Pinched Nerve in the Back and Neck
A Pinched nerve is the term for pain or impaired function of a nerve that is under pressure. It happens to nerves that control muscle movements or relay sensations to the brain.
Symptoms of a pinched nerve:
- Burning sensation or shooting pains down the buttocks and legs or in the neck, shoulders, arms and fingers.
Sometimes the pains and sensations are distant from the point of pressure. For instance, a pinched nerve in the low back may cause pain in the calf as the only symptom. There can be nerve damage due to the constant pressure on the nerve, causing increased weakness. There may be a loss of reflexes, movement skills, sensation in the affected area, and withering (atrophy) of the affected muscles can occur.
A nerve can be pinched as it leaves the neck or the back by a herniated disc or by bone spurs that form from spinal arthritis.
When one has a pinched nerve in the low back, pain is usually perceived as radiating down the leg. When one has a pinched nerve in the neck, pain starts from the neck, through the shoulders, down the arms and into the hands. Pinched nerves can also cause muscle spasms in the back, along with weakness in the arm and leg. The two most common pinched nerves in the lower back are L5 (lumbar 5) and S1 (sacral 1).
What is a nerve?
Nerves are extensions from the brain that reach out into the arms or legs to go to the muscles or skin. A nerve is a cell that is microscopic in size, and its fibers may run several feet in length toward its destination. Central nerves are those that live in the brain or within the spinal cord. Peripheral nerves are nerves that leave the spine to go into the arms. These peripheral nerves are actually bundles of millions of nerve fibers that leave the spinal cord and branch to their target muscles to make them move or go to the skin to provide feeling.
When there is a “pinched nerve”, there is a reduction in the flow up and down of nutrients and signals to the brain and spinal cord. When membranes loose their health, their ability to transmit the tiny electrical charges is reduced and nerve fibers stop working. When enough fibers stop working, the skin may feel numbness or a muscle may not contract.
Causes of a Pinched Nerve
Common causes of pinched nerves in the spine include:
- Herniated discs
- Bulging discs
- Desgenerative disc disease
- Compression of a nerve at the elbow or wrist
- Bone spurs
- Job Injury
- Prolonged cramped position
Pinched nerves in the lumbar region:
Pinched nerve at L5 - The L5 nerve supplies the nerves to the muscles that Read real testimonials from real patients raise the foot and big toe, and consequently, impingement of this nerve may lead to weakness in these muscles. Numbness for L5 runs over the top of the foot. Pain will be in the lower back running to the hip, down the lateral part of your thigh and calf and to the top of the foot.
Pinched nerve at S1 - Impingement of the S1 nerve can lead to weakness with the large gastronemius muscle in the back of the calf, causing difficulty with foot push off. Numbness for the S1 nerve runs on the outside of the foot. Pain will be in the lower back running to the buttocks, down the back of the thigh and calf to the lateral aspect of the foot (to the little toe).
Pinched nerves at L3, L4 and L5 - The sciatic nerve is the largest nerve in the body. It starts in the low back at lumbar segment 3 (L3). The sciatic nerve roots run through the bony canal, and at each level in the lower back a pair of nerve roots exits from the spine. The nerve is named for the upper vertebral body that it runs between (for example, the nerve that exits at L4-L5 is named L4). The nerve passing to the next level runs over a weak spot in the disc space, which is the reason discs tend to herniate (extrude) right under the sciatic nerve root and can cause sciatica. The sciatica symptoms (low back pain, leg pain, numbness, tingling, weakness) are different depending on where the pressure on the nerve occurs. For example, a lumbar segment 5 (L5) nerve impingement can cause weakness in extension of the big toe and potentially in the ankle (foot drop).
Pinched nerves in the cervical region:
Pinched nerve at C5 - This can cause shoulder pain, deltoid weakness, and possibly a small area of numbness in the shoulder. On physical exam, a patient's biceps reflex may be diminished.
Pinched nerve at C6 - This can cause weakness in the biceps and wrist extensors, and pain/numbness that runs down the arm to the thumb. On physical exam, the brachioradialis reflex (mid-forearm) may be diminished.
Pinched nerve at C7 - This can cause pain/numbness that runs down the arm to the middle finger. On physical exam, the triceps reflex may be diminished.
Pinched nerve at C8 - This can cause hand dysfunction (this nerve supplies innervation to the small muscles of the hand). Pain/numbness can run to the outside of the hand (little finger) and impair its reflex.
Treatment of Pinched Nerve
Recommended treatment is generally open back surgery, with high risks, hospital stays and lengthy recuperation time.
Our clinic offers minimally invasive, outpatient surgery, laser-assisted, that can correct the causes of a pinched nerve and leave the patient free of the painful symptoms. These procedures are called Percutaneous Arthroscopic Discectomy, Foraminotomy or Laminotomy.
These laser spine procedures remove the portion of the extruding or herniated disc that is pressing against a nerve causing the sometimes painful symptoms. By removing or shrinking the disc or disc material that is causing the nerve to be impinged with the laser we can decompress the spinal cord or nerve root that is being impinged. At this point excess disc material is removed and the symptoms of a pinched nerve generally disappear.
Once the procedure is complete, the patient (with a companion) is free to go after 1 - 2 hours of monitoring. We generally encourage patients to take a long walk the afternoon or evening of their procedure. The patient then returns the following day for a post-operative visit to get clearance from the doctor to return home.
Endoscopic Arthroscopic Micro Laser Spine Surgery Our clinic provides minimally invasive procedures to combat spinal and nerve conditions, often times the cause of neck and back pain. Treatment options include Foraminotomy, Percutaneous Discectomy, Facet Thermal Ablation and Fusion Alternatives. These procedures are offered to treat such spinal conditions as back pain, herniated discs, bulging discs, degenerative disc disease, arthritis of the spine, bone spurs, pinched nerves, scar tissue formation, foraminal stenosis, spinal stenosis, facet disease and sciatica.
Dr. P. Richard Emmanuel, M.D and his team of experienced and friendly medical professionals, are well trained in spinal disorders and work hard to ensure a quick recovery for patients. After-surgery options include physical therapy sessions to help minimize the recuperation period.