A pinched nerve occurs when surrounding tissue, such as tendons, muscles, and bone, puts pressure on a nerve. This usually causes pain, pins and needles, numbness, and weakness. The nerve can be trapped in the spine or the upper or lower limb. So, what does a pinched nerve feel like, and how do we treat it?
Causes of a pinched nerve
Nerves can become pinched when compressed by inflamed tissue or tight spaces. Inflammation in the tissue around a nerve can be caused by trauma (an ankle sprain or a broken bone) or conditions that cause general inflammation and swelling (such as diabetes, thyroid problems, obesity, or pregnancy).
Disc bulges can compress spinal discs as they leave the spine, causing radiculopathy. Moreover, inflammation and growth in the pathway can compress nerves in the arms or legs. Examples include carpal tunnel syndrome, cubital tunnel syndrome, and meralgia paraesthetica.
What does a pinched nerve feel like?
Generally, a pinched nerve will lead to symptoms and signs that make us suspect pressure on the nerve.
Common symptoms of a pinched nerve include the following:
- Sharp stabbing pain at the site of pinching
- Burning feeling
- Numbness or pins and needles
- A feeling that the hand or foot falls asleep
- A hot or cold sensation in the affected area, often with a change in the colour of the skin
- Weakness of the muscles supplied by the nerve. For example, a pinched nerve in the calf can cause weakness and foot tripping.
- In more severe cases, a pinched nerve can affect physical functions such as bowel and bladder control. ressure on nerves in the lower back can lead to a serious condition called cauda equina syndrome.
- Sometimes, unexplained pain may be due to a pinched nerve
Your doctor will examine you to see if the pinched nerve is coming from the spine, arms, or legs. They will test your sensation, muscle strength, and reflexes. Also, pressing on the nerve at the pinching site will often bring on pain and other symptoms.
Diagnostic tests for a pinched nerve
Usually, imaging such as ultrasound or MRI is used to find the cause of pressure on the nerve. However, ultrasound is increasingly valuable as it can detect pinched nerve changes such as swelling and thickness. For example, we think ultrasound is good at picking up nerve changes in carpal tunnel syndrome. Nerve conduction studies and EMG can show where a nerve is being compressed. These tests use tiny needles and electric currents to determine whether the nerve works correctly. Also, it can suggest the exact site of compression. These tests are mildly painful but only take a few minutes.
Sometimes, in complex cases, an injection of local anaesthetic and cortisone at the site where we think trapping occurs can be helpful. Frequently, this injection is done with ultrasound to pinpoint the exact spot.
Differential diagnosis for what does a pinched nerve feels like
Sometimes, other conditions cause symptoms similar to those of a pinched nerve. These conditions include muscle and nerve inflammation, such as multiple sclerosis or peripheral neuropathy. Therefore, seeing an experienced doctor who can rule out these other causes is essential.
Treatment
Overall, the treatment principles focus on improving symptoms and preventing worsening nerve damage.
Generally, we separate treatment into a few groups:
Conservative measures
Firstly, you must avoid or treat activities that cause the pinched nerve. For example, in cases of carpal tunnel, you should avoid the particular actions that cause pain. If weight gain is the reason, then losing weight will help. Secondly, physiotherapy can help reduce the tension on pinched nerves. For example, manual therapy will help loosen the tissue around the nerve, and neural stretches and glides will reduce nerve tension. Also, splinting to rest the nerve can help in specific conditions, i.e., carpal tunnel syndrome and cubital tunnel syndrome. Finally, massage, acupuncture, and TENS can reduce nerve sensitivity.
Medication
If inflammation around the nerve is an essential factor, topical and oral NSAIDs such as ibuprofen can help. Other tablets, such as amitriptyline and duloxetine, also known as nerve stabilisers, can reduce nerve sensitivity. Capsaicin cream applied to the arm or leg area will reduce nerve symptoms. Finally, some practitioners use lidocaine patches 5% applied for 12 hours to the affected area.
Injections
Overall, we use injections to reduce inflammation around a pinched nerve. Generally, we use cortisone around a pinched nerve to reduce swelling and nerve symptoms. However, in most cases, we must direct the cortisone to the area above and below the nerve. This accurate placement of cortisone is helped by using ultrasound. Ultrasound locates the trapping site and allows you to direct a small volume of cortisone where it is needed. This improves accuracy and reduces the side effects of cortisone going to an unnecessary area. Examples of conditions for which ultrasound is used include carpal tunnel syndrome, cubital tunnel syndrome, and meralgia paraesthetica.
Another injection technique is a nerve hydrodissection, where a high fluid volume separates the nerves from scar tissue or adhesions. Injectable agents include local anaesthetics, sterile water, dextrose, or PRP.
Surgery
When conservative measures, medication, and injections fail, we recommend surgery to reduce pressure on the nerve. Examples of where surgery can be effective include carpal tunnel syndrome, meralgia paraesthetica, and sciatica. However, surgery should be performed only if nerve tests have confirmed the diagnosis of a pinched nerve.
Final word from Sportdoctorlondon about what does a pinched nerve feel like
A trapped nerve can cause unexplained pain in the arm or leg despite a normal X-ray or MRI. Therefore, you need to think about a pinched nerve in cases that don’t make sense. Ultrasound and other tests can help confirm or exclude the nerve as the source of pain.
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