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Pinched nerve - what is the cause and what helps?
A pinched nerve can lead to very painful complaints and functional disorders in different parts of the body. Affected people are often severely restricted in their everyday lives, especially if it is a chronic course with long-lasting symptoms. If the cause is known, simple, conservative treatment measures can often help. Naturopathy and holistic medicine also offer many therapeutic options for light nerve compression. Surgery is only necessary in rare, severe cases.
Brief overview - nerve trapped
Definition: pinched nerve
Colloquially, a pinched nerve refers to nerve compression or nerve constriction that can lead to various symptoms and diseases. This general term encompasses complaints that occur at a wide variety of locations in the body or can originate from a wide variety of locations in the nervous system.
Peripheral nerves of the extremities are particularly often pinched at certain narrow points, such as in the carpal tunnel of the wrist. Spinal complaints are often associated with a pinched nerve, which is why there are widespread associations with neck pain, back pain, lumbago and sciatica pain, for example.
Frequent pinched nerve locations
Nerve compression occurs more often in certain parts of the body than in others. These are areas in which different nerve tracts run through certain anatomical constrictions and can be narrowed there rather than at other parts of the body.
In the spinal canal of the spine, painful compressions of the spinal nerves or spinal cord can occur due to degeneration and diseases of the spine (for example, herniated disc or spinal stenosis). Problems that extend across the lower back, buttocks, and legs are often related to a pinched sciatic nerve. A known condition in the upper area of the spine is the so-called cervical spine syndrome (cervical spine). Pain that originates from here can pull up to the shoulders and arms or trigger a headache (back of the head).
In addition, the so-called Lateral cutaneous femoral nerve, which rises from the spinal cord at the level of the lumbar spine and runs to the thigh, is narrowed under the groin ligament. Symptoms caused by this are called Bernhardt-Roth syndrome (Meralgia paraesthetica) or Inguinaltunnel syndrome.
In the area of the limbs, for example, the ulnar groove (elbow) and the carpal tunnel (wrist / wrist) are narrow passages, which can lead to ulnar groove syndrome (cubital tunnel syndrome) or carpal tunnel syndrome. The tarsal tunnel (inner side of the ankle) is also such a fragile structure (tarsal tunnel syndrome). These complaints are among the so-called bottleneck syndromes.
Symptoms of pinched nerves
The neurological symptoms are very diverse and primarily depend on which nerve is affected in which area and how severely.
In general, nerve compression leads to so-called neuralgia (nerve pain) or neuropathic pain.
The pain arises in the affected nerve regions, but also radiates to other parts of the body (supply area of the affected nerves) or occurs as projected pain in other parts of the body. In accordance with the frequent localizations (see above), sufferers often complain of stinging or burning pain in the back, neck and shoulder area as well as in the head, arms / hands or legs / feet.
In addition to the pain, there are often sensory disorders or sensation disorders in the limbs, such as tingling and numbness. Impaired movement can also be part of the symptoms, and in more serious cases even paralysis and regression of muscle tissue.
If, for example, the sciatic nerve is pinched, this can not only lead to back pain (lower back pain), buttock pain and back pain in the thighs, but also to sensory and functional disorders in the entire leg.
With a compression of the Ulnar nerve The ulnar groove on the elbow is often accompanied by a feeling of numbness in the fingers (little finger, ring finger) and the palm of the hand. Muscle weakness in the corresponding supply area is often accompanied. A pinched nerve in the area of the legs is often associated with foot pain or foot pain.
Causes of nerve compression
A common cause of a pinched nerve is a hardening of the surrounding muscles (muscle hardening), which presses directly on a nerve tract. This can be due to congenital anatomical impairments or incorrect loads (e.g. due to lifting that is too heavy or incorrect). Overloading ("one-sided") or repeating certain movements can also lead to changes in muscle and other body structures and thereby impair nerve pathways.
Furthermore, nerves can be pinched in the course of an impairment of the skeletal system. This often happens when the nerves are pinched in the back. For example, in the event of a herniated disc, nerves running through the tissue that have escaped into the spinal canal are narrowed.
The so-called vertebral sliding spondylolisthesis) can also pinch the nerves in the spinal canal. These and other diseases can occur as part of various degenerative processes on the spine, which are the main cause of narrowing of the spinal canal (spinal stenosis). If there is a vertebral blockage, this usually triggers the muscle tension mentioned, but it is usually easier to treat.
Pinched nerves in the shoulder often occur when the shoulder joint is dislocated (shoulder dislocation). The nerve pathways running here (especially Axillary nerve) are then pinched off and lead to severe shoulder pain and further discomfort in the arms and hands.
Injuries (such as broken bones and hematomas) or tumors can also put pressure on nerve tracts or cause nerves to become trapped. The same applies to external mechanical compression, for example due to clothing that is too tight or tight seat belts. In addition, the burden of a particularly large belly (overweight or pregnancy) can put enormous pressure on the tissue and, for example, cause nerve compression in the hip and pelvic area.
Sometimes a detailed patient survey of the symptoms that have occurred and a simple clinical examination are sufficient to make a reliable diagnosis. Muscle hardening can usually be determined by targeted palpation. The underlying causes for this can often be found in (professional) everyday life and in movement habits.
In some cases, however, it is not possible to clearly determine whether it is neuropathic pain or other forms of pain (so-called nociceptive pain). There are also so-called mixed pain forms. In order to determine the correct therapy regimen, precise characterization and delimitation of the pain during the medical history is particularly important. Further neurological examinations also serve to describe pain more precisely and to find the cause.
If there is a suspicion of a serious cause and a more serious illness or injury, further investigation must be undertaken. Imaging methods such as ultrasound, X-ray, computer tomography (CT) or magnetic resonance tomography (MRT) are often used. Changes in the skeleton and other structures can be made visible.
If there are still doubts, the measurement of the nerve conduction speed and other further examinations can be arranged.
Treatment: Treat pinched nerves
Due to the different causes of nerve compression, different treatment options are available, which are used individually depending on the case. Depending on the intensity of the pain, a temporary drug pain therapy can be a useful addition to the cause-specific treatment.
If nerves are pinched due to hardening of the muscles, certain movement therapies and physiotherapy are often used first. Individual movement and stretching exercises can relax muscles and relieve pain accordingly. These measures are also effective in terms of prevention. Depending on the need, a short sparing phase and immobilization before the therapeutic measures can be useful. Basically, however: Movement is important!
If the nerve is triggered by impairments of the skeletal system, these must be remedied. A dislocated shoulder can often be quickly and easily retracted; however, a severe herniated disc or other diseases of the spine cannot always be treated conservatively. In some cases, after all conservative options have been exhausted, surgery may be necessary to free those affected from their suffering.
Surgery may also be required for carpal tunnel and cubital tunnel syndromes. In the first place and if the symptoms are rather mild, conservative therapy should be used. In many cases, for example, immobilization of the joints in an extended position using splints is very effective.
If tumors press on tissue structures and nerves, surgical removal is usually necessary. In the case of malignant ulcers or cancer, the combination of surgery, chemotherapy and / or radiation therapy is often the only treatment option.
Naturopathy and holistic medicine
If serious causes have been ruled out - which require quick medical care and treatment - in addition to the (conservative) therapeutic methods of conventional medicine, other non-invasive treatment methods from the field of holistic medicine can also be considered. These methods can be used in addition or alternatively.
Exercise therapy, for example, can be supplemented sensibly and effectively with special Pilates exercises and yoga practices.
When it comes to muscle tension, various massage techniques, heat treatments or acupuncture are often used to loosen the muscles, relieve the compression of the nerves and relieve the pain that occurs.
In addition, certain changes that lead to a pinched nerve can be effectively treated by various manual procedures from the field of osteopathy (for example treatment according to the fascia distortion model and trigger point therapy). Other methods such as Rolfing and chiropractic are also considered in this context, even if the effectiveness of these forms of treatment is considered controversial due to the lack of sufficient scientific evidence.
The manual therapies are intended to relieve tension in the muscles and correct malpositions. In line with their holistic approach, the procedures also deal with complaints that are initially not clearly related to the pinched nerve.
Another and still relatively new method of holistic medicine with many indications is neural therapy, which includes various forms of therapy. The healing methods are only partially recognized (by the health insurance companies) - because the effectiveness is not sufficiently proven for all therapies.
Another controversial option for treating a pinched nerve and the associated pain due to muscle cramping are homeopathic remedies (e.g. arnica or bryonia) and Schuessler salts (Magnesium Phosphoricum, Schuessler salt number seven). The connection between muscle tension and a possible existing acidity of the organism has not been proven by recognized studies, so that the accompanying measures to balance the acid-base balance (deacidification) are offered, but their effectiveness is considered questionable.
For some people, it can be helpful to work on their own inner posture using various methods and to reduce psychological tension and stress in order to also release physical tension. (tf, fp, cs)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- German Society for Neurology (ed.): S2k guideline: Diagnosis and non-interventional therapy of neuropathic pain, as of May 2019, AWMF register number 030-114, awmf.org
- Baron, Ralf: Diagnostics and therapy of neuropathic pain, in: Deutsches Ärzteblatt CME Kompakt 1 (2) / 2009, aerzteblatt.de
- Pschyrembel: Clinical dictionary. 267th, revised edition, De Gruyter, 2017
- Fachverlag Gesundheit und Medizin (Hrsg.): Information platform counselor nerves www.ratgeber-nerven.de, back pain due to pinched nerves, access: 30.09.2019, ratgeber-nerven.de
- Assmus, Hans, Antoniadis, Gregor and Bischoff, Christian: Carpal tunnel, cubital tunnel and rare nerve compression syndromes, in: Deutsches Ärzteblatt International 112/2015, aerzteblatt.de
- Peter J. Moley: Lower back pain, MSD Manual (patient edition), accessed August 15, 2019, msdmanuals.com