How can I tell if I have a pinched nerve?

man explains shoulder pain like a pinched nerve to physical therapist
Scott Hein 2021
PT, DPT
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“I think I have a pinched nerve.” This is something that as a physical therapist, I’ve heard many times from patients over the years. Often this is not the case, but sometimes it is. Let’s look more into what a pinched nerve really is – what it feels like, what causes it, and how to treat it.

What are the signs and symptoms of a pinched nerve?

A pinched nerve can evoke an image of something “squeezing” a nerve, causing it to be constricted and irritated. This is not necessarily what occurs, though our nerves and nerve roots (where a nerve begins as it exits the spinal cord) can become compressed. This can happen mechanically by other tissue nudging up against the root or by swelling in the area, creating an increase in pressure on the nerve tissue.

If this occurs, the compression on the nerve can cause the conduction of its electrical signals to slow along its path. This can be tested relatively easily by a physical therapist without imaging. A person with true nerve root compression will present in our clinics with specific muscle weakness, a change in reflex testing and/or sensation deficits.

More commonly people will experience an “irritated” nerve than they do a “pinched” or compressed nerve. 

An irritated nerve or nerve root can feel much the same as a compressed nerve because pain, numbness and tingling can be present. However, with testing in the clinic, these people will have normal muscle strength and reflexes and often will have normal sensation. Even when a person “feels” numb, they may not have true loss of sensation with testing.

physical therapist test arm and shoulder strength of a patient

Whether someone is dealing with an irritated or compressed nerve root, the problem often occurs at the neck and the lower back. With this condition, back pain and neck pain may be present, but this is not necessarily the person’s main complaint.

If present at the neck, then a person will often feel shoulder or shoulder blade pain, arm pain, and at times numbness/tingling at the arm and hand. 

If present at the back, symptoms can include hip pain/leg pain and numbness/tingling at the leg and foot. 

How long does a pinched nerve last?

Irritated, compressed, or injured nerves will often take between 6-12 weeks to calm down and heal on their own. This occurs when the “angry” nerve that is responsible for sending the brain an agitated, sensitive signal will usually “fizzle out” after this amount of time. 

Physicians may prescribe medication to ease inflammation and pain during this period. There are exceptions where the nerve tissue can remain sensitive for much longer or worsen in the initial weeks of symptoms to the point that a person will benefit from surgery.

What is the best treatment for a pinched nerve?

Physical therapy is a common “first line” treatment for an irritated or compressed nerve. Nerves need movement, blood flow and physical space from other tissues to be healthy. PTs will evaluate the state of a person’s nerve conduction as well as the ability for that person’s nerves to move through other tissue.

physical therapist evaluates a patient for low back pain

If there are deficits present, then treatment will often include teaching a person how to position, remain active and exercise in ways that promote the movement and circulation that nerves need, while also trying to lessen pressure on the effected nerve.

Teaching postural changes and specific exercises to “glide and slide” a nerve gently through the body to promote health to the nerve can be helpful while time helps it run its course and heal. There is not one perfect exercise for compressed or irritated nerves at the neck or back, because each case is unique. A thorough examination at the initial PT visit will allow a therapist to guide the person to the best exercises for them.

So, if you think you or someone you know is suffering from pain or other problems related to a “pinched nerve,” then consider scheduling an appointment with your local Therapeutic Associates Physical Therapy clinic asap. Your PT can partner with you to make the best decision for the treatment of the problem and can help explain what is happening, how long it should take to recover, and what can be done to treat it.

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