Albuquerque Neck and Back Pain Treatment - Pinched Nerve PainIn order to feel pain, nerves are used to transmit information from your body to your brain. There is a complex network of many different types of nerves that transmit information to your brain. The specialized nerves that deal directly with pain are called nociceptors. These nerves carry the pain signal from the location of injury such as hand, leg, or back to the spinal cord and then to the brain. These nerves are sensitive to tissue injury, inflammation, mechanical strain, burns, or a stimulus that if prolonged would result in damage to the body. Once they are stimulated, they transmit a signal to the spinal cord where there are multiple ways the signal can be altered, eventually propagating to the brain where the awareness of pain is processed. If a nerve is pinched, injured, or damaged along its path, it sends out a signal alerting the body of the issue.
Causes of Pinched Nerves
The most common cause of a pinched nerve is by “compression”. Compression of a nerve usually happens from a disc in the spine (neck, mid back, or low back) bulges and places pressure on the nerve next to it. Discs can be injured from repetitive motions, injuries, wear and tear, or lifting something that is heavy. Discs can weaken, tear, and bulge or herniate resulting in direct contact and pressure on an adjacent nerve. Nerves can also be injured outside of the spine and are most vulnerable at places in your body where they travel through narrow spaces, where there is a lack of soft tissue for protection, or where they contact a bone, ligament, or tendon. A common example of this would be a condition called carpal tunnel syndrome where the median nerve is compressed in the wrist causing hand numbness and pain.
Nerves are sensitive structures and are susceptible to injury. It is important not to ignore symptoms of numbness, tingling, or weakness as with prolonged compression, a nerve can be permanently damaged. Some of the common concerning symptoms of compressed nerves are weakness, "Pins and needles" or a burning sensation, pain in the neck or low back, radiating pain, numbness and/or tingling.
Treatment for Pinched nerves and Back Pain
Treatment of pinched nerves usually requires a good understanding of what is causing the nerve to be irritated. There are not only discs and nerves in the back, there are also joints called facet joints. The holes that the nerves exit the spine and go out to the leg or arm can be compressed by a disc but also by arthritic changes in the joint, thickening of ligaments, and postural changes.
Epidural Steroid Injection - One of the mainstays of treatment for pinched nerves is an epidural steroid injection. In this procedure, a small needle is inserted close to the spine where the nerve is getting compressed and a local pain killer or an anesthetic mixed with a steroid is administered over the affected area. The anesthetic helps break the pain cycle and muscle spasms while the steroid helps block the inflammatory response from the compression. By stopping the inflammation, the amount of stimulus to the pain fibers decreases, and our Albuquerque pinched nerve and disc treatment allows the patient time to engage in a rehabilitation program.
It is important to treat the other causes of compression while the pain is decreased. If posture, arthritis, ligament laxity, or certain activities are making the compression worse, post injection is the time to address these.
Other Modalities – There are a lot of modalities that can be used to help treat the overall condition that has lead to a pinched nerve such as strengthening, stretching, traction, spinal manipulation if appropriate, massage, and range of motion.
It these treatments are not sufficient; care can be escalated to minimally invasive or more aggressive surgery vs spinal cord stimulator trials to see if this helps.