Surgical Treatments for Pinched Nerves
A pinched nerve (radiculopathy) occurs when too much pressure is applied to a given nerve. This is generally caused by surrounding tissues, such as cartilage, muscles, bones, or tendons. This pressure can stop the nerve from functioning properly. Furthermore, people with this condition often feel pain, tingling, numbness or weakness.
This condition can occur in the body at a variety of different spots. For example, a herniated disc can cause lumbar radiculopathy (or sciatica) that radiates pain down the back of the leg. In some cases, a pinched nerve in the wrist can affect the hands and fingers (known as Carpal Tunnel Syndrome, or CTS).
The recovery period for pinched nerves is normally a few days or weeks provided that conservative treatment is given. It is important that patients with pinched nerves get plenty of rest, especially those who need surgery.
Conditions that can cause a pinched nerve
If pinched nerve symptoms are affecting daily functioning, it is important to see a physician. A doctor can provide an exam to find out if a degenerative condition is the cause. Some of the possible culprits are:
- Ruptured or Bulging Discs: These can apply pressure to nearby nerves.
- Spinal Stenosis: Narrowing of the spaces within the spine.
- Spinal Osteoarthritis: The cartilage breakdown of discs and joints in the lower back and neck.
- Facet Disease: A form of degenerative arthritis that affects the facet joints.
- Spondylolisthesis: Occurs when the spine loses structure due to weakening from stress fractures and cracks.
- Foraminal Stenosis: Narrowing of cervical disc space from joint enlargement.
Other possible causes
In the case of (CTS), the tissues surrounding the nerve are responsible for the compression. This form of the condition is not related to the spine at all. There are numerous reasons a tissue may compress and put pressure on the nerves, such as:
- Bone Spurs: Injuries or conditions such as osteoarthritis can cause bone spurs. The spine can also become stiffened by calcification. This narrows the spaces through which the nerves can travel.
- Sex: Women are more likely to develop (CTS) than men. This is likely because women have smaller carpal tunnels.
- Thyroid Disease: Patients with this condition are more likely to develop (CTS).
- Rheumatoid Arthritis (RA): Inflammation from (RA) can cause nerve compression. This is especially true in the joints.
- Prolonged Bed Rest: Lying down for long periods of time can increase the chance of developing a pinched nerve.
- Overuse: Tasks that require repetitive movements can also lead to nerve compression.
- Pregnancy: Weight and water gain from pregnancy can cause swelling of the nerve pathways.
- Diabetes: Patients with diabetes are more likely to develop a pinched nerve.
There is usually no permanent damage if a patient’s nerve is pinched for a short amount of time. Relief from the nerve pressure will allow the nerve to regain its function. That being said, if the condition is left unchecked and the pressure continues, permanent nerve damage can occur.
Symptoms of Pinched Nerves
Nerve compression in the spine can lead to symptoms in other parts of the body. These symptoms include numbness, pain, tingling, and muscle weakness in seemingly random places. The affected spinal region determines the location of these symptoms.
In the cervical spine, symptoms travel to the neck, upper back, shoulders, and arms. The thoracic region affects the middle back, torso, ribs, and internal organs. Lastly, a pinched nerve in the lumbar spine will cause symptoms in the hips, lower back, legs, and buttocks.
Out of these three areas, the cervical and lumbar regions of the spine are where nerve compression is most common. This is because these areas are designed to move much more than the thoracic region, which is relatively stable.
A general list of symptoms for pinched nerves are as follows:
- Sharp, burning, or aching pain that may radiate outward
- Paresthesia (aka tingling sensations)
- Muscle weakness
- Decreased sensation or numbness
- Frequent feeling that a hand or foot has fallen asleep
Treatments for a Pinched Nerve
There are many treatment options available for pinched nerves, ranging from conservative therapies to minimally invasive surgery. Some treatments focus more on relieving pressure in the spine, whereas others conentrate on alleviating pain. Since there are many different treatment options, it is important to consult with a doctor. A doctor will be able to tell you which treatment option best suits your needs. Furthermore, the wrong treatment could potentially worsen symptoms or prove ineffective at best.
Conservative methods are generally tried before surgery. This may include:
- Anti-inflammatory OTC drugs or pain medication
- Low-impact exercises
- Physical therapy
- Limited rest
- Deep tissue massage
- Application of heat or ice
If these options do not work for you, then your doctor may recommend surgery. The following are examples with brief descriptions:
- Used to treat the narrowing of the spinal canal (this causes pinched nerves)
- One or more small incisions are made on the back near the affected area
- Muscles and ligaments are then moved carefully to the side
- Part or all of the lamina (2 thin bones that encase the spinal cord and nearby nerves) are removed
- This relieves the pressure on these structures and in turn reduces the painful symptoms
- Used to treat bulging or herniated discs
- Your surgeon will make a 1-2 inch incision on the back above the affected disc
- Endoscopic tubes and a high-resolution microscope are then used to reach the spine
- These tools allow the surgeon to treat the area with minimal damage to surrounding tissues
- Instead of being cut, muscles and ligaments are carefully lifted off the spine and are held in place with retractors
- Once the affected area is reached, part of the lamina is removed, giving the surgeon better access to the discs
- Sometimes, your surgeon will need to remove part of the facet joint for the same reason
- The doctor widens passageways to relieve pressure
- Then, the doctor removes the bulging or herniated portion of the disc by using small tubes and instruments
- Used to treat nerve compression caused by the narrowing of the foramina
- Your surgeon will make a 1-2 inch incision to the side or above the affected area
- In addition, your doctor will gently move muscles and nerves to the side
- Using magnification and small instruments, your suurgeon will remove a portion of the vertebrae
- Your doctor will also remove any protruding or herniated disc debris
- This relieves pressure on the pinched spinal nerves
- Used to treat damaged discs in the neck
- Your surgeon will make a small incision on the front of the neck
- This makes it easier to avoid damaging muscles and nerves at the back of the neck
- This also allows the surgeon to gently move tissues, organs, and vascular structures to the side
- Using specialized instruments, the surgeon removes the entirety or a portion of the damaged disc
- If foraminal narrowing or bone spurs are present at this stage, your surgeon will resolve them through widening or extraction
- After the disc is gone, the space is bridged with a prosthetic spacer filled with bone graft material
- The bone tissue may come from the patient’s hip bone, synthetic materials, or donor bone tissue
- The doctor places screws, rods, and/or plates to stabilize the spine during fusion
- After surgery, the bones will grow in and around the graft
- This promotes lasting pain relief and long-term stability
If you believe you have a pinched nerve, then contact our patient advocates today. Our board-certified, fellowship-trained spine surgeons are internationally recognized for delivering the highest standard of care. At The Advanced Spine Center, you can feel comfortable knowing that you will get the best treatment to suit your needs.