Pinched Nerve in Neck
Neck pain can be caused by numerous conditions but often it is attributed, rightly or wrongly, as being due to a pinched nerve in the neck. The nervous system is highly complex and, as with any complex system, there are lots of ways things can go wrong.
Herniated Disc and a Thickened Ligamentum Flavum
An Overview of the Nervous System
Nerves extend from the brain into the extremities of the body, leaving the spine to do so; these are called peripheral nerves. Peripheral nerves contain millions of nerve fibers which branch out from the spinal cord to every part of the body to make muscles move, to give us our sense of touch, to control cellular responses to heat and cold, and numerous other actions.
Nerves are protected by insulation in the majority of cases, and have the capacity to transmit or receive an electrical charge from the brain or from parts of the spinal cord. If the insulation or membrane becomes damaged or unhealthy due to lack of nutrition or injury then these electrical signals can be interrupted, become faulty or cease entirely
Short-term and Long-term Nerve Compression
Short-term nerve compression, provided it is not severe, rarely causes permanent nerve damage, although symptoms may take a long time to recover from. Long-term, persistent, or severe compression can result in permanent dysfunction of the nerve; surgical decompression is indicated in these circumstances. Nerves can also be overstretched if having to accommodate a herniated disc or bony growth. The symptoms will be the same as for pinched nerves, with transmission problems.
Pinched Nerve in Neck Causes
To better understand causes of a pinched nerve in the neck, conditions of the cervical spine should be examined. As it leaves the spine, a nerve can be affected by an unwanted condition such as a neck bone spur (osteophytes) or a bulging, or herniated neck disc compressing the nerve. Carpal tunnel syndrome is another example of pinched nerves, although this is due to nerve compression in the wrist rather than the spine. If a nerve is compressed in the neck then symptoms are still likely to be felt in the peripheral limbs as signals are prevented from being transmitted and received throughout the length of that nerve. Calcification of the soft tissues surrounding the spine can reduce the foramina through which the nerves pass and lead to compression on the nerve fibers. Acute or chronic neck pain may be the result of this nerve impingement.
Pinched Nerve in Neck Causes by Injury
Damage and inflammation due to injury, through trauma, contact sports, whiplash, or infection can also cause pinched nerves and loss of function and sensation. If a cervical disc slips out of place in the neck then this can lead to pinched nerves, as can spinal stenosis, disc degeneration and bony growths from neck conditions like cervical arthritis.
Short Term and Long Term Nerve Compression
Short-term nerve compression, provided it is not severe, rarely causes permanent nerve damage, although symptoms may take a long time to recover from. Long-term, persistent, or severe compression can result in permanent dysfunction of the nerve; surgical decompression is indicated in these circumstances. Nerves can also be overstretched if having to accommodate a herniated disc or bony growth. The symptoms will be the same as for pinched nerves, with transmission problems. Damage to the myelin (insulation) around the nerves may mean faulty signal transmission occurs.
As previously mentioned, pinched nerve in neck causes are typically brought on by spinal conditions although in some cases they can be mistaken for pinched nerve in the shoulder so it’s best to make an appointment with a licensed medical practioner to receive a proper examination.
Pinched Nerve Neck Symptoms
Pinched or entrapped nerves can cause myriad symptoms. As each nerve is responsible for the sending and receiving of signals from specific body parts they can cause symptoms far from the actual site of nerve compression. Common symptoms of pinched nerves include pain, numbness, radiculopathy, weakness in the associated muscles, and poor dexterity in the extremities. Paraesthesia, or pins and needles, often occur as the nerve is compressed. A similar sensation can occur when a nerve has been temporarily compressed, by an awkward sleeping position for example, and is comparable to the feeling of a ‘dead leg’ or a limb that has ‘fallen asleep’. The difference is that a pinched nerve neck is often more of a chronic problem and may lead to permanent damage and debility.
Consequences of Pinched Nerves in the Neck
Pinched nerves in the neck can have far-reaching consequences as they innervate the muscles in the arm, neck, chest, back, and the head. Neck stiffness and pain are common, as are muscular cramps and spasms due to faulty nerve signalling. Chest and neck pain can occur in some cases, and may mimic other conditions such as a heart attack. Head and neck pain are also possible consequences of a pinched cervical nerve, with migraines and cervicogenic headaches frequently reported.
Numbness and other Sensations
Numbness is commonly preceded by paraesthesia, which include prickling or burning sensations, and is experienced as a loss of sensation and paralysis of an area. Acute onset of this with no obvious cause (such as having sat awkwardly for a long time) warrants immediate medical attention, particularly if the patient is aware of any underlying cervical joint issues such as spinal stenosis, or bulging disc. Paraesthesia is usually temporary and reversible, although it often indicates an underlying problem if it occurs frequently. Numbness suggests a more serious problem with a nerve or nerves. Conditions such as diabetes also cause peripheral neuropathy, as does lupus, multiple sclerosis, and Guillain-Barre syndrome. Having these conditions and experiencing these pains, paraesthesia, or numbness does not mean that the patient can be complacent as it can still indicate an underlying change in the cervical spine.
Symptoms of pinched nerves may also provide insight for the diagnosing physician as a cervical pain map associated with disc herniation in the neck can correlate the site of pain and paraesthesia with the specific vertebra involved in the pathology. For example, a disc herniation at C4-C5 is likely to produce shoulder pain and weakness of the deltoid muscles without tingling or numbness in most cases. Other sites of disc herniation produce alternate patterns of pain, paraesthesia, and numbness.
Diagnosis of a Pinched Nerve
As the symptoms of a pinched nerve can mirror vascular issues and even a heart attack it is important not to self-diagnose. Symptoms include radiating neck pain, chest pain, sensation problems, weakness, numbness, burning and/or prickling (also known as peripheral neuropathy).
Suspected pinched nerves in the neck can be diagnosed by a physician performing a physical involving manipulation of the patient’s neck. X-rays, Computerised Tomography(CT) scans or magnetic resonance imaging (MRI) scans may also be used.
Sometimes a pinched nerve in the neck results in peripheral symptoms only, and can therefore be misdiagnosed as there is no actual ‘pain’ being felt in the neck.
A lot of cases of pinched nerves resolve themselves naturally within six weeks or so, although some may lead to ongoing problems including worsening peripheral neuropathy and chronic neck pain. If a patient has persistent neck pain, tenderness in the cervical spine, and symptoms of peripheral neuropathy then it may be caused by a pinched nerve and requires a thorough check-up by a qualified physician to ensure the problem does not worsen.
Treatments for a Pinched Nerve in Neck
Most physicians are likely to recommend adequate rest until your pinched nerve in neck symptoms improve. They may suggest use of a cervical collar to prevent excessive movement and stabilize the neck area. If there is evidence of inflammation then NSAIDs and pain-relieving medications(analgesics) may be advised. There are, of course, natural alternatives to prescription anti-inflammatories and painkillers that may alleviate the condition without the problems of NSAID side-effects suffered by many using these medications.
Physical therapy for neck pain is often encouraged for treatment of acute neck pain and pinched nerves; this should, however, be conducted in line with professional guidance as, if done incorrectly, strengthening neck exercises could exacerbate the condition. Physical therapy may also include electrical stimulation, cervical traction, neck massage, and heat/ice treatments to stimulate circulation and reduce inflammation.
Of course, cervical spine surgery is another option if the condition does not respond to non-surgical intervention. Surgery is rarely conducted, but can in some cases be a key part of relieving pressure on pinched nerves in the neck. The use of a TENS unit may be of benefit to some with acute neck symptoms of pinched nerves, in order to relieve the pain whilst the body repairs itself; they may also find benefit from chronic neck pain in some cases.