A so-called pinched nerve can take a variety of forms. Equally varied are the backgrounds from which a pinched nerve can result.
What is a pinched nerve?
Typically, the pain associated with a pinched nerve is sharp or burning; in addition, such pain may be accompanied by numbness or profuse sweating. A pinched nerve manifests itself in many sufferers, especially in the area of the shoulder, back or neck. The term pinched nerve is used colloquially, but also by physicians, for various complaints:
These include nerve irritation or irritation of adjacent muscles as well as inflammatory processes of the nerves. In this context, a pinched nerve in the shoulder, neck and back area is usually accompanied by very severe back pain. Typically, the pain associated with a pinched nerve is sharp or burning; in addition, such pain may be accompanied by numbness or profuse sweating (in some cases, these complaints may occur without accompanying pain). It is estimated that, in the German population, a pinched nerve manifests itself in an average of one in three residents during their lifetime.
Causes
A pinched nerve can have a variety of causes; in most cases, a pinched nerve is the result of a long-term process of poor posture or unbalanced stress. Such incorrect postures or one-sided stresses can, for example, be the result of many years of overhead work (as is the case with painters and varnishers, among others) or even years of working at a PC. A pinched nerve can also be caused by carrying or incorrectly lifting heavy loads; and a pinched nerve can also follow unfavorable movement sequences during sports. A pinched nerve can also be caused by strains, tension or misalignments that occur during sleep. Finally, injuries, such as whiplash or fractures (broken bones), as well as signs of wear and tear or dysfunction of the spine, among others, can also follow a pinched nerve.
Diseases with this symptom
- Whiplash
- Nasal fracture
- Metacarpal fracture
- Base of skull fracture
- External ankle fracture
- Radius fracture (fracture of the radius)
- Elbow fracture
- Finger fracture
- Ankle fracture
- Jones fracture
- Femoral neck fracture
- Cervical spine fracture
- Jaw fracture
- Tibial plateau fracture
- Humeral head fracture
Typical symptoms and signs
- Severe pain in the area of the neck and throat.
- Severe back pain
- Tension in the muscles of the back
- Reflex attenuation
- Chest pain
- Headache
- Stiffness of movement
Diagnosis and course
The pain and discomfort (among other things, this may be limitations of movement) that a pinched nerve brings, in most cases, starts suddenly. The nature and occurrence of this pain may initially lead to a tentative diagnosis. Whether a pinched nerve is present can then be tested, for example, by measuring the nerve conduction velocity; this allows a statement to be made about a functional restriction of the nerve. So-called imaging procedures, such as sonography or computer tomography, can clarify, for example, a deformation of a nerve that a pinched nerve may exhibit. The course that a pinched nerve takes varies from person to person, depending on the cause and the effectiveness of therapy, among other factors. The cooperation of the affected person in a treatment also usually has a positive effect.
Complications
If a nerve is pinched, severe complications occur in many cases. There is almost always severe pain and numbness in the affected region of the body, accompanied by motor restrictions and insensations. If sensitive nerves are affected, there is an unpleasant tingling sensation in the entire supply area around the pinched nerve. This must be treated promptly, otherwise the restrictions will result in muscle atrophy, unnatural movements and other complications.Later, the complaints then spread to other parts of the body and the symptoms increase. If the pinched nerve occurs as a result of a metabolic disease, such as the case with swelling of the tendon sheaths during pregnancy and menopause, the complications can sometimes be very different. Not infrequently, complications occur as a result of surgical intervention. If the pinched nerve is not completely freed, secondary bleeding, excessive scarring or wound infection of the nerves may occur. Injuries to adjacent nerves, usually caused by the surgery itself, are also a risk factor. Following the operation, numbness may also occur in the area around the freed nerve, although this should subside after a few hours to days. Complications such as muscle atrophy and other limitations of the affected body parts do not always completely resolve, even after surgery.
When should you see a doctor?
In the case of disturbances of well-being or even pain, a medical layman does not always know the cause. It is a mystery to him where the numbness in the arm comes from or the pulling in the back. Is it due to sports? Did he exert himself too much the other day while gardening? Many people don’t think about the real reason – a scheduled nerve – when they experience such complaints. They often wait to see if the discomfort goes away on its own. If it doesn’t, most people go to the doctor, often after just a few days. It is right to consult a doctor as soon as possible in the case of unexplained physical sensations such as pain, numbness, tingling, pulling, but also, for example, unexplained sweating, if the symptoms do not subside within a few days. A pinched nerve may be behind these complaints. Waiting too long to see a doctor can cause irreparable damage to the pinched nerve. The family doctor is the ideal first point of contact. In his anamnesis he will include a pinched nerve as a possible cause in the diagnosis. If there are reasonable grounds for suspicion, the family doctor will arrange for a referral to a neurologist and possibly also to an orthopedist. In case of doubt, it is always better to go to the doctor. For him, there are no “too intrusive” patients.
Treatment and therapy
If there is a suspicion that a pinched nerve is present in an affected person, it is often advisable to consult a doctor who can check this suspicion and advise the patient on an individually suitable therapy. In the case of sudden onset of pain caused by a pinched nerve, the affected person can initially observe some immediate measures: For example, it may be helpful to take slow, deep breaths and initially remain in the position in which the pain occurred for a few minutes. A pinched nerve can then be treated medically in various ways: Drug therapy, for example, may include pain-relieving or anti-inflammatory agents. Physiotherapeutically, a pinched nerve can be treated in parallel, for example, with measures such as massages, gymnastic exercises or heat applications. In severe cases, a pinched nerve can be treated surgically. Therapy can be supported by the affected person through various measures: If a pinched nerve is present, a patient can, for example, avoid heavy lifting, observe a level of rest recommended by the doctor and, if possible, prevent too fast and sudden movements.
Outlook and prognosis
A pinched nerve usually resolves on its own. If the symptoms are treated promptly and adequately, there is a good chance of rapid recovery. Typical accompanying symptoms such as headache or chest pain can usually be alleviated immediately by various measures. However, if complications such as inflammation or further irritation of the pinched nerve occur during the recovery process, complete healing may take several weeks or months. The prognosis also depends on which nerve is pinched. If it is the sciatic nerve, for example, carpal tunnel syndrome may result, which can usually only be remedied by surgical intervention and physiotherapy. With pinched nerves in the cervical spine, temporary paralysis and further complications can worsen the outlook; in general, however, the prognosis is relatively good.Those affected are usually already fully recovered after a few weeks and do not have to fear any long-term consequences. If the pinched nerve is not treated or is treated inadequately, it can lead to permanent poor posture with a further worsening of the symptoms. In the long term, this also increases the risk of similar complaints. The final prognosis for a pinched nerve can only be made by the doctor in charge.
Prevention
In order for a pinched nerve to be prevented in advance, it is helpful, among other things, to avoid various risk factors; for example, a pinched nerve can be promoted by incorrect postures, carrying loads incorrectly, and lack of physical exercise. A pinched nerve can be combated preventively, for example, by interrupting or changing monotonous postures (such as when working on a PC) at regular intervals.
What you can do yourself
Everyday and self-help measures for a pinched nerve consist of trying to alleviate the causes of the compressed nerve so that some pressure relief is achieved. Heat applications to the affected area usually help. Heat, which penetrates the tissues from the outside, relaxes the muscle areas and connective tissues. If successful, heat treatment is rewarded by a lessening of pain and a return of sensation because the compressed nerve usually regenerates very quickly as compression is released. Heat application can be done with simple means such as hot water bottles or warming compresses. Heat patches, available at any pharmacy, can also provide heat that lasts for hours. In addition and parallel to the heat treatments, movement exercises without stress are recommended. The movements support the dissolution of blockades and muscle hardenings. A protective posture and the complete avoidance of movements are usually counterproductive in these cases, because the blockages do not dissolve as a result. Active relaxation, meditation and breathing exercises have a supporting effect, helping the parasympathetic nervous system to collect stress hormones of the sympathetic nervous system and to tune the metabolism for regeneration and growth. If the pinching of the nerve has no organic causes, further measures consist of targeted massage aimed at releasing the palpable muscle blockages.
