, testing reflexes, tenderness and pain
- Assessment of your medical history, family history and injuries
- Tests for muscle strength or weakness, testing for signs of muscle atrophy, twitching, numbness
- Testing pain based on motion, touch and pressure
- Testing joint dysfunction through moving your limbs and torso
- Diagnostic tests, including CT scan or magnetic resonance imaging (MRI), to look at disc alignment and configuration
Once the location of your pain has been identified and a pinched nerve is diagnosed, conventional treatments might include: (7)
- Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used medications. These include aspirin, ibuprofen or naproxen. Sometimes doctors even perscribe strong narcotics for chronic nerve pain. They can help dull inflammation and pain, but long term they won’t solve the pinched nerve and can cause side effects when used for long durations (like indigestion, for example).
- Corticosteroids: Used to lower swelling.
- Microdiscectomy spinal surgery: This removes part of the disc that’s bulging out or other material that’s irritating a root nerve. It’s a risky type of spine surgery that’s usually only effective for treating degenerative disc diseases — however, it doesn’t always address the real cause of pain associated with a pinched nerve.
- Surgery to remove other material that’s pressing on a nerve, such as scar tissue or bone.
1. Follow a Collagen Repair Diet
- Consume a diet high in natural sources of collagen, which helps repair damaged connective tissue and adds cushion to spaces between bones and joints, reducing friction and pressure. Collagen is the most abundant natural protein found within our bodies and an important building block of all tissue. Bone broth is one of the best suppliers of collagen, along with other beneficial nutrients, including glucosamine, chondroitin, hyaluronic acid and amino acids.
- Eating omega-3 foods, such as wild-caught fish like salmon, grass-fed beef, chia seeds and flaxseeds, helps naturally control inflammation and reduce the effects of aging.
- Get even more antioxidants and anti-inflammatory compounds through organic vegetables, organic fruits and herbs like turmeric, garlic and ginger. These anti-inflammatory foods help slow the effects of aging by reducing oxidative stress and supply essential vitamins and minerals to help you recover.
- High-fiber foods can also help control your appetite, and many supply important vitamins, antioxidants and minerals. Obesity and excess weight can add pressure to nerves and make pain worse, so try limiting added sugar, sweetened drinks, fried or packaged foods, and refined carbohydrates.
2. Posture Correction Exercises and Treatment
Proper posture is crucial for helping take unwanted stress off of delicate joints, especially joints that have been injured or under increased pressure for a long time. I recommend seeing an Egoscue posture therapist and/or seeing a spinal correction chiropractic doctor to help target the spinal problem at its root (such as sclerosis or spinal stenosis). Egoscue is a postural therapy protocol that focus on fixing musculoskeletal misalignment. A trained practitioner can help you restore proper posture for good and limit muscular compensations that might make your pain worse long term.
I also recommend doing exercises on your own (once cleared) that help strengthen your core in order to take pressure off of your back and prevent low back pain, along with other exercises to improve your posture. Working with a physical therapist at first is a smart idea if you’ve been injured or are still healing.
Prolotherapy is a cutting-edge form of regenerative medicine used to treat both acute and chronic injuries and growing in popularity even among elite athletes. Prolotherapy has been shown to be beneficial for conditions that can compress root nerves, including:
- bulging discs
- torn ligaments
- joint pains in the neck, low back, knee or shoulders
How does prolotherapy work? Platelet-rich plasma uses your body’s own platelets and growth factors to heal damaged tissues by promoting a minor inflammatory response. Glucose along with other active ingredients are injected into the damaged tissue to re-create your body’s own natural healing process, and in this case inflammation helps to rebuild the damaged tissue.
4. Soft Tissue Therapy
Relieving tight muscles and trigger points can make a big difference in reducing joint stress. Consider the following soft tissue therapies to help treat the underlying causes of a pinched nerve. A trained practitioner in one of the following manipulative therapies can help “turn on” muscles that have been “turned off” due to injury and eliminate muscular pain. I’ve worked with active release technique practitioners for years to help me overcome a number of muscle and joint-related injuries.
- Active Release Technique
- Graston Technique®
- Dry Needling
- Neurokinetic Therapy
Most people are nutritionally bankrupt and their diets very low in specific nutrients that support musculoskeletal healing. Therefore, taking some quality supplements can make a big difference in terms of recovery and pain reduction. In order to heal damaged tissue, you need nutrients that help reduce inflammation, support tissue repair and increase growth factors. Some antioxidant compounds can also help support the body’s own stem-cell production and initiate tissue reconstruction.
I recommend taking the following supplements to help treat a pinched nerve:
- Turmeric and ginger
- Omega-3 fatty acids
- Bone broth (contains type 2 collagen, glucosamine, chondroitin and hyaluronic acid to help aid in tissue repair)
- Bovine collagen (has type 1 and 3 collagen)
- Antioxidant-boosting compounds, including resveratrol, green tea, medicinal mushrooms like cordyceps, and berry extracts, such as acai or goji
Anatomy of a Pinched Nerve
There are several different types of disorders affecting root nerves, which are commonly grouped together under the umbrella term “pinched nerve”:
- Lumbar radiculopathy: The type of pinched nerve located in the lower (lumbar) region of the spine. “Lumbar” refers to the five large, flexible vertebrae toward the bottom of the spine. This is the most common place for a pinched nerve to develop since the lower back bears a lot of weight and stress, especially during movement or lifting.
- Cervical radiculopathy: The type of pinched nerve located near the neck, which causes nerve pain and numbness to travel outward down the arms, upper back, chest or shoulders. “Cervical” refers to the seven vertebrae at the top of the backbone. Cervical radiculopathy is linked to conditions including herniated disc, a bulging disc, degenerative disc disease, osteoarthritis and stenosis. (8)
- Thoracic radiculopathy: This is the least common type of pinched nerve, which affects the root nerves of the middle section of the spine (called the thoracic region). Due to the middle back’s lack of flexibility and mobility (since the ribs serve as an anchor and support system of the torso and upper body), the thoracic vertebrae are usually far less stressed than the other spinal regions.
- Sciatica: Sciatic nerve pain radiates downward from the lower back through one or both thighs and legs.
Pinched Nerve vs. Sciatica
- Leg pain that runs down the length of the leg from the lower back is usually referred to as sciatica, or sciatic nerve pain. Sciatica is a type of pinched nerve pain, and the most common cause of sciatica is a herniated disc in the lower back. (9) For this reason, many experts consider sciatica to be a form of lumbar radiculopathy.
- Sciatica causes painful throbbing, stiffness and tenderness in the lower back and limbs. Often the throbbing is reoccurring and felt in only one leg, although it can also be felt throughout the lower back and both legs simultaneously.
- Natural treatments for sciatic nerve pain include chiropractic adjustments, stretching, yoga, massage therapy, acupuncture and exercise.
- For some people, pinched nerve pain will go away on its own within several weeks. If you experience strong pain suddenly that doesn’t respond to over-the-counter pain relievers, definitely make a trip to your doctor.
- Look out for signs of infections, such as a fever, chills and nausea. These signs can indicate a more serious nerve-related problem and shouldn’t be ignored.
- Depending on your condition, your doctor might also ask you to stop any activities that cause or aggravate the compression and pain. Get your doctor’s advice on whether or not rest; a splint or brace might be needed to help immobilize the area while it heals.
- Pinched nerves are compressed root nerves that cause radiating pain, tingling, numbness and weakness.
- Sciatica (pain radiating along the sciatic nerve down the leg), lumbar radiculopathy, cervical radiculopathy and thoracic radiculopathy are the primary types of pinched nerves.
- Pinched nerve symptoms can be felt in the back, thighs, shoulders, wrists, neck or hands.
- Treatments for pinched nerves include active release technique and other soft tissue therapies, supplementation, exercise, physical therapy, and a diet high in collagen.