In a Pinch

Q: What is a pinched nerve? I've been experiencing a stiff neck for the past two days and it’s getting quite bothersome. It is very painful and I can't move my head.

A: When a nerve, or group of nerves, gets “pinched,” it means it’s being stretched, compressed, constricted or irritated by the bones, muscles, tendons or ligaments around it. This pinching can trigger a cascade of symptoms: pain, muscle spasm, tingling or numbness. Fortunately, most people find relief with rest, moist heat to afflicted area and physical therapy.

Our nervous system intertwines throughout our bodies. These nerves transmit signals and messages from one part of the body to another. Depending upon the type of nerve, their vital information may help you feel that a burner’s hot, see a beautiful sunset, or talk with a loved one.

If something interferes with a nerve’s ability to send messages, say, an inflammation or injury, you’ll feel it. In your case, a cervical (neck) nerve sounds like it is being pinched as it leaves your spine, causing it to send conflicting information to your neck muscles. As a result, you have a painful stiff neck.

Factors that may increase the risk for a pinched nerve include:

• A change in structure from a broken bone or osteoarthritis.
• A change in location of a body tissue, such as a herniated disc or tumor.
• Repetitive motion or vibration injuries, such as carpel tunnel syndrome or jack-hammer use.
• Uncomfortable body position and poor posture.
• Compression injury, from a cast or improper use of crutches, for example.
• Heredity; susceptibility to pinched nerves may run in families.
• Obesity.

Symptoms that a nerve is pinched or irritated may range from subtle to severe. They can last minutes, weeks or even longer. Typical symptoms are:

• A feeling that the arm, hand, foot or leg has fallen asleep.
• Tingling or numbness.
• Burning or stabbing, as in feeling pins and needles.
• Referred or shooting pain over a broad area, such as in the buttocks and down the leg.
• Muscle weakness or twitching.

Fortunately, as previously mentioned, many people with a pinched nerve can find relief via common-sense measures: Moist heat, change in activity or body position (corrected ergonomic positions at work), enhanced muscle strength, better posture, and improved flexibility through formal exercise programs such as gentle versions of Pilates or yoga. If these conservative measures don’t work, or if the pain or other symptoms get worse, it is very important to have a complete medical evaluation.

During your doctor’s visit you’ll be asked how long you have had the symptoms, if you remember what triggered them, what positions make them better, which positions and movements make them worse. Additionally, your muscle strength, range of motion, reflexes as well as ability to sense both soft and deep sensations will be tested. If after this time your physician suspects a pinched nerve, further diagnostic testing such as electromyography (tests for any damage to the nerves leading to the muscles) and a magnetic resonance imaging test, an MRI, may be advised.

Traditional treatments for many pinched nerves include but aren't limited to: anti-inflammatory medications, osteopathic manipulative therapy, physical therapy, chiropractic care and massage, in addition to the previously mentioned common-sense measures. If there is little or no improvement after several months of treatments, surgery may be considered to alleviate the pain.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)