While we’ve all heard the common expression “pain in the neck” to describe an unpleasant situation or person, having a pinched nerve in your neck is no mere annoyance—it can be downright painful.
The good news is that with prompt treatment, most people recover from a pinched nerve within a few weeks. We talked to UNC Health neurosurgeon Joshua Loewenstein, MD, MBA, to learn more.
What is a pinched nerve?
The medical term for a pinched nerve is cervical radiculopathy. It occurs when too much pressure or force is put on part of a nerve, which can damage it and cause it to send warning signals to the brain. Symptoms can include neck pain, as well as tingling, numbness and weakness in the neck or arms.
“When these nerves become irritated or compressed, a pain can radiate down into the arm with numbness, tingling and weakness in the arm,” Dr. Loewenstein says.
Anyone can get cervical radiculopathy, but it’s more common in adults.
How is a pinched nerve in your neck diagnosed?
If you’re experiencing pain and discomfort in your neck or arms that lasts more than a month, it’s important to seek medical attention. Early treatment can prevent nerve damage and long-term pain.
“Most people who have a pinched nerve in their neck that lasts longer than about a month should get imaging to identify exactly which of the cervical nerves is being affected,” Dr. Loewenstein says.
Either a neurosurgeon or a pain management doctor can order this imaging and evaluate the findings.
What are nonsurgical treatments for a pinched nerve?
Depending on what the imaging shows, there are both nonsurgical and surgical treatment options for a pinched nerve, and most patients can be treated with nonsurgical treatments, Dr. Loewenstein says.
Often, resting the affected area and avoiding strenuous activities that may worsen these symptoms can help alleviate pain and improve overall function.
Other nonsurgical treatments include physical therapy, pain-relieving medication such as ibuprofen (Advil) or naproxen sodium (Aleve), or a short course of oral corticosteroids, which are drugs that closely resemble the hormone cortisol and may help relieve pain by reducing swelling and inflammation within the nerve. Cervical traction is another option; a physical therapist or another clinician can use a medical device or their hands to “temporarily stretch out those spaces in your neck and relieve compression,” Dr. Loewenstein says.
There are also a variety of treatments that pain management physicians can offer to relieve these symptoms. One of them is the epidural injection—a procedure that brings anti-inflammatory and pain-relieving medications directly to the point of compression.
When do you need surgery for a pinched nerve?
Surgery may be necessary if you have exhausted all nonsurgical treatment options and still have pain, have significant neurologic deficits related to the nerve compression such as arm weakness, or if you have any “red flag signs” that indicate your spinal cord is being pinched, such as issues with manual dexterity, fine motor control or your balance, Dr. Loewenstein says.
Surgery aims to relieve pressure on the affected nerve and, in some cases, improve the alignment of the cervical spine. There are two main surgical approaches to address a pinched nerve: One is done from the front of the neck (anterior) and the other from the back of the neck (posterior).
The procedure your doctor will recommend will depend on many factors, including what symptoms you are experiencing and the location of the involved nerve. “Depending upon people’s anatomy, it’ll differ on which one is a better option for a specific patient,” Dr. Loewenstein says.
In other words, your surgery will largely depend on which nerve is getting pinched and what is pinching it.
Recovery from either surgery takes about six weeks. Most patients are pleased that they took the time and effort to relieve their pain, he says.
“Things can get better,” Dr. Loewenstein says, “and most people who have a pinched nerve in their neck are treatable.”
Worried about a pinched nerve? Talk to your doctor. If you need a doctor, find one near you.