Pinched Nerve

Diagnosis

To identify a pinched nerve, your doctor will inquire about your symptoms and perform a physical examination.

If a pinched nerve is suspected, further tests may be required, which could include:

• Blood tests. Tests to check your thyroid function or fasting blood glucose may be necessary.
• The lumbar puncture, also referred to as a spinal tap. Cerebrospinal fluid (CSF) is taken from the region around your spinal cord during this test. A lab may get the CSF to check for infection or inflammation.
• Radiology images. The positions of the bones are displayed in these photos. They can show whether there is injury or narrowing that might result in a pinched nerve.
• Nerve conduction study. Using electrodes applied to your skin, this test assesses the electrical nerve impulses and functionality in your muscles and nerves. Your nerve signals’ electrical impulses are measured in the study when a tiny current flows through the nerve. Test findings can indicate whether you have nerve damage.
• Electromyography (EMG) is one. An electrode needle is placed under your skin into many different muscles to record an EMG. Your muscles’ electrical activity during contractions and at rest is assessed by this test. The findings of the tests indicate to your healthcare provider whether there is injury to the nerves that supply the muscles.
• Computed tomography (CT) scan. A CT scan provides three-dimensional images and offers greater detail of the spine compared to an X-ray. (2)
• Magnetic resonance imaging (MRI). This test creates precise pictures of your body in various planes using radio waves and a strong magnetic field. If a medical expert believes you may have nerve root compression, they may use this test.
• Ultrasound with high resolution. High-frequency sound waves are used in ultrasound to create images of the body’s internal structures. It is useful in the diagnosis of carpal tunnel syndrome and other conditions involving nerve compression.

Treatment

Resting the affected area is typically the initial treatment suggestion for a pinched nerve. It’s important to avoid activities that worsen compression or aggravate symptoms. Depending on the nerve’s location, immobilization with a splint, collar, or brace may be necessary. For example, individuals with carpal tunnel syndrome might need to wear a splint both day and night since wrist movement commonly happens during sleep. 

Physical therapy

A physical therapist can instruct you in exercises designed to strengthen and stretch muscles, thereby alleviating pressure on the nerve. Additionally, they may suggest modifications to activities that exacerbate nerve irritation. 

Medications

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen or naproxen sodium are effective in alleviating pain associated with a pinched nerve. Additionally, anti-seizure medications such as gabapentin can help manage nerve-related pain. Tricyclic antidepressants like nortriptyline and amitriptyline are also utilized for pain relief. Corticosteroids, administered orally or via injection, may aid in reducing both pain and inflammation. 

Surgery

If symptoms persist despite several weeks to a few months of conservative treatments, surgery may be necessary. Surgery aims to alleviate pressure on the nerve, and the specific type of procedure depends on the location of the pinched nerve.

Surgical interventions may entail the removal of bone spurs or a portion of a herniated disk in the spine. In cases of carpal tunnel syndrome, surgery involves cutting the carpal ligament to create additional space for the nerve to pass through the wrist.