What is a “pinched nerve”?
A “pinched nerve” is a lay expression for a couple of types of medical conditions.
More commonly, it refers to the compression and irritation of the nerve root(s) as they exit the spine, in medical terms known as a radiculopathy, derived from the Latin word radix, meaning “root,” and the Greek word patheia, meaning “suffering.”
On the other hand, if a nerve is compressed and irritated on route into a muscle or peripheral tissue, it may be known as an entrapment peripheral neuropathy. Sometimes an ultrasound examination may be done to confirm the presence of a peripherally compressed nerve.
As these are fairly common clinical presentations, the following is an overview of cervical and lumbar radiculopathies.
Symptoms of a radiculopathy
As the irritation tends to confine to one or few nerve roots, the radicular pain tends to narrow in distribution and exhibit a more predictable pattern, whereas a referred pain (such as that in a heart attack) tends to have a wide, vague and non-dermatomal distribution.
There may also be paraesthesia (pins and needles, and is often described to have an electric nature), and typically weakness or muscle loss (motor deficits), e.g. see pictures below, loss or reduction of sensation (sensory deficits), and reduced reflexes (hyporeflexia).
Treatment
Treatment options may include mechanical traction to relieve the compression, spinal manipulative therapy to mobilise stiff adjacent joints acupuncture or electrostimulation (e.g. TENS) for pain relief, medications, sometimes injections, and only rarely in severe and rapidly progressive cases, would surgery be a consideration. Fortunately, most radiculopathies subside over time.
