Working out with a pinched nerve demands careful consideration because the condition is a nerve that is compressed by surrounding tissues, such as bone, cartilage, muscle, or tendon. This compression leads to a range of symptoms. While the idea of continued exercise is often appealing, the decision to work out is highly conditional and requires extreme caution to avoid further injury. Movement can be therapeutic, but only if it does not aggravate the underlying nerve compression or introduce new neurological symptoms.
Understanding the Mechanics of a Pinched Nerve
A pinched nerve, medically known as radiculopathy when it involves a spinal nerve root, occurs when pressure is placed on the nerve. Common causes include a herniated disc, which pushes its soft interior material out to compress a nerve root, or bone spurs (osteophytes) that form as a result of osteoarthritis. The location of the compression dictates the symptoms and the medical term, such as cervical radiculopathy in the neck or lumbar radiculopathy in the lower back. This mechanical pressure interferes with the nerve’s ability to transmit signals, resulting in pain, numbness, tingling, or muscle weakness that often radiates along the nerve’s pathway, such as sciatica traveling down the leg.
Immediate Exercise Restrictions and Warning Signs
Continuing exercise is strictly prohibited when certain neurological warning signs are present, as these symptoms indicate potentially serious nerve damage. A sharp, shooting pain that radiates further down a limb during or immediately after a movement is a clear signal to stop the activity immediately. Any sudden or progressive loss of muscle strength, such as difficulty lifting the foot (foot drop) or a noticeable reduction in grip strength, requires immediate medical consultation. Furthermore, any change in bowel or bladder function, which is a rare but severe sign, must be treated as a medical emergency. Exercise should only be considered if the pain is mild, non-radiating, and does not involve these neurological deficits.
Safe Movement Strategies and Modifications
For minor, manageable symptoms, modifying the workout routine can allow for continued movement without exacerbating nerve compression. Movement should focus on low-impact aerobic activities that do not jar the spine. Options like walking, swimming, or cycling are generally well-tolerated because they increase blood flow. Heavy lifting, especially exercises that compress the spine axially, such as back squats or deadlifts, should be avoided entirely. Movements that involve twisting the torso or spine, like kettlebell swings or certain yoga poses, can also aggravate a pinched nerve and should be eliminated. When performing any exercise, maintaining a neutral spine and reducing the range of motion can prevent further nerve irritation. If using weights, the intensity must be significantly reduced to focus on stability and endurance rather than maximal strength. Any exercise that causes the pain to worsen, even slightly, must be stopped immediately and replaced with a different movement.
The Role of Targeted Physical Therapy
While general exercise modifications can help manage symptoms, professional rehabilitation through physical therapy offers a targeted approach to address the underlying cause of the nerve compression. A physical therapist conducts a comprehensive assessment to pinpoint the specific structures contributing to the pinched nerve. Therapy often focuses on strengthening the muscles that stabilize the spine and joints, which helps to reduce pressure on the vulnerable nerve roots. Techniques like manual therapy, joint mobilization, and therapeutic exercises are used to reduce inflammation and release tension in surrounding soft tissues. Patients are also taught nerve gliding exercises, which help the nerve move freely through its pathway, and are educated on proper posture and body mechanics to prevent future episodes.