How can I get relief from a pinched nerve?
What are the best ways to help pinched nerves?
The majority of patients with a pinched spinal nerve get better with time and never need surgery. Some do not need any treatment at all if their basic problem is minor. Most will notice a slow and gradual reduction of pain and other symptoms over several days to weeks, while others take longer. If the symptoms are essentially minor and slowly proceeding toward improvement, often rest and hot/cold applications are the only care needed. However, if the symptoms are not improving or are too easily returning and worsening when they return, it is wise to seek professional evaluation and treatment of a pinched nerve.
Nonsurgical treatment of a pinched nerve
A doctor or chiropractor will usually recommend an initial course of non-drug and non-surgical pinched nerve treatment.
Determine what is pinching the nerve and correct that – if possible
There are three primarily ways a nerve can be pinched in the neck or other areas of the spine , from my experience:
1. Arthritis that changes the spinal structure that in turn often encroach on or apply pressure to (pinches) the spinal cord or spinal nerves as they exit the spine. If the arthritis is extensive and has caused boney out-growths or spurs to develop that are pinching the nerve tissue, then spinal surgery just might be indicated if other more conservative measure like those shown below have not helped. If the arthritis has caused swelling or thickening of surrounding tissues of the spine, then there is a good chance that the following measures will either control or eliminate the symptoms of a pinched nerve.
2. Abnormal mechanics of the spine due to misalignment of one or more spinal bones or soft tissue contraction that is reducing movement of the spinal bones. If this is the fundamental problem that is pinching a never in the spine, then a trip to the chiropractor is usually a good idea and will result in prompt and satisfying reduction of pinched nerve symptoms.
3. Both arthritis and abnormal spinal mechanics are pinching on one or more nerves. In this situation it is difficult to know for sure if the arthritis is the primary problem that is aggravating a relatively small issue of faulty spinal mechanics, or the opposite is happening with major faulty mechanics aggravating a relatively small problem of arthritis. If these two overlapping problems are present then a trip to the chiropractor is still a good idea. Correction of any degree of faulty spinal mechanics and misalignment will often reduce enough of the overall stress going on when these two problems are present that good reduction of pinched nerve symptoms will occur. ––
Avoidance of postures and activities that aggravate symptoms.
After just a few minutes anyone with a pinched nerve soon learns what is causing the pain to suddenly flare up. For as long as the problem is in the acute stage, if it hurts, don’t do it.
Flexible low back support or a soft collar for the neck
In many cases a pinched nerve can be treated with just rest and avoidance. A good way to assure a deep level of continued rest of the neck or low back is to wear a light brace or support that limits activity, but does not totally stop it. With some movement being allowed the area of pain will receive a reasonable amount of limited movement which will prevent swelling (edema) of the tissue from accumulating at the site of complaint. If the patient is resting and is not in constant pain there is no need to wear a support; a brace is usually used only when active and the spine is in need of additional support.
A soft cervical collar, or neck brace, will allow the muscles of the neck to rest while limited neck motion is still allowed. The head is typically held with the chin slightly elevated so the cervical nerve openings are as large as possible. This decreases pinching of nerve roots during movement and especially controls flexing and extending the neck. Soft collars should not been worn too long, just during the most intense pain symptoms, since long-term use will allow the neck muscles to become smaller and weaker (atrophy).
An elastic low back brace that provides rest and support for the lumbar spine yet still allows some movement can be helpful for recovery. The back brace should be worn firmly. Wearing a lumbar support is not an excuse for continuing to work or stand for a long time, but is used to enable greater rest of the injured area.
Hot and cold packs are to be used on the area of discomfort at the spine, not at the extremity. With a pinched nerve the pain sometimes travels far from the source of the problem. If the pinched nerve in neck is causing the arm and hand to hurt, the hot and cold packs are still used on the neck where the nerve is pinched.
Stretching and strengthening exercises
As with any soft tissue injury (muscles, ligaments, tendons and cartilage), gentle stretching of the site of involvement keeps the area mobile and relaxed, and increases the rate of healing. As recovery progresses it is always recommended to include strengthening exercises when pain is greatly reduced since this assists prevention.
Various medications can also be used to treat a severely pinched nerve or condition that is not responding well to more conservative measures.
- Nonsteroidal anti-inflammatories (NSAIDs) – Over-the-counter drugs like aspirin and ibuprofen, and naproxen may be helpful for the pain of nerve irritation and swelling. Other medications used specifically for nerve related pain include gabapentin (Neurontin) or pregabalin (Lyrica).
- Oral corticosteroids – In more stubborn or extensive injury a short course of oral corticosteroids can reduce swelling and pain.
- Narcotics – Reserved for severe pain and those patients who are not relieved by aggressive use of other conservative options; prescribed for a limited time only.
- Steroid spinal injections – Corticosteroid injection placed directly in the spine at the site of nerve compression, reducing the inflammation and pain sufficiently to speed up the recovery process of an otherwise poorly responding spinal injury or osteoarthritis.
Surgical treatment for a pinched nerve
If the symptoms from a nerve root compression are not responding adequately under conservative care, or if symptoms are worsening, or if there are signs of more severe nerve damage (loss of bladder or bowel control, or loss of sensation in fingers), surgery may be recommended using any of several specialized surgical procedures for radiculopathy.
If the pinched nerve is in the neck or lower back does not respond favorably to conservative measures, a spine surgeon or neurosurgeon can remove that portion of the herniated or bulged disc or bone spur that is compressing the inflamed nerve. If a large piece of bone or disc must be removed the surgeon will perform a spinal fusion of two or more vertebrae to stabilize the spine.
When to see a doctor when you suspect a pinched nerve
See your doctor or chiropractor if the signs and symptoms of a pinched nerve slowly increase or last for several days and don’t respond to self-care measures, such as rest and over-the-counter pain relievers.