What You Need to Know About Pinched Nerves
Here's a formula for avoiding what most athletes call a pinched nerve: (1) select the right parents, (2) don't wear out your body too early, and (3) lead a life sheltered from turning, twisting, and lifting.
"In other words," says Angela Smith, MD, an orthopaedic surgeon and former president of the American College of Sports Medicine, "there isn't much you can do to protect yourself from this condition. It's simply going to happen to some people."
Even though many people associate a pinched nerve with the neck or shoulder, it can happen anywhere. In the wrist, it might be a cause of carpal tunnel syndrome. In the elbow, it might be a by-product of tennis elbow, and in the lower back, it could be sciatica. The good news is that, in the vast majority of people, the condition improves or goes away with rest and over-the-counter pain medications. In very mild cases, the problem goes away within a few minutes. In severe cases, surgery may be the only solution.
How a Pinched Nerve Happens
A pinched nerve develops when one or more nerves are compressed or constricted by a bone, muscle, cartilage, or tendon. Among the things that could cause the pressure are poor posture, overuse on the job, exercising, playing a sport, a genetic predisposition to the condition (narrowing of the spine, for example), or obesity. As soon as the pressure is relieved, the pain subsides. It can be relieved over time without intervention, with conservative methods (massage, OTC medications, exercises), or with surgery.
“Pinched nerves occur in areas that are prone to doing too much work,” says Anna Hartman, a performance physical therapist at Athletes' Performance. “For example, in the low back or neck segments of the body, the area below the injury can be hypomobile—it has abnormally limited movement. If there's a hypomobile segment, another joint above or below has to take up the slack and move more than normal, which can create injury. In the neck, it's often the thoracic (middle) spine that's become hypomobile. In the low back, it's the hips that may have become hypomobile. Addressing these limitations may decrease the likelihood of suffering from a pinched nerve.”
Pinched Nerves by the Numbers
The percent of people who will develop low back pain, some of which can be attributed to a pinched nerve.
The percent of people whose symptoms will subside with rest and over-the-counter anti-inflammatory drugs.
Pinched Nerves: More Common in the Back
Even though many people associate this condition with the neck, it's more common in the lower back. There's a shooting pain that travels to a specific part of the leg. The doctor and the patient can actually follow the pain pathway. If the nerves in the area of the neck are affected, then pain will shoot down the arm. Pinched nerves in the neck could also be the result of an impact or repeatedly bending the neck.
When nerves in the neck are impinged, there will be limited neck motion and pain may extend over the top of the shoulders and even to the chest. It can be mistaken for symptoms of a heart attack, and the person may also have headaches, dizziness, or difficulty sleeping.
When the pain extends into the legs, an athlete won't be able to participate in sports. Walking, running, standing, twisting, or lifting will make the pain worse. The primary symptom of a pinched nerve is pain, which some people describe as "shooting" or "like lightning." In some cases, part of the limb can lose sensation, causing numbness or tingling down the path of the nerve. In severe episodes, reflexes are lost and muscle atrophy and weakness can develop.
Who’s At Risk for a Pinched Nerve
There's no compelling evidence that a pinched nerve is more likely to affect athletes in one sport more than in another. However, because the condition often involves overuse and repetitive movements, racquet sports, track and field, gymnastics, and weight lifting are activities that set the stage for pinched nerves.
Symptoms depend on the location of the pinched nerve. Regardless of location, here are some common denominator red flags:
- Numbness (like when your foot “falls asleep”)
- Tingling sensation in the limbs
- Pain radiating from the source to another part of the body (like sciatica in which the pain radiates down the leg)
- Increased pain when walking, running, standing, twisting or lifting
- Possible weakness or muscle atrophy (diminished muscle mass)
- When nerves in the neck are involved, the symptoms might be mistaken for a heart attack, and the symptoms may include headaches, dizziness, or difficulty in sleeping.
- Stop activities that might put pressure on the affected area and rest.
- Give the symptoms time to subside. Don’t rush back to training or competition.
- Use moist heat for 15-20 minutes, three to four times a day.
- Aspirin, acetaminophen, ibuprofen, and naproxen may relieve pain and reduce inflammation.
Sports medicine physicians and physical therapists encourage athletes to begin rehabilitation as soon as the pain will allow it. If surgery is needed, which is very rare, it may take three months before a player can return to training or competition. Use a foam roll, massage stick, or tennis ball to gently massage the area.
Incorporate these prehab exercises into your comeback program:
- Thoracic Spine Mobility - Tennis Ball
- Thoracic Rotation Stretch - Heel Sit
- Quadruped Posterior Rocking
How to Avoid a Pinched Nerve
Follow these tips to avoid developing a pinched nerve:
- Maintain good posture (head up, shoulders back, sit up straight, no slumping).
- Limit repetitive activities when possible.
- Take regular breaks during work and workouts.
Incorporate these Movement Prep exercises into your workout program:
Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.
- Anna J. Hartman, MS, ATC, CSCS, manager of performance physical therapy services at Athletes' Performance
- National Institute of Neurological Disorders and Stroke
- University of Washington Orthopaedics and Sports Medicine