Trapped Nerve

Introduction

This article will talk about a medical condition known as trapped nerve (also known as compressed nerve or pinched nerve). It will also discuss specific types of trapped nerves such as sciatica, carpal tunnel syndrome and radiculopathy. Described below are the symptoms, causes, how to prevent trapped nerves, as well as risk factors, possible treatments and in general what to expect from this condition.

What is a trapped nerve?

• What is it?
• Where can it occur?

A trapped nerve is what happens when the tissue that surrounds a nerve (such as bone, cartilage, muscle or tendons) pinches or compresses it.¹ This added pressure interferes with the functioning of the nerve and results in the symptoms of the condition.² Severe cases of a trapped nerve can lead to chronic pain and nerve damage if left untreated.⁶ 

Trapped nerves can occur in a way that seems to be spontaneous, or as a result of surgery. Depending on the procedure the patient underwent as well as other variables, roughly 30% of patients report a trapped nerve after surgery. Thisis not an uncommon issue. A trapped nerve is known as cutaneous nerve entrapment in this case.⁶ 

Depending on where the affected nerve is located, trapped nerves can appear in any part of the body. For example, if the sciatic nerve (which runs from the lower back down to the feet) is compressed or irritated then symptoms are felt in the feet, toes, back of the leg and buttocks. This is a type of trapped nerve known as sciatica.³

Alternatively, when the median nerve in the wrist is compressed, this condition is called carpal tunnel syndrome and is the most common type of trapped nerve. Carpal tunnel syndrome mostly affects the hand, though the wrist, arm and even shoulder can be affected in more severe cases.⁴

Radiculopathy is another type of trapped nerve. This condition is caused by the compression of nerve roots (which branch out from the spinal cord). Cervical radiculopathy occurs in the cervical section of the spine (which is mostly in the neck), whilst lumbar radiculopathy occurs in the lumbar section (the lower back). Cervical radiculopathy can therefore lead to symptoms located in the neck, arm, hand, or shoulder._⁵ Lumbar radiculopathy results in symptoms in the back and legs.⁷ 

Symptoms

A trapped or pinched nerve most commonly results in symptoms such as numbness or a tingling/pins-and-needles sensation in the areas affected by the nerve that is being compressed. There can also be muscle weakness or a pain that may feel burning, stabbing, or shooting.^{1, 3} 

Causes

Conditions such as arthritis, thyroid disease, diabetes, pregnancy or spinal stenosis (when the space inside the backbone is too small) can lead to a trapped nerve. As well as this, poor posture, overuse, repetitive work or movement, a slipped disc (in the spine) or an injury may also cause this condition.^{1, 2} 

Prevention

Not all cases of trapped nerves can be prevented, particularly those that result from surgery. However, having good posture, not doing repetitive activities for too long, and not remaining in one position for an extended period of time can help reduce the risk of trapped nerves arising spontaneously. Having a balanced, healthy diet, exercising regularly, quitting smoking (if you smoke) or losing weight (if you are overweight) will also help.^{2, 3} 

Treatments

If the pain from a trapped nerve is getting worse, is getting in the way of your everyday life, and has not improved after a week or two, then it is important to see a doctor.³ 

A medical professional will conduct a physical examination to determine if you have a trapped nerve. This involves testing your reflexes and how well your muscles can move.² They may also ask you questions. You may also undergo an MRI or CT scan to determine which tissues are pressing on the nerve.¹ 

If the doctor finds that you do have a trapped nerve, there are plenty of nonsurgical treatment options. Exercise stretches, massages or physiotherapy is often enough to sort the problem and decrease tension in muscles and soft tissue, reducing pressure on the nerve.⁸ NSAIDs (non-steroid anti-inflammatory drugs) like ibuprofen can be given to act as pain relief in the meantime. 

For more extreme pain which will not be relieved by oral painkillers, a doctor may prescribe painkiller injections containing drugs such as narcotics or steroids (such as hydrocortisone). Steroid injections must be administered by a medical professional, and most take a few days to kick in, however, can last up to a few months. They can be injected into a joint, a muscle, the spine or the blood and work by decreasing the inflammation (swelling) in that area (or throughout the whole body, if injected into the blood).⁹ 

Heat packs can be used on the affected area to ease the pain, however, care must be taken if the area is numb not to burn/scald yourself.³ With trapped nerves such as sciatica, placing a cushion between or under the knees whilst sleeping may give some relief.³ Changing sleep position may also help.² Whilst it may be painful to move about with a trapped nerve, it is much better to do so and go about everyday life, as you may get better faster.³ 

In cases of trapped nerve such as carpal tunnel syndrome, splints can be used to keep the wrist in a fixed position that decreases pressure on the nerve.⁸ Corticosteroid injection is also a possible treatment for this condition.¹⁰ 

• NSAIDS
• Oral corticosteroids
• Narcotics
• Steroid injections
• Physical therapy
• Splint
• Surgery

How long does a trapped nerve last?

Most trapped nerves return to normal within 6-12 weeks of first-line treatments such as physical therapy or NSAIDs.² How long they last depends on factors like your body’s immune response, the degree of compression of the nerve and the cause of the inflammation.² If the trapped nerve is still bothering you after a few months, then surgery (such as decompression surgery) may be considered to avoid chronic pain and more serious nerve damage. Surgery comes with its risks and a lengthy recovery, however, hence why simpler treatments are attempted first.² 

Summary

In summary, a trapped nerve occurs when pressure is put on a nerve from surrounding tissue. This affects the nerve’s function and can cause symptoms such as numbness, tingling or pain. There are many causes of trapped nerves, such as repetitive movement or injury, or even surgical mistakes. Many cases of trapped nerves can be prevented by having an active, healthy lifestyle and by avoiding too much repetitive movement or overuse. Treatment is usually fairly straightforward, involving physical therapy and painkillers, however, serious cases can require surgery. If you suspect that you have a trapped nerve, then it is best to speak to a medical professional about the treatment option that is best for you.