Can physical therapy help individuals with a pinched nerve in the neck?
Pinched Nerve In The Neck
A pinched nerve in the neck can cause pain, numbness, and weakness that extends through the neck, shoulder, and arm. (American Academy of Orthopaedic Surgeons, 2024) Over-the-counter pain medications, resting the muscles, and gentle stretching can help. However, if you’re still in pain after a few days, see a healthcare provider. Common treatments include:
Rest
Over-the-counter (OTC) pain meds
Physical therapy
Steroid injections
Wearing a neck collar
Surgery is rarely needed, but it can provide relief if other treatments don’t help. Most of the time, a pinched nerve resolves within days or weeks.
Sharp pain that extends into the shoulder and arm.
The pain worsens, or there is a shooting sensation when turning the head.
Tingling or feeling of pins-and-needles in the fingers or hand.
Weakness in the arm, shoulder, or hand.
Numbness or loss of feeling.
Often, these symptoms occur only on one side. Some find their pain less when they lift their hand onto their head, which can relieve pressure on the nerve.
Causes
The cervical spine is the spinal cord area around the neck. It’s made up of seven vertebrae. Nerves branch off the spinal cords in the spaces between the vertebrae. Nerve compression occurs when the space between two vertebrae is reduced, putting pressure on the nerve, pinching it, and causing pain. Pinched nerves develop from age because the spinal discs between the vertebrae become compressed over time. Age causes about 70% to 80% of nerve compression. Other factors that cause pinched nerves include: (Harvard Health Publishing, 2021)
Degenerative disc disease
A herniated disc
Injuries like car accidents falls, or other trauma to the spine
Find a comfortable position and try to allow the muscles in your neck to relax and rest.
Heat or Ice
Warmth and coolness can relieve pain and inflammation.
Use a warm or cool compress for 15 minutes at a time.
Over-The-Counter Pain Medications
Pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), can help bring relief.
Treatment for Severe Symptoms
If pain doesn’t resolve within a few days, or if it is so bad that you can’t go about daily activities, it’s recommended to see a healthcare provider. They can diagnose a pinched nerve after a physical exam and may also recommend imaging, including an X-ray, CT scan, MRI, or EMG, to reveal what’s causing the symptoms. After diagnosing the condition, the healthcare provider will develop a personalized treatment plan, which may include the following (Harvard Health Publishing, 2021)
Physical Therapy
Physical therapy can help build strength and flexibility in the neck.
This is especially important if there is frequent nerve pain in the same spot.
Cervical Collar
A soft cervical collar is a brace that fits around the neck.
It supports your head so the neck muscles can relax, facilitating healing.
The collar can also keep the head from turning in painful ways.
Oral Corticosteroids
Oral steroids like prednisone can help reduce inflammation.
If inflammation or swelling in the neck puts more pressure on the nerve, they can help.
Steroid Injections
Steroid shots right into the painful tissue reduce inflammation right away.
Muscle Relaxers
These medications keep the muscles in the neck from seizing up.
As the muscles relax, this brings pain relief.
Narcotic Pain Medications
Narcotic pain medications can be used short-term by individuals who have severe pain.
A healthcare provider will inform the patient of the benefits and drawbacks of these medications, which include opiates.
Hold for 20 seconds, then return to a neutral position.
Do this five times.
Eyes to Sky
Lean your head back and look toward the sky.
Hold for 20 seconds, then return to your starting position.
Do this five times.
Side to Side
Turn your head to the right as far as possible, bringing your chin in line with your shoulder.
Hold for 20 seconds, then turn as far as possible toward the left.
Repeat four times.
Ear to Shoulder
Bring your ear down toward your shoulder.
Hold for 20 seconds, then repeat the exercise on the other side.
Alternate between the right and left, stretching each side five times.
While it’s normal for exercises to hurt from stretching the muscles, they should never hurt more than a five on a pain scale of 1 to 10. If they do, stop exercising (National Health Service, 2025)
Healing Time
Healing and recovery depend on the severity of the injury. Some individuals find that the pain from a pinched nerve goes away in days, while for others, it can last for weeks. The pain goes away and then returns. If pain doesn’t go away with the conservative treatments or lasts more than a few days, talk with a healthcare provider or return for a second visit. Rarely do individuals need surgery to bring pain relief. The healthcare provider will discuss whether surgery is the best option and what to expect regarding pain relief. (American Academy of Orthopaedic Surgeons, 2024)
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Revitalize and Rebuild with Chiropractic
References
American Academy of Orthopaedic Surgeons. OrthoInfo. (2024). Cervical radiculopathy (pinched nerve). https://orthoinfo.aaos.org/en/diseases–conditions/cervical-radiculopathy-pinched-nerve/
Harvard Health Publishing. Publishing, H. H. (2021). Treating a pinched nerve. https://www.health.harvard.edu/pain/treating-a-pinched-nerve
National Institute of Neurological Disorders and Stroke. (2025). Pinched Nerve Definition. Retrieved from https://www.ninds.nih.gov/health-information/disorders/glossary-neurological-terms#-P-
National Health Service. Service, N. H. (2025). Exercises for neck problems. https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/neck-and-back-problems-and-conditions/exercises-for-neck-problems
For individuals experiencing pelvic pain, it could be a disorder of the pudendal nerve known as pudendal neuropathy or neuralgia that leads to chronic pain. The condition can be caused by pudendal nerve entrapment, where the nerve becomes compressed or damaged. Can knowing the symptoms help healthcare providers correctly diagnose the condition and develop an effective treatment plan?
Pudendal Neuropathy
The pudendal nerve is the main nerve that serves the perineum, which is the area between the anus and the genitalia – the scrotum in men and the vulva in women. The pudendal nerve runs through the gluteus muscles/buttocks and into the perineum. It carries sensory information from the external genitalia and the skin around the anus and perineum and transmits motor/movement signals to various pelvic muscles. (Origoni, M. et al., 2014) Pudendal neuralgia, also referred to as pudendal neuropathy, is a disorder of the pudendal nerve that can lead to chronic pelvic pain.
Causes
Chronic pelvic pain from pudendal neuropathy can be caused by any of the following (Kaur J. et al., 2024)
Excessive sitting on hard surfaces, chairs, bicycle seats, etc. Bicyclists tend to develop pudendal nerve entrapment.
Trauma to the buttocks or pelvis.
Childbirth.
Diabetic neuropathy.
Bony formations that push against the pudendal nerve.
Thickening of ligaments around the pudendal nerve.
Symptoms
Pudendal nerve pain can be described as stabbing, cramping, burning, numbness, or pins and needles and can present (Kaur J. et al., 2024)
In the perineum.
In the anal region.
In men, pain in the scrotum or penis.
In women, pain in the labia or vulva.
During intercourse.
When urinating.
During a bowel movement.
When sitting and goes away after standing up.
Because the symptoms are often hard to distinguish, pudendal neuropathy can often be hard to differentiate from other types of chronic pelvic pain.
Cyclist’s Syndrome
Prolonged sitting on a bicycle seat can cause pelvic nerve compression, which can lead to chronic pelvic pain. The frequency of pudendal neuropathy (chronic pelvic pain caused by entrapment or compression of the pudendal nerve) is often referred to as Cyclist’s Syndrome. Sitting on certain bicycle seats for long periods places significant pressure on the pudendal nerve. The pressure can cause swelling around the nerve, which causes pain and, over time, can lead to nerve trauma. Nerve compression and swelling can cause pain described as burning, stinging, or pins and needles. (Durante, J. A., and Macintyre, I. G. 2010) For individuals with pudendal neuropathy caused by bicycling, symptoms can appear after prolonged biking and sometimes months or years later.
Take breaks at least 20–30 seconds after each 20 minutes of riding.
While riding, change positions frequently.
Stand up to pedal periodically.
Take time off between riding sessions and races to rest and relax the pelvic nerves. 3–10 day breaks can help in recovery. (Durante, J. A., and Macintyre, I. G. 2010)
If pelvic pain symptoms are barely starting to develop, rest and see a healthcare provider or specialist for an examination.
Seat
Use a soft, wide seat with a short nose.
Have the seat level or tilted slightly forward.
Seats with cutout holes place more pressure on the perineum.
If numbness or pain is present, try a seat without holes.
Bike Fitting
Adjust the seat height so the knee is slightly bent at the bottom of the pedal stroke.
The body’s weight should rest on the sitting bones/ischial tuberosities.
Keeping the handlebar height below the seat can reduce pressure.
The Triathlon bike’s extreme-forward position should be avoided.
A more upright posture is better.
Mountain bikes have been associated with an increased risk of erectile dysfunction than road bikes.
Shorts
Wear padded bike shorts.
Treatments
A healthcare provider may use a combination of treatments.
The neuropathy can be treated with rest if the cause is excessive sitting or cycling.
Injury Medical Chiropractic and Functional Medicine Clinic care plans and clinical services are specialized and focused on injuries and the complete recovery process. Our areas of practice include Wellness and nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, severe sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, and Functional Medicine Treatments. If the individual requires other treatment, they will be referred to a clinic or physician best suited for their condition, as Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, therapists, trainers, and premiere rehabilitation providers.
Pregnancy and Sciatica
References
Origoni, M., Leone Roberti Maggiore, U., Salvatore, S., & Candiani, M. (2014). Neurobiological mechanisms of pelvic pain. BioMed research international, 2014, 903848. https://doi.org/10.1155/2014/903848
Kaur, J., Leslie, S. W., & Singh, P. (2024). Pudendal Nerve Entrapment Syndrome. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/31334992
Durante, J. A., & Macintyre, I. G. (2010). Pudendal nerve entrapment in an Ironman athlete: a case report. The Journal of the Canadian Chiropractic Association, 54(4), 276–281.
Chiaramonte, R., Pavone, P., & Vecchio, M. (2021). Diagnosis, Rehabilitation and Preventive Strategies for Pudendal Neuropathy in Cyclists, A Systematic Review. Journal of functional morphology and kinesiology, 6(2), 42. https://doi.org/10.3390/jfmk6020042
For individuals who have exhausted all other treatment options for low back pain and nerve root compression, can laser spine surgery help alleviate nerve compression and provide long-lasting pain relief?
Laser Spine Surgery
Laser spine surgery is a minimally invasive surgical procedure that uses a laser to cut through and remove spinal structures that are compressing nerves and causing intense pain. The minimally invasive procedure often results in less pain, tissue damage, and faster recovery than more extensive surgeries.
How It Works
Minimally invasive procedures result in less scarring and damage to surrounding structures, often reducing pain symptoms and a shorter recovery time. (Stern, J. 2009) Small incisions are made to access spinal column structures. With open-back surgery, a large incision is made down the back to access the spine. The surgery differs from other surgeries in that a laser beam, rather than other surgical instruments, is used to cut structures in the spine. However, the initial incision through the skin is made with a surgical scalpel. Laser is an acronym for Light Amplification Stimulated by Emission of Radiation. A laser can generate intense heat to cut through soft tissues, especially those with a high water content, like spinal column discs. (Stern, J. 2009) For many spine surgeries, the laser cannot be used to cut through bone as it generates instant sparks that can damage surrounding structures. Rather, laser spine surgery is primarily used to perform a discectomy, which is a surgical technique that removes a portion of a bulging or herniated disc that is pushing against the surrounding nerve roots, causing nerve compression and sciatic pain. (Stern, J. 2009)
Surgical Risks
Laser spine surgery may help resolve the cause of nerve root compression, but there is an increased risk of damage to nearby structures. Associated risks include: (Brouwer, P. A. et al., 2015)
Infection
Bleeding
Blood clots
Remaining symptoms
Returning symptoms
Further nerve damage
Damage to the membrane around the spinal cord.
Need for additional surgery
A laser beam is not precise like other surgical tools and requires practiced mastery and control to avoid damage to the spinal cord and nerve roots. (Stern, J. 2009) Because lasers cannot cut through bone, other surgical instruments are often used around corners and at different angles because they are more efficient and allow greater accuracy. (Atlantic Brain and Spine, 2022)
Purpose
Laser spine surgery is performed to remove structures that are causing nerve root compression. Nerve root compression is associated with the following conditions (Cleveland Clinic. 2018)
Bulging discs
Herniated discs
Sciatica
Spinal stenosis
Spinal cord tumors
Nerve roots that are injured or damaged and constantly send chronic pain signals can be ablated with laser surgery, known as nerve ablation. The laser burns and destroys the nerve fibers. (Stern, J. 2009) Because laser spine surgery is limited in treating certain spinal disorders, most minimally invasive spine procedures do not use a laser. (Atlantic Brain and Spine. 2022)
Preparation
The surgical team will provide more detailed instructions on what to do in the days and hours before surgery. To promote optimal healing and a smooth recovery, it is recommended that the patient stay active, eat a healthy diet, and stop smoking prior to the operation. Individuals may need to stop taking certain medications to prevent excess bleeding or interaction with anesthesia during the operation. Inform the healthcare provider about all prescriptions, over-the-counter drugs, and supplements being taken.
Laser spine surgery is an outpatient procedure at a hospital or outpatient surgical center. The patient will likely go home on the same day of the operation. (Cleveland Clinic. 2018) Patients cannot drive to or from the hospital before or after their surgery, so arrange for family or friends to provide transportation. Minimizing stress and prioritizing healthy mental and emotional well-being is important to lowering inflammation and aiding recovery. The healthier the patient goes into surgery, the easier the recovery and rehabilitation will be.
Expectations
The surgery will be decided by the patient and healthcare provider and scheduled at a hospital or outpatient surgical center. Arrange for a friend or family member to drive to the surgery and home.
Before Surgery
The patient will be taken to a pre-operative room and asked to change into a gown.
The patient will undergo a brief physical examination and answer questions about medical history.
The patient lies on a hospital bed, and a nurse inserts an IV to deliver medication and fluids.
The surgical team will use the hospital bed to transport the patient in and out of the operating room.
The surgical team will assist the patient in getting onto the operating table, and the patient will be administered anesthesia.
The patient may receive general anesthesia, which will cause the patient to sleep for the surgery, or regional anesthesia, injected into the spine to numb the affected area. (Cleveland Clinic. 2018)
The surgical team will sterilize the skin where the incision will be made.
An antiseptic solution will be used to kill bacteria and prevent the risk of infection.
Once sanitized, the body will be covered with sterilized linens to keep the surgical site clean.
During Surgery
For a discectomy, the surgeon will make a small incision less than one inch in length with a scalpel along the spine to access the nerve roots.
A surgical tool called an endoscope is a camera inserted into the incision to view the spine. (Brouwer, P. A. et al., 2015)
Once the problematic disc portion causing the compression is located, the laser is inserted to cut through it.
The cut disc portion is removed, and the incision site is sutured.
After Surgery
After surgery, the patient is brought to a recovery room, where vital signs are monitored as the effects of the anesthesia wear off.
Once stabilized, the patient can usually go home one or two hours after the operation.
The surgeon will determine when the individual is clear to resume driving.
Recovery
Following a discectomy, the individual can return to work within a few days to a few weeks, depending on the severity, but it can take up to three months to return to normal activities. Length of recovery can range from two to four weeks or less to resume a sedentary job or eight to 12 weeks for a more physically demanding job that requires heavy lifting. (University of Wisconsin School of Medicine and Public Health, 2021) During the first two weeks, the patient will be given restrictions to facilitate the spine’s healing until it becomes more stable. Restrictions can include: (University of Wisconsin School of Medicine and Public Health, 2021)
No bending, twisting, or lifting.
No strenuous physical activity, including exercise, housework, yard work, and sex.
No alcohol in the initial stage of recovery or while taking narcotic pain medications.
No driving or operating a motor vehicle until discussed with the surgeon.
The healthcare provider may recommend physical therapy to relax, strengthen, and maintain musculoskeletal health. Physical therapy may be two to three times weekly for four to six weeks.
Process
Optimal recovery recommendations include:
Getting enough sleep, at least seven to eight hours.
Maintaining a positive attitude and learning how to cope and manage stress.
Maintaining body hydration.
Following the exercise program as prescribed by the physical therapist.
Practicing healthy posture with sitting, standing, walking, and sleeping.
Staying active and limiting the amount of time spent sitting. Try to get up and walk every one to two hours during the day to stay active and prevent blood clots. Gradually increase the amount of time or distance as recovery progresses.
Do not push to do too much too soon. Overexertion can increase pain and delay recovery.
Learning correct lifting techniques to utilize the core and leg muscles to prevent increased pressure on the spine.
Discuss treatment options for managing symptoms with a healthcare provider or specialist to determine if laser spine surgery is appropriate. Injury Medical Chiropractic and Functional Medicine Clinic care plans and clinical services are specialized and focused on injuries and the complete recovery process. Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, therapists, trainers, and premiere rehabilitation providers. We focus on restoring normal body functions after trauma and soft tissue injuries using Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols.
The Non-Surgical Approach
References
Stern, J. SpineLine. (2009). Lasers in Spine Surgery: A Review. Current Concepts, 17-23. https://www.spine.org/Portals/0/assets/downloads/KnowYourBack/LaserSurgery.pdf
Brouwer, P. A., Brand, R., van den Akker-van Marle, M. E., Jacobs, W. C., Schenk, B., van den Berg-Huijsmans, A. A., Koes, B. W., van Buchem, M. A., Arts, M. P., & Peul, W. C. (2015). Percutaneous laser disc decompression versus conventional microdiscectomy in sciatica: a randomized controlled trial. The spine journal : official journal of the North American Spine Society, 15(5), 857–865. https://doi.org/10.1016/j.spinee.2015.01.020
Atlantic Brain and Spine. (2022). The Truth About Laser Spine Surgery [2022 Update]. Atlantic Brain and Spine Blog. https://www.brainspinesurgery.com/blog/the-truth-about-laser-spine-surgery-2022-update?rq=Laser%20Spine%20Surgery
Cleveland Clinic. (2018). Can Laser Spine Surgery Fix Your Back Pain? https://health.clevelandclinic.org/can-laser-spine-surgery-fix-your-back-pain/
University of Wisconsin School of Medicine and Public Health. (2021). Home Care Instructions after Lumbar Laminectomy, Decompression or Discectomy Surgery. https://patient.uwhealth.org/healthfacts/4466
Facet hypertrophy is an incurable, chronic disease that affects the facet joints in the spine. Can recognizing symptoms, help in diagnosis, and treatment?
Facet Hypertrophy
Facet hypertrophy causes the facet joints in the spine to enlarge. They are found where the vertebrae come into contact on the back of the vertebrae that form the backbone. These joints stabilize the spine when twisting and bending. Hypertrophy results when damage wears down the cartilage that cushions the bones that meet in the joint. This can include:
Aging
Wear and tear
Arthritis
Other joint diseases can damage facet joints.
Swelling, new bone growth, and bone spurs can occur as the joint tries to repair the damaged cartilage. The swelling and new bone growth can narrow the spinal canal and compress surrounding nerves, causing pain and other sensation symptoms. This ailment does not have a cure and worsens over time. The objective of treatment is to manage the pain symptoms and slow down the disease’s progress.
Types
Facet hypertrophy can be described as unilateral or bilateral.
Symptoms can have a wide range of intensity, from a dull ache to chronic, disabling pain. The location of symptoms depends on the affected joint and the nerves involved, Pain manifests when the enlarged joints and new bone growth compresses the nearby nerves. The result leads to nerve damage and the following symptoms: (Weill Cornell Medicine Brain & Spine Center. 2023) (Cedars Sinai. 2022)
Stiffness, especially when standing up or getting out of a chair.
Inability to stand straight when walking.
Inability to look up to the left or right without turning the whole body.
Reduced range of motion and mobility.
Numbness or a tingling sensation of pins and needles.
Radiating pain from the affected joint into the buttocks, hips, and upper thigh when the affected joint/s are in the lower back.
Radiating pain from the affected joint into the shoulder, neck, and back of the head when the affected joint/s are in the upper back.
Headaches when the affected joint is in the neck.
Causes
A common cause is the age-related degeneration of the joints, called spondylosis. Research indicates that more than 80% of individuals who are 40 or older have radiologic evidence of spondylosis, even though they may not have symptoms. (The University of Toledo Medical Center. N.D.) The following conditions can also increase the risk of facet hypertrophy (Weill Cornell Medicine Brain & Spine Center. 2023)
Unhealthy posture
Being overweight or obese
Sedentary lifestyle
Injury or trauma to the spine
Inflammatory conditions like rheumatoid arthritis or ankylosing spondylitis
Osteoarthritis
Genetic predisposition to the condition
Diagnosis
Diagnosis can be challenging when neck or back pain is the main complaint, as symptoms can mimic conditions such as sciatica from a herniated disc or hip arthritis. (Weill Cornell Medicine Brain & Spine Center. 2023)
A healthcare provider will conduct a complete physical examination, medical history, and discussion of symptoms.
CT scans with or without myelogram – the use of contrast dye in the space around the spinal cord.
MRI
X-rays with or without a myelogram
A diagnosis is confirmed by injecting a diagnostic block that involves administering an anesthetic injection, sometimes with an anti-inflammatory like cortisone, into the joint or nerves near the affected joint. Two injections are given at different times to confirm the effect. (Romain Perolat et al., 2018)
If immediate relief improves after each injection, the facet joint is confirmed as the source of the pain symptoms.
If the block does not decrease the pain, the facet joint is probably not the source of the pain symptoms. (Brigham and Women’s Hospital. 2023)
Treatment
There is no cure for facet hypertrophy.
The goal of treatment is to make the pain more manageable.
Conservative treatment is usually successful in making a difference.
Nonsteroidal anti-inflammatory – aspirin, ibuprofen, and naproxen.
Muscle relaxers – cyclobenzaprine or metaxalone.
Steroid injection into the facet joints.
Injection of platelet-rich plasma/PRP into the joints.
Medial Branch or Facet Block
A medial branch block injects local anesthetic near the medial nerves that connect to an inflamed joint.
Medial nerves are small nerves outside the joint space near the nerve that transmit signals and other impulses to the brain.
A facet block injects the medication outside the joint space near the nerve that supplies the joint called the medial branch.
Neurolysis
Neurolysis, also known as rhizotomy or neurotomy, is a procedure that destroys affected nerve fibers to relieve pain, reduce disability, and reduce the need for analgesics. This treatment can relieve pain for six to 12 months until the nerve regenerates, where further treatments may be necessary. (Matthew Smuck et al., 2012) Neurolysis can be performed using one of the following techniques (Romain Perolat et al., 2018)
Radiofrequency ablation RFA – the application of heat through radiofrequency.
Cryoneurolysis – the application of cold temperatures to the targeted nerve.
Chemical neurolysis – applying chemical agents, like a combination of phenol and alcohol.
Severing the nerves with surgical instrumentation.
Surgery
When one or more facet joints are severely damaged, they can become nonfunctional and painful. Surgery may be recommended when symptoms are not relieved by other therapies. (Ali Fahir Ozer, et al., 2015)
Prognosis
Facet hypertrophy is a chronic condition that progresses with age and does not affect life expectancy. (Weill Cornell Medicine Brain & Spine Center. 2023) The disorder is incurable, but symptoms can be managed with conservative therapies
A healthcare provider can help develop a treatment plan based on the extent and location of the joint affected.
Early diagnosis and treatment can help individuals achieve the best results.
Maintaining an active lifestyle and healthy weight can help prevent further joint stress. Individuals may be recommended to do regular stretching and strengthening exercises to lower inflammation, reduce stress, and improve overall health.
Facet Syndrome Treatment
References
Perolat, R., Kastler, A., Nicot, B., Pellat, J. M., Tahon, F., Attye, A., Heck, O., Boubagra, K., Grand, S., & Krainik, A. (2018). Facet joint syndrome: from diagnosis to interventional management. Insights into imaging, 9(5), 773–789. https://doi.org/10.1007/s13244-018-0638-x
Smuck, M., Crisostomo, R. A., Trivedi, K., & Agrawal, D. (2012). Success of initial and repeated medial branch neurotomy for zygapophysial joint pain: a systematic review. PM & R : the journal of injury, function, and rehabilitation, 4(9), 686–692. https://doi.org/10.1016/j.pmrj.2012.06.007
Ozer, A. F., Suzer, T., Sasani, M., Oktenoglu, T., Cezayirli, P., Marandi, H. J., & Erbulut, D. U. (2015). Simple facet joint repair with dynamic pedicular system: Technical note and case series. Journal of craniovertebral junction & spine, 6(2), 65–68. https://doi.org/10.4103/0974-8237.156049
Individuals feeling tingling or pins and needles sensations that overtake the arms or legs could be experiencing paresthesia, which occurs when a nerve has been compressed or damaged. Can knowing the symptoms and causes help in diagnosis and treatment?
Paresthesia Body Sensations
The numbness or tingling feeling when an arm, leg, or foot has fallen asleep is not so much about blood circulation but nerve function.
Paresthesia is an abnormal sensation felt in the body due to the compression or irritation of nerves.
It can be a mechanical cause like a compressed/pinched nerve.
Or it may be due to a medical condition, injury, or illness.
The symptoms typically last for 30 minutes or less.
Shaking the affected limb often relieves the sensations.
Paresthesia usually affects only one arm or leg at a time.
However, both arms and legs can be affected, depending on the cause.
Consult a healthcare provider if the symptoms last for more than 30 minutes. Treatment may be required if paresthesia body sensations are brought on by a serious underlying cause.
Causes
Sitting with incorrect and unhealthy postures can compress a nerve and generate symptoms. However, some causes are more concerning and can include:
If the symptoms don’t go away after 30 minutes or keep returning for unknown reasons, call a healthcare provider to find out what is causing the abnormal sensations. A worsening case should be monitored by a healthcare provider.
Peripheral neuropathy caused by diabetes usually begins with a feeling of paresthesia in the foot/feet and can worsen and lead to other complications.
A healthcare provider will work with the individual to understand the symptoms and perform the appropriate diagnostic tests to determine the cause. A healthcare provider will choose the tests based on a physical examination. Common diagnostic procedures include: (Merck Manual Professional Version. 2022)
Magnetic resonance imaging – MRI of the spine, brain, or extremities.
X-ray to rule out bone abnormalities, like a fracture.
Blood tests.
Electromyography – EMG studies.
Nerve conduction velocity – NCV test.
If paresthesia is accompanied by back or neck pain, a healthcare provider may suspect a compressed/pinched spinal nerve.
If the individual has a history of diabetes that is poorly controlled, they may suspect peripheral neuropathy.
Treatment
Treatment for paresthesia depends on the diagnosis. A healthcare provider can help determine the best course of action for the specific condition.
Nervous System
If symptoms are triggered by a central nervous condition like MS, individuals will work closely with their healthcare provider to get the appropriate treatment.
If paresthesia is caused by compression of a spinal nerve, like sciatica, individuals may be referred to a chiropractor and physical therapy team to release the nerve and pressure. (Julie M. Fritz, et al., 2021)
A physical therapist may prescribe spinal exercises to relieve compression of the nerve and restore normal sensations and motion.
Strengthening exercises to restore flexibility and mobility may be prescribed if weakness presents along with paresthesia body sensations.
Herniated Disc
If a herniated disc is causing the abnormal sensations, and there has been no improvement with conservative measures, a healthcare provider may suggest surgery to relieve pressure on the nerve/s. (American Association of Neurological Surgeons. 2023)
In surgical procedures like a laminectomy or discectomy, the objective is to restore nerve function.
Post-surgery, individuals may be recommended to a physical therapist to help regain mobility.
National Institute of Neurological Disorders and Stroke. (2023) Paresthesia.
American Association of Neurological Surgeons. (2023) Herniated disc.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018) Peripheral neuropathy.
Merck Manual Professional Version. (2022) Numbness.
Razazian, N., Yavari, Z., Farnia, V., Azizi, A., Kordavani, L., Bahmani, D. S., Holsboer-Trachsler, E., & Brand, S. (2016). Exercising Impacts on Fatigue, Depression, and Paresthesia in Female Patients with Multiple Sclerosis. Medicine and science in sports and exercise, 48(5), 796–803. https://doi.org/10.1249/MSS.0000000000000834
Fritz, J. M., Lane, E., McFadden, M., Brennan, G., Magel, J. S., Thackeray, A., Minick, K., Meier, W., & Greene, T. (2021). Physical Therapy Referral From Primary Care for Acute Back Pain With Sciatica : A Randomized Controlled Trial. Annals of internal medicine, 174(1), 8–17. https://doi.org/10.7326/M20-4187
The brachial plexus is a network of nerves that begin in the cervical/neck spinal cord and travel down the cervicoaxillary canal into the armpit. Forming in the area of the shoulder joint at the branch junction of the brachial plexus, the radial nerve extends down the arm, through the elbow joint, into the forearm, across the wrist, and tips of the fingers. The nerves are susceptible to injury that can cause abnormal function leading to unusual sensations and impaired muscle function.
Radial Nerve
One of the major nerves of the upper extremity.
There is one brachial plexus on each side of the body that carries the nerves to each arm.
The radial nerve has two major functions.
One is to provide sensations in the hands, forearms, arms, and fingers.
The other is to deliver messages to muscles about when to contract.
Motor Function
The radial nerve transmits signals to the muscles of the back of the arm and forearm on when to contract.
Individuals who have abnormal radial nerve function can experience weakness of the muscles and symptoms like wrist drop.
A wrist drop occurs when the back forearm muscles cannot support the wrist, causing the individual to hold the wrist in a flexed posture.
Abnormal radial nerve function can cause symptoms of numbness or tingling in the back of the hand.
Conditions
Associated conditions to the radial nerve include lacerations, contusions, fractures, and palsies.
Nerve Contusion
A contusion typically occurs through blunt force trauma that can crush and smash the nerve area.
This causes abnormal or no function.
A nerve contusion can occur from a personal, work, or sports injury or other conditions that generate intense pressure on the nerve/s.
Nerve Lacerations
A laceration occurs when there is a penetrating injury that cuts and/or severs the nerve.
This injury can occur from stab wounds or sliced by broken glass, metal, etc.
Fractures
Broken bones of the upper extremity can lead to extended damage to the nerves near the damaged bone.
The most common type of fracture associated with radial nerve malfunction is fractures to the humerus bone.
The nerve wraps tightly around the humerus and can be injured with a fracture.
Most fracture-related radial nerve injuries heal on their own and do not require surgery.
However, the way the injury heals can be the difference between normal function and chronic pain.
Crutch Palsy
Crutch palsy is pressure on the radial nerve in the armpit resulting from using crutches incorrectly.
To use crutches properly, the individual needs to support their body weight through the hands.
However, many tend to place pressure around the armpit at the top of the crutch, causing irritation to the nerve in that area.
Padding the top of crutches and using the proper form can prevent the condition.
Saturday Night Palsy
Saturday night palsy is the abnormal function of the radial nerve after sleeping in a position that causes direct pressure against the nerve.
This often occurs when an individual falls asleep with their arm draped over an armrest on a chair.
The name comes from when individuals are intoxicated and fall asleep in a location other than the bed and in awkward positions.
Treatment
Nerve injuries often cause symptoms at different locations other than where the nerve damage is, complicating diagnosis. Determining the specific location of nerve damage is the first step in developing an appropriate treatment plan. Once the location has been identified, steps can be taken to prevent worsening damage to the nerve.
The objective is to relieve the pressure from the irritation or compression.
Massage to relax the area and increase blood circulation.
Decompression to physically restore alignment.
Adjustments to restore body balance.
Exercises and stretches to maintain treatment, strengthen the muscles, and prevent injuries.
In cases where there is structural damage, surgery may be necessary to remove pressure or repair damage.
Avoid Surgery
References
Ansari FH, Juergens AL. Saturday Night Palsy. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557520/
Barton, N J. “Radial nerve lesions.” The Hand vol. 5,3 (1973): 200-8. doi:10.1016/0072-968x(73)90029-6
Daly, Michael, and Chris Langhammer. “Radial Nerve Injury in Humeral Shaft Fracture.” The Orthopedic Clinics of North America vol. 53,2 (2022): 145-154. doi:10.1016/j.ocl.2022.01.001
DeCastro A, Keefe P. Wrist Drop. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532993/
Eaton, C J, and G D Lister. “Radial nerve compression.” Hand Clinics vol. 8,2 (1992): 345-57.
Glover NM, Murphy PB. Anatomy, Shoulder and Upper Limb, Radial Nerve. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534840/
Ljungquist, Karin L et al. “Radial nerve injuries.” The Journal of hand surgery vol. 40,1 (2015): 166-72. doi:10.1016/j.jhsa.2014.05.010
Neck injuries are more common than people realize and can lead to mobility issues, affecting the head and shoulders. This is caused by herniated or compressed cervical discs, which can irritate spinal nerve roots. Neck muscles can also be injured, resulting in shoulder pain, stiffness, or headaches. Neck pain is the second most common problem after back pain. Poor posture, phone usage, and computer work can all contribute to neck pain, which can worsen over time if left untreated. Fortunately, therapies are available to gently stretch affected muscles and realign cervical discs, providing relief. Our article discusses how neck pain affects the body, factors related to anterior cervical compression, and how spinal decompression can alleviate neck pain. We work with certified medical providers who use our patients’ valuable information to provide cervical disc treatments for individuals with neck pain affecting their cervical spine and causing mobility issues. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
How Does Neck Pain Affect The Body?
Are you experiencing muscle stiffness between your neck and shoulders? Do you feel discomfort when working for long periods in a hunched position? Or are you suffering from persistent headaches that won’t go away? These symptoms could be caused by neck pain associated with anterior cervical disc compression, a common issue affecting many people. Neck pain is the second most common pain-related problem after low back pain, and it carries corresponding risk profiles that can lead to its development. Research studies revealed that cervical disc herniation associated with neck pain can affect the upper body extremities, ranging from mild to severe symptoms. The spine has three regions: cervical, thoracic, and lumbar, which protect the spinal cord that branches out the nerve roots, allowing mobility and flexibility for the head, neck, and shoulders. When the cervical discs become herniated, they can aggravate the nerve roots, leading to numerous symptoms that can affect the surrounding muscles in the neck and shoulders. Further research studies have revealed that when the cervical intervertebral discs are compressed, they become a common source of neck pain, usually accompanied by neck stiffness and other overlapping risk profiles that can cause referred pain to the upper body extremities. Therefore, neck pain associated with anterior cervical disc compression can become an issue when multiple environmental factors are involved.
Factors Associated With Anterior Cervical Compression To The Neck
Neck pain caused by anterior cervical compression can be due to numerous factors such as poor posture, degenerative disc disease (DDD), spinal stenosis, constantly looking down at a cell phone, being in a hunched or slouched position at work, and repetitive lifting of heavy objects. When individuals engage in repetitive motions that strain the neck, it can result in cervical compression that affects the nerve roots, causing abnormal neuron signals and shoulder or neck pain, according to research studies. This can also lead to overlapping risk profiles, causing referred pain to the upper extremities and somato-visceral pain. Additionally, anterior cervical compression can affect the cardiovascular system, resulting in unwanted symptoms like headaches and neck stiffness, causing significant discomfort.
Chiropractic Recovery Testimony-Video
Are you experiencing frequent headaches or stiffness between your shoulders and neck? Do you feel pain when stretching your neck from side to side? These symptoms may be related to anterior cervical compression in your cervical spine, which can cause herniation of the spinal disc and affect the nerve roots within muscle and tissue fibers. This can lead to referred pain in the neck and shoulder regions. Fortunately, there are various ways to alleviate pain and stiffness in the neck and treat chronic conditions associated with cervical disc herniation. Non-surgical treatments like chiropractic care can relieve neck and shoulder pain caused by cervical disc herniation. Combining non-surgical treatments with other therapies can prevent neck pain from recurring and improve posture. Chiropractic care can also alleviate referred pain caused by neck pain through manual and mechanical manipulation. Check out the video above for more information on non-surgical treatments for cervical disc herniation.
How Spinal Decompression Can Alleviate Neck Pain
Neck pain can be confusing because it can affect the shoulders and chest, leading to referred visceral-somatic pain. Fortunately, many treatments are available to alleviate neck pain and its associated symptoms. According to “The Ultimate Spinal Decompression” by Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., unwanted pressure on the cervical spinal disc can cause damage and ongoing pain by pressing the nerve root. If this happens, some people choose anterior cervical discectomy, which involves a small incision in the neck to remove the damaged disc and relieve pressure on the nerve root. Others opt for spinal decompression if the disc is herniated and aggravates the nerve root in the cervical spine region.
Studies have shown that spinal decompression can help ease neck and shoulder pain by gently stretching the spine through traction. This allows the herniated disc to be pulled back to its original position, relieving pressure on the affected nerve root and muscles. Spinal decompression is a safe and non-invasive treatment option that can be combined with other non-surgical therapies. It is also cost-effective and can benefit individuals who incorporate it into their health and wellness plans.
Conclusion
Neck pain is commonly caused by cervical disc herniation, leading to discomfort in the upper extremities around the neck. Repetitive motions associated with normal activities, such as poor posture, phone usage, and desk work, can also contribute to neck pain. Fortunately, non-surgical treatments like spinal decompression are available. This gentle technique uses traction to stretch the spine and alleviate pain from disc herniation, making it a cost-efficient option. By combining spinal decompression with other therapies, individuals can prevent the recurrence of neck pain and enjoy a pain-free life.
References
Kaplan, E., & Bard, P. (2023). The Ultimate Spinal Decompression. JETLAUNCH.
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