Pinched nerve

Diagnosis

To diagnose a pinched nerve or compression on a nerve root, your healthcare professional asks about your symptoms and conducts a physical exam.

If your healthcare professional suspects a pinched nerve, you may need some tests. These tests may include:

• Blood tests. You may need tests to measure your fasting blood glucose or thyroid levels.
• Spinal tap, also known as a lumbar puncture. This test collects a sample of cerebrospinal fluid (CSF) from the area surrounding your spinal cord. The CSF may be sent to a lab and examined for signs of inflammation or infection.
• X-rays. These images show how the bones are positioned. They can reveal if there is narrowing or damage that could cause a pinched nerve.
• Nerve conduction study. This test measures electrical nerve impulses and functioning in your muscles and nerves through electrodes placed on your skin. The study measures the electrical impulses in your nerve signals when a small current passes through the nerve. Test results can show whether you have a damaged nerve.
• Electromyography (EMG). During an EMG, a needle electrode is inserted through your skin into various muscles. The test evaluates the electrical activity of your muscles when they contract and when they're at rest. Test results tell your healthcare professional if there is damage to the nerves leading to the muscles.
• Magnetic resonance imaging (MRI). This test uses a powerful magnetic field and radio waves to produce detailed views of your body in multiple planes. This test may be used if your healthcare professional suspects you have nerve root compression.
• High-resolution ultrasound. Ultrasound uses high-frequency sound waves to produce images of structures within the body. It's helpful for diagnosing nerve compression syndromes, such as carpal tunnel syndrome.

Treatment

A common treatment for a pinched nerve is to rest the affected area for a short time. Stop any activities that cause the compression or make symptoms worse.

Depending on the location of the pinched nerve, you may need a splint, collar or brace to restrict movement of the area. If you have carpal tunnel syndrome, you may need to wear a splint during the day and at night. The wrists flex and extend often during sleep.

Other treatments for a pinched nerve or pinched nerve root include:

Physical therapy

A physical therapist can teach you exercises that strengthen and stretch the muscles to relieve pressure on the nerve. The physical therapist also may recommend that you modify activities that aggravate the nerve.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), can help relieve pain. Anti-seizure medicines such as gabapentin (Neurontin, Horizant, Gralise) may help some types of nerve-related pain. Tricyclic medicines such as nortriptyline and amitriptyline also may be used for some pinched nerves.

Corticosteroids, given by mouth or by injection, may help minimize pain and inflammation.

Surgery

If symptoms don't improve after several weeks to a few months of conservative treatments, you may need surgery. Surgery can take pressure off the nerve. The type of surgery varies depending on the location of the pinched nerve or pinched nerve root.

Surgery may involve removing bone spurs or a part of a herniated disk in the spine. For carpal tunnel syndrome, surgery involves cutting the carpal ligament to allow more room for the nerve to pass through the wrist. For cubital tunnel syndrome, tarsal tunnel syndrome and ulnar tunnel syndrome, removing tissue and bone can relieve pressure on the nerve.

Preparing for your appointment

You're likely to first see your healthcare professional. Here's some information to help you get ready for your appointment and know what to expect.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance. You might ask if you need to restrict your diet or wear loose-fitting clothes if you need an imaging exam.
• Write down any symptoms you're experiencing. Include any that may not seem related to the reason for which you scheduled the appointment.
• Make a list of all medicines, vitamins or supplements that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be hard to remember all of the information provided to you during an appointment. Someone who comes with you may remember something that you missed or forgot.
• Write down questions to ask during the appointment.

Preparing a list of questions will help you make the most of your time during your appointment. For a suspected pinched nerve, some basic questions to ask include:

• What's the most likely cause of my symptoms?
• What kinds of tests do I need?
• Is my condition likely short term or long-lasting?
• What treatment do you recommend?
• Are there other treatments in addition to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage these conditions together?
• Are there any activity restrictions that I need to follow?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

In addition to the questions that you've prepared, don't hesitate to ask others during your appointment.

What to expect from your doctor

Your healthcare professional is likely to ask you several questions. They may include:

• What are your symptoms? Do you feel pain, numbness, tingling or weakness?
• Where, specifically, are you feeling these symptoms?
• How long have you been having these symptoms?
• Do your symptoms occur all the time or only sometimes?
• Is there an activity or a position that triggers your symptoms?
• Is there an activity or a position that relieves your symptoms?
• Do you have a job or hobby that requires you to make the same motions over and over?