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Feeling the Pinch: What Does a Pinched Nerve Feel Like?

Vadim Goz, MD

Back and neck pain are very common issues that affect over 90% of people. We have many patients who ask us “Doc, this pain is terrible, do I have a pinched nerve?”. This article will discuss how to tell if you have a pinched nerve in your back or neck. A brief overview of spine anatomy is helpful to explain what makes nerve pain different than pain from other structures in the spine.

The spine is split up into three sections: the cervical spine refers to the neck, the mid back is also called the thoracic spine and the lower back is called the lumbar spine. While each area is anatomically unique, there are certain aspects that are shared between all three regions. The spine is composed of bones called vertebra, multiple joints including intervertebral discs, ligaments that connect two bones together, muscles, and tendons that connect muscle to bone. The spinal cord and spinal nerves run in nerve tunnels and are surrounded by bones, ligaments, discs, and small joints called facet joints.

At each level of the spine there is a large disc that provides cushion between two vertebra. Behind the discs are the neural elements which include the spinal cord and nerve roots. And further behind the neural elements are two smaller joints called the facet joints. This is in addition to the large muscles called the paraspinal muscles which hold the spine in an upright position.

As we age the joints and ligaments in the back gradually wear and degenerate, the ligaments can thicken, and the discs can begin to bulge. This gradually narrows the nerve tunnel and can lead to nerve pinching. Nerves provide sensation and muscle strength to the arms and legs. When a nerve is pinched or inflamed, this causes pain that shoots down the arms or legs. Typically, this happens in the pattern that the nerve supplies sensation to. A pinched nerve in the lower back most commonly causes shooting pain down the back of the thigh and back of the calf or down the side of the thigh and side of the calf. It is also possible to have pain that shoots into the buttock and wraps around to the inner thigh. This pain is often described as a lightning bolt and can be sharp or burning in nature. Pain from a pinched nerve can be associated with arm/leg numbness or weakness

What makes nerve pain unique is that it tends to travel down the arms or legs. Pain from the muscles, tendons, ligaments and joints of the spine is called ‘mechanical pain’.  Mechanical pain can affect the neck or back.  The pain can be sharp or dull and can be quite severe in nature. The most important distinguishing factor is that mechanical pain does not shoot down the arms or legs.

So now that you know what nerve pain feels like, the next question is what do you do if you have it? In most cases we try to avoid surgery and start treatment with conservative management including anti-inflammatory medications, nerve pain medications, physical therapy, and injections by pain management providers. If your pain is very severe or associated with leg weakness, please make an appointment with Dr. Goz and Dr. Sekhon right away, the only combined Orthopedic Spine – Neurosurgery team in Reno!