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Pinched Nerves Radiculopathy

The Rochester Regional Health Spine and Pain Center offers evaluation and treatment services for pinched nerves, or radiculopathy. Pinched nerves occur when too much pressure is applied to a nerve by surrounding tissues, and this pressure disrupts the nerve's function, causing pain, tingling, numbness, or weakness. 

Learn more about pinched nerves, common symptoms, possible causes, and how our team of expert doctors evaluates and treats this condition below. 

What are the Major Components of the Spine?

There are four major parts of the spine - the vertebrae, joints, discs, and nerves.

The vertebrae are composed of separate bones that link together to form a "tunnel" that protects the nerves and spinal cord. The lumbar vertebrae are constantly under pressure from the weight of the upper body. The wear and tear of this pressure, over time, can contribute to the development of low back pain.

Joints are the spaces between two or more bones and can be found throughout the body. They allow for different degrees of movement that change the position of the bones, since bones are too rigid to bend without damage. The joints that are located at each vertebrae provide flexibility and stability within the vertebral column. 

Made up of a fibrous outer ring called the annulus and a gelatinous inner core (nucleus), discs are located between the vertebrae and act as "shock absorbers," preventing the vertebrae from rubbing together. Discs not only function as the glue that holds the vertebrae together - they also provide flexibility within the vertebral column. Discs are often the first to show signs of wear and tear associated with the aging process, since they are constantly "squeezed" and "stretched" under the forces of the vertebrae. 

At each disc level, a pair of spinal nerves exits and passes into arms and legs. The spinal cord and the spinal nerves act as a "telephone" to allow impulses to travel to the brain - and then the arms and legs - to control sensation and movements. The spinal nerves "wire," or innervate, the body in a very precise way, and these innervations are called dermatomes. The fibers of one spinal nerve affect a specific area of the body. Therefore, a nerve that is compressed or "pinched," causes symptoms in a specific region of the body. For example, a nerve pinched at the fifth lumbar vertebrae typically produces pain at the outer part of the lower leg and foot. 

Causes of Pinched Nerves

Disc herniations occur when the outer rim (annulus) of the disc weakens or tears, causing the nucleus to push outward. When the disc herniates backward, or to the right or left, it may impinge - or pinch - on a spinal nerve and/or the spinal cord, causing symptoms in the corresponding dermatome area. This is called radiculopathy. A radiculopathy may occur spontaneously or with trauma.

Common Symptoms of Pinched Nerves

When a disc herniates and impinges a spinal nerve, it may cause pain, changes in sensation (numbness), and loss of muscle strength in the affected area. Muscle weakness and numbness are often felt in the corresponding dermatomes area. Typically, neck cervical radiculopathy causes more pain in the lower arm than in the neck area. Lumbar (lower spine) radiculopathy usually causes more pain in the leg than in the back area. 

Diagnosis of Pinched Nerves

Often, disc herniation and radiculopathy can be diagnosed on the basis of history and physical examination. Therefore, an MRI or CT scan may not be required on the initial physician visit. If, however, non-surgical treatment fails or surgery is contemplated, a diagnostic study will be required. 

Pinched Nerve Treatment

Generally, medical management is encouraged for pinched nerves before surgery is considered. Medical management includes one or more of the following:

  • Active physical therapy, simple analgesics, muscle relaxants, non-steroidal anti-inflammatory medication such as ibuprofen or naproxen, epidural blocks, or a short course of steroids
  • Time is also important - the disc fragment may shrink over 2-8 weeks, removing pressure on the nerve

Most patients with herniations and radiculopathy improve with non-surgical treatment. When surgery is needed, however, it proves quite effective. Improper post-surgical activity, poor posture, excess body weight, and genetic factors can cause relapses to occur.

To learn more or make an appointment, call (585) 723-7705.

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