Nerve-Related Spine Conditions

Causes, Symptoms and Treatment for Pinched Nerves in the Neck and Back

Nerve-related spine conditions occur when a spinal nerve or the spinal cord becomes compressed, irritated or inflamed. This can lead to symptoms such as neck or back pain, pain that travels into the arms or legs, numbness, tingling, weakness, or difficulty with balance and mobility.

At Orthopaedic Associates of Wisconsin, our spine specialists evaluate the underlying cause of nerve-related symptoms and develop an individualized treatment plan. Depending on the condition, treatment may include physical therapy, pain management, injections or surgery.

What Causes Nerve Compression in the Spine?

The nerves that travel through and exit the spine can become compressed for several reasons. Common causes include:

Herniated Disc

A herniated disc occurs when material from inside a spinal disc pushes through its outer layer and irritates or compresses a nearby nerve.

A herniated disc in the neck may cause pain, numbness, tingling or weakness that travels into the shoulder, arm or hand. A herniated disc in the lower back may cause symptoms that travel into the buttock, leg or foot.

Spinal Stenosis

Spinal stenosis is a narrowing of the spinal canal or the spaces where nerves exit the spine. This narrowing can place pressure on the spinal cord or nerve roots.

Cervical spinal stenosis affects the neck, while lumbar spinal stenosis affects the lower back.

Degenerative Disc Disease

Spinal discs naturally change with age. As a disc loses height or flexibility, there may be less room for nearby nerves. Degenerative changes may also contribute to bone spurs and other changes that cause nerve compression.

Foraminal Stenosis

The neural foramina are small openings where nerves exit the spinal column. When these spaces become narrowed, the exiting nerve can become compressed.

Depending on where the narrowing occurs, foraminal stenosis may cause pain, weakness, numbness or tingling in an arm or leg.

Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward relative to the vertebra below it. This can narrow the spaces around the spinal nerves and cause pain or neurologic symptoms.

Sciatica

Sciatica refers to symptoms caused by irritation or compression of the sciatic nerve or the nerve roots that form it.

Symptoms commonly include pain that begins in the lower back or buttock and travels down the leg. Numbness, tingling or weakness may also occur.

What Does a Pinched Nerve in the Spine Feel Like?

Symptoms vary depending on which nerve is affected and whether the problem is located in the cervical, thoracic or lumbar spine.

Common symptoms include:

• Neck or back pain
• Pain that travels into the shoulder, arm, hand, buttock, leg or foot
• Numbness or tingling
• Muscle weakness
• Burning, electric or shooting pain
• Difficulty walking or standing for extended periods
• Changes in coordination or balance

Symptoms affecting the neck and arms are often associated with cervical nerve compression, while symptoms traveling into the legs are more commonly associated with lumbar nerve compression.

What Is Cervical Radiculopathy?

Cervical radiculopathy occurs when a nerve root in the neck becomes compressed or irritated.

It may cause:

• Neck pain
• Shoulder or arm pain
• Numbness or tingling in the arm or hand
• Weakness in the shoulder, arm or hand

Common causes include a cervical herniated disc, degenerative disc disease, bone spurs and narrowing around the nerve.

Treatment depends on the severity of symptoms and the underlying cause.

How Are Nerve-Related Spine Conditions Diagnosed?

Diagnosis usually begins with a physical examination and discussion of your symptoms, medical history and how the condition is affecting your daily activities.

Diagnostic testing may include:

• X-rays
• MRI
• CT imaging
• Electromyography or nerve conduction testing when appropriate

Imaging helps identify problems such as herniated discs, spinal stenosis, degenerative changes and nerve compression.

How Are Pinched Nerves and Nerve-Related Spine Conditions Treated?

Many nerve-related spine conditions can initially be treated without surgery.

Treatment may include:

Physical Therapy

Physical therapy may help improve strength, flexibility and movement while reducing stress on irritated nerves.

Medications

Anti-inflammatory medications or other medications may be used to help manage pain and inflammation.

Spine Injections and Pain Management

Epidural steroid injections, nerve blocks and other interventional treatments may help reduce inflammation and pain associated with nerve compression.

Spine Surgery

Surgery may be considered when symptoms persist despite nonsurgical treatment, when nerve compression is severe, or when progressive weakness or other neurologic symptoms are present.

The type of surgery depends on the location and cause of the nerve compression.

Procedures may include:

• Discectomy
• Decompression or laminectomy
• Spinal fusion
• Cervical disc replacement

When Is Cervical Disc Replacement Used for Nerve Compression?

Cervical disc replacement may be an option for certain patients when a damaged or herniated disc in the neck is compressing a nerve or the spinal cord.

During cervical disc replacement, the damaged disc is removed and replaced with an artificial disc designed to maintain motion at the treated level of the neck.

Unlike cervical fusion, which stabilizes the spine by joining two vertebrae together, cervical disc replacement is designed to preserve movement.

Not every patient with cervical nerve compression is a candidate. The appropriate treatment depends on the condition of the disc, the number of levels involved, spinal stability, arthritis, bone quality and other factors.

Learn more about cervical disc replacement.

When Should I See a Spine Specialist?

Consider scheduling an evaluation if you have:

• Persistent neck or back pain
• Pain that travels into an arm or leg
• Ongoing numbness or tingling
• Weakness in an arm, hand, leg or foot
• Symptoms that are interfering with work, sleep or everyday activities
• Symptoms that have not improved with conservative treatment

New or worsening weakness, difficulty walking, or loss of bowel or bladder control should be evaluated promptly.

Frequently Asked Questions

Can a herniated disc cause numbness and tingling?

Yes. When a herniated disc presses on a spinal nerve, it can cause pain, numbness, tingling or weakness along the path of that nerve.

What is the difference between a pinched nerve and spinal stenosis?

A pinched nerve describes nerve compression. Spinal stenosis is one possible cause of that compression and occurs when the spinal canal or the openings around the nerves become narrowed.

Can a pinched nerve heal without surgery?

Many patients improve with nonsurgical treatment. Treatment may include activity modification, physical therapy, medications or injections. Surgery may be considered when symptoms persist or significant nerve compression is present.

Can a pinched nerve in the neck cause arm pain?

Yes. Cervical nerve compression can cause pain that travels from the neck into the shoulder, arm or hand. Numbness, tingling or weakness may also occur.

Is cervical disc replacement used to treat a pinched nerve?

It can be used in appropriately selected patients when a damaged cervical disc is causing nerve or spinal cord compression. A spine specialist can determine whether cervical disc replacement, fusion or another treatment is appropriate.

What is the difference between cervical disc replacement and fusion?

Both procedures can be used to treat certain cervical spine conditions. Fusion joins two vertebrae together to stabilize the treated area, while cervical disc replacement uses an artificial disc designed to preserve motion.