A pinched nerve occurs when surrounding tissues apply pressure to a nerve, disrupting its normal function. This pressure can cause symptoms such as pain, tingling, numbness, or muscle weakness. While many instances of a pinched nerve are temporary and resolve with conservative care, some can lead to significant and lasting issues if left unaddressed. It is important to understand when a pinched nerve warrants medical attention to prevent potential long-term complications.
What is a Pinched Nerve?
A pinched nerve occurs when surrounding tissues, such as bone, cartilage, muscles, or tendons, exert pressure on a nerve. Nerves are particularly vulnerable in areas where they travel through narrow spaces with minimal protective soft tissue.
Common areas for pinched nerves include the neck (cervical radiculopathy), lower back (lumbar radiculopathy), and wrist (carpal tunnel syndrome). Causes often involve repetitive motions, maintaining a single posture for extended periods, or injuries. Conditions like a herniated disk, where the soft cushion between vertebrae presses on a nerve root, or bone spurs, which are bony overgrowths, can also lead to nerve compression.
When a Pinched Nerve Becomes Serious
While many pinched nerves improve on their own, certain signs indicate a more serious condition requiring prompt medical attention. A sudden onset of severe pain, especially following trauma, or pain that rapidly worsens, becomes debilitating, or does not improve with rest, warrants immediate evaluation.
A key sign is new or rapidly progressing weakness in a limb, such as difficulty gripping objects or lifting an arm or leg, which can signal substantial nerve damage. Cauda equina syndrome is another serious condition, occurring when the bundle of nerves at the base of the spinal cord becomes compressed. Its symptoms include severe lower back pain, weakness or numbness in both legs, loss of sensation in the “saddle region” (buttocks, inner thighs, and genital area), and changes in bladder or bowel control (e.g., difficulty urinating, urinary retention, or incontinence). These symptoms require emergency medical care to prevent permanent damage.
Long-Term Risks of Untreated Pinched Nerves
Ignoring a pinched nerve can lead to lasting issues. If pressure on a nerve continues, it can result in chronic pain that persists even after the initial cause of compression is resolved, affecting daily life.
Prolonged compression can also cause permanent nerve damage. This damage may manifest as persistent numbness, a reduced sense of feeling, or tingling sensations in the affected area. Over time, the protective layer around the nerves, called the myelin sheath, can deteriorate, further compromising nerve function.
Muscle weakness is another long-term risk. If the nerve responsible for controlling a muscle remains compressed, the muscle may not receive proper signals from the brain, leading to muscle atrophy, where the muscle wastes away. These issues can result in functional limitations, impacting a person’s ability to perform routine activities and reducing mobility and strength.
Getting a Diagnosis and Treatment
A healthcare professional begins the diagnostic process for a pinched nerve with a thorough physical examination and a review of medical history. They will assess muscle strength, reflexes, and sensation to pinpoint the affected nerve. To confirm a diagnosis and identify the source of compression, various imaging and nerve tests may be used. These can include X-rays to visualize bone changes, MRI or CT scans to show soft tissues like disks and ligaments, and nerve conduction studies or electromyography (EMG) to measure nerve electrical activity and muscle response.
Treatment often begins with conservative methods. These include rest, sometimes with a splint or brace, and over-the-counter pain relievers or NSAIDs to manage pain and inflammation. Physical therapy, with exercises to strengthen and stretch muscles, can also relieve nerve pressure.
If conservative treatments are ineffective, a healthcare provider may consider corticosteroid injections or nerve pain medications. For severe, persistent symptoms, or progressive weakness/nerve damage, surgical intervention may be considered to relieve pressure. Surgical options vary by nerve location and cause, and can involve removing bone spurs or parts of a herniated disk.