Feeling the pinch
A pinch to the skin delivers a quick twinge of pain. A pinched nerve? Way less pleasant.
If your neck is screaming in pain, you might have a pinched nerve.
The good news is that most pinched nerves are not severe enough to require surgery—although that may be necessary in some cases.
What is a pinched nerve in the neck?
As the name suggests, a pinched nerve in the neck occurs when a nerve in your neck is inflamed or squeezed, a condition also known as cervical radiculopathy.
Often this involves one of the discs in the neck. Those discs provide a cushion between the bones of the spinal cord, but they can cause problems when dislodged or torn.
“A pinched nerve refers to when a herniated disc is pushing against one of the nerves that come off of the spinal cord and exit through the foramen [a small hole between the vertebrae] to go into the arm or different areas of the neck,” says Huma U. Sheikh, MD, assistant professor of neurology at Mount Sinai Icahn School of Medicine in New York and CEO of NY Neurology Medicine.
What can cause a pinched nerve?
The primary cause of a pinched nerve in the neck is a herniated disc, but there are other possible causes.
These include a disc bulging due to degenerative disc disease, bone spurs or growths from advanced disc and spine degeneration, or tumors that pinch the nerve.
While it could happen to anyone, some people may be more likely to experience a pinched nerve in the neck.
Risk factors for a pinched nerve in the neck
The following factors tend to increase a person’s risk of a pinched nerve in the neck:
Trauma due to a car accident or other injury
Improper lifting of heavy weight
Prolonged periods of sitting at a desk or computer
Symptoms of a pinched nerve in the neck
Neck pain is a common symptom of a pinched nerve, although the pain may not be limited to your neck alone.
“Neck pain that radiates down the arm and past the elbow and/or into the fingers is typically only possible with a pinched nerve in the neck,” says Kaliq Chang, MD, an interventional pain-management specialist with the Atlantic Spine Center in West Orange, New Jersey.
How it feels can vary from person to person.
“The pain is typically described as any or all of these sensations: aching, burning, numbing, tingling, stabbing and/or shooting,” he adds. “There may also be associated weakness in the arm or hand.”
How is a pinched nerve in the neck diagnosed?
If your neck pain does not improve, or if you experience other symptoms of a pinched nerve, you should consult with your doctor right away.
At your appointment, your doctor likely will likely record your medical history and conduct a physical exam to determine the location of the pain.
That physical exam could include the Spurling test, wherein you extend your neck and rotate your head to the side where it hurts. Your doctor will then apply downward pressure on top of your head to assess the nerve root pain.
If necessary, your doctor may order imaging tests. X-rays or an MRI may be conducted to reveal the cause of the pinched nerve and determine the extent of the injury.
A CT scan also can provide 3D images with a detailed look at the spine. In some cases, your doctor may also order an electromyography (EMG) nerve test to determine the level of nerve damage.
“The ultimate way to tell is by getting an MRI that can show the disc and if there is impingement of a nerve or spinal cord,” Dr. Sheikh says.
How is a pinched nerve treated?
In most cases of a pinched nerve in the neck, you can treat the condition with pain relievers like medication, heat, and physical therapy.
Medications may include acetaminophen as well as non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.
The more serious the pinched nerve, however, the more advanced treatment it may require.
“In severe or persistent cases, X-ray-guided epidural steroid injections may be helpful to reduce the inflammation in the spine and nerves directly,” Dr. Chang says. “After these measures have failed, the patient may require surgery to remove the disc or bone on the nerve.”
Surgery options range from an anterior cervical discectomy and fusion (ACDF)—which removes the disc or bone spurs and joins the vertebrae to form a single bone—to artificial disc replacement, wherein an artificial disc is used to replace the damaged discs.
Another option is a posterior cervical laminoforaminotomy, in which the surgeon reduces the thickness of the arching bone on the back side of the spinal canal to remove any bone spurs or tissues pressing on the nerve.
Tips to prevent a pinched nerve in the neck
Reducing your risk factors is the best way to avoid a pinched nerve in the neck. This includes maintaining a healthy lifestyle with regular exercise, eating a healthful diet, and not smoking.
If your occupation requires a lot of desk time or heavy lifting, take steps to reduce the risk of harm to your neck.
“Don’t hesitate to take breaks from heavy labor or extensive desk/computer work before an injury occurs,” Dr. Chang says.
Start now by adding these chair exercises into your fitness routine—you can do them at your desk.
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