Why Pinched Nerves Cause Back and Neck Pain
People commonly talk about having a pinched nerve, but what is a pinched nerve? To help answer the question, it is important to understand a little about the spinal cord and the types of nerves that can be pinched.
Brain to the Spinal Cord and Beyond
Nerves extend from the brain into the arms and legs to send messages to the muscles or skin. A nerve that leaves the spine to go into the arms or legs is called a peripheral nerve. Peripheral nerves are bundles of millions of nerve fibers that leave the spinal cord and branch outward to other parts of the body such as muscles and skin. For example, these nerves make muscles move and enable skin sensation (feeling).
Nerves Carry Signals Throughout the Body
A peripheral nerve is like a fiber-optic cable, with many fibers encased in an outer sheath. You can think of each individual fiber as a microscopic garden hose. The green part of the hose is a fine membrane where a static electrical charge can travel to or from the brain. The inside of the hose transports fluid from the nerve cell body that helps nourish and replenish the ever-changing components of the green part, or membrane.
If the nerve is pinched, the flow up and down the inside of the hose is reduced or blocked, meaning nutrients stop flowing. Eventually, the membrane starts to lose its healthy ability to transmit tiny electrical charges and the nerve fiber may eventually die. When enough fibers stop working, a muscle may not contract and skin may feel numb.
A nerve can be pinched as it leaves the spine by a herniated disc or bone spurs that form from spinal arthritis. Another common place for pinched nerves is the carpal tunnel. This is a bottleneck area, through which all the finger flexor tendons and the median nerve must pass to the hand. Regardless of where the nerve is pinched, in the neck or carpal tunnel, the patient often will feel similar symptoms of numbness in the hand, because the brain does not know how to tell the difference between the beginning, middle, or end of a nerve. It only knows that it is not receiving signals from the hand, and so numbness begins.
A pinched nerve in the low back usually is perceived as radiating down the leg. Here again, the symptoms the person experiences seem to be traveling into the leg along the usual path. This is the basis of referred pain.
Muscle spasm in the back commonly accompanies pinched nerves and can be quite painful.
Sometimes, nerves can be pinched and the only symptoms may be numbness and weakness in the arm or leg without pain. Other symptoms include tingling, burning, electric, and a hot/cold sensation.
If you just woke up with something that feels like a pinched nerve—or if you seem to have developed that pain over the course of the day—you do have some self-care options.
The pain may be coming from a muscle spasm or strain that's putting pressure on the nerve, so you can try relaxing your muscles. Try, for example:
- alternating between heat and ice on the affected area: switch between them every 20 minutes, and remember to wrap the heat and ice packs in a towel before putting them on your skin.
- taking a hot shower
- laying down with a rolled up towel under your neck
- using a handheld massager
- getting a massage
Although you may not feel like it, you may want to try simply keeping your body and joints moving to find relief from a pinched nerve pain. You can:
- do general range of motion stretches and movements: if your neck has the pinched nerve, you can do some simple neck rolls. As you stretch the affected area, your body will release endorphins in response to the movement. Those endorphins can give pain relief.
- take a light stroll: this is especially good if your low back is hurting you.
- lay on a bed/couch and pull your knees up towards your chest: this is especially good if your low back is hurting you.
Another self-care option is to take an over-the-counter anti-inflammatory, such as Aleve or Advil.
If your pain persists more than a couple of days, make an appointment to see your doctor. See the article When to Call a Doctor for a Pinched Nerve for other signs of when you should get help.
After more specifically diagnosing the cause of your pinched nerve, your doctor will be able to develop a treatment plan. This plan may include:
- physical therapy
- cortisone injections
Very few patients end up needing surgery for pinched nerves; for most of them, non-surgical treatments work to relieve their pain.