Pinched Nerve

Pinched Nerve is a terminology which describes a form of damage or injury to a single nerve or set of nerves. Due to compression, stretching or constriction this injury can occur. Pinched nerve can occur at any location in our body.

When excessive pressure is applied by surrounding tissue to a nerve then it can be pinched. This tissue can be a bone or cartilage for example in case of herniated spinal disc, it compresses the nerve ending. Sometimes muscles or tendons being the surrounding tissue, exerts pressure. For example, in case of carpal tunnel syndrome a variety of tissues like muscles and tendons exert pressure which results in median nerve, including inflammation of tendon sheath which results in narrowing of tunnel by thickening of bone or ligament degeneration. To understand the pathology behind pinched nerve, we have to take a look at anatomy and physiology of nerve.

Nerves
Central Nervous System of human body plays a premier role in neurological functions. It consists of brain, spinal chord and network of nerves. Nerves are extensions from brain which travel to every part of body, organ, muscles, bones, ligaments, skin etc. Anatomically, a nerve cell is a microscopic structure with its fibers running a great length towards its destination. The group of nerve cells that located in brain or in the spinal chord is commonly known as central nerve while nerves which run from the spinal chord to other destinations like arms, legs, different organs, skin and vice-versa are recognised as peripheral nerves. A peripheral nerve is actually a group of numerous neurons fibers that travels from spinal chord and branch to their target destination where the functions like action, sensation are carried out by means of signals.

So, in case of peripheral nerve, it is like a bundle of many fibers encased within an outer sheath. Static electrical ions travel on this sheath from CNS towards the destination and vice-versa. Inside the sheath, neuron fluid is present which nourishes the components of the outer membrane. If any nerve is pinched then the flow of this neuron fluid gets blocked or reduced which eventually results in degeneration of membrane. The outer membrane starts loosing its ability to carry electrical charges which hampers the main function of any nerve cell.

Symptoms
There are number of noticeable pinched nerve symptoms. We can feel a lack of sensation which is also known as numbness in a particular location where the nerve has been affected. Sometimes we may experience a sharp pain which radiates outward. If the location of pinched nerve is in the spinal chord then involuntary actions like sneezing or coughing aggravate the pain. In some cases, we may feel our foot or hand has become numb (fallen asleep). Sometimes in cases like paresthesia, tinkling or prickling sensation is noticed which is commonly known as pins and needles.

Causes
Pinched nerve is a result of its compression by surrounding tissues. There are numerous reasons responsible to compress a nerve by such tissues. Poor posture, injury, obesity, adventurous hobbies, sports activities, mental and physical stress after doing a repetitive job and in some cases, osteoarthritis are the most common reasons for pinched nerve. The pressure exerted due to all these factors disrupts the neuron functions and causes its inflammation. If the condition remains for shorter span then there will be no permanent injury because the nerve will return to its normal functioning once the pressure gets released. But, if the condition remained for longer time, there is a risk of permanent damage to nerve. Sometimes in few cases, people are genetically prone to such conditions which can result to a "pinched" state.

Diagnosis
The foremost diagnosis is done on the basis of information provided by the patient. There are few tests which can be carried out by physicians.
1. Nerve Conduction Study is a test which can identify and confirm the existence of the damage nerve. A test, also known as a nerve conduction velocity test, includes placing of patch like electrodes to stimulate the suspected nerve with mild electrical shock.
2. Electromyography measures the electrical discharges. This test includes inserting of thin needle electrode to record electric discharges in muscle.
3. Magnetic Resonance Imaging (MRI) is conducted by physicians to confirm the diagnosis.

Treatment
Rest for the affected area of pinched nerve is the premier recommended treatment. Any activities that aggravate the compression of nerve should be avoided. Help of splint or braces is taken to immobilize the affected area. Physical therapy often makes a supplementary part of such treatments. It aims at strengthening and stretching the muscles in the affected area by doing gradual exercises. Nonsteroidal Anti-Inflammatory Drugs (NSAID) like ibuprofen, naproxen can help as painkillers and reduce the inflammation. Corticosteroid injections are introduced to lessen the pain and inflammation. In very rare cases if the situation stays unaffected or minor surgery may be required to release the pressure.

The agony of pinched nerve can be prevented with maintaining a good posture, healthy weight and incorporating flexibility and muscle strength by regular exercises.