Where pinched nerves happen
Cervical radiculopathy affects nerves in the neck and causes symptoms in the shoulder, arm and hand. Lumbar radiculopathy affects nerves in the low back and causes symptoms in the buttock, leg and foot; this is commonly called sciatica. Thoracic radiculopathy, in the mid-back, is less common and can cause pain that wraps around the chest.
Causes
- Disc herniation
- Bone spurs and arthritis narrowing the nerve exit (foraminal stenosis)
- Spondylolisthesis and loss of disc height
- Less commonly, tumors, infection or trauma
Diagnosis
The pattern of symptoms and exam findings usually points to the specific nerve root. MRI confirms the compression. In some cases, an EMG/nerve conduction study helps distinguish a pinched nerve in the spine from a peripheral problem such as carpal tunnel syndrome. A selective nerve root block can also confirm which nerve is responsible.
Treatment
Most radiculopathy improves with time and conservative care: activity modification, anti-inflammatory medication, a short steroid course, physical therapy and epidural injections. Surgery is recommended when pain persists, when weakness develops or worsens, or when imaging and symptoms clearly match. Options include microendoscopic discectomy and foraminotomy in the low back, and ACDF or posterior foraminotomy in the neck.
Common questions
How long does a pinched nerve take to heal?
Many pinched nerves improve significantly within six to twelve weeks. Numbness may take longer to resolve than pain, and longstanding weakness may not fully recover, which is why progressive weakness is an indication for earlier surgery.
What should I avoid with a pinched nerve?
Avoid heavy lifting, repetitive bending or overhead work that reproduces your symptoms, and prolonged positions that aggravate the nerve. Gentle movement is generally better than bed rest.