Pinched Nerve Treatment

A pinched nerve can develop from one of several causes, including repetitive motion or holding a body part in one position for an extended length of time. Pain that travels down the neck and into the arm, or from the spine and down the leg, may cause you to become worried, especially if you have never experienced this type of pain before. Treatment of pinched nerves is vital, because symptoms and pain can worsen, limiting your activities and leading to more complex problems down the road.

A pinched nerve is actually an expression

It is a commonly-used term collectively describing multiple mechanisms of mechanical nerve dysfunctions, such as entrapment, compression, loss of gliding, and tension.

What is a Pinched Nerve?

Nerves originate at your brain and spinal cord and travel throughout every part of your body. Your brain sends messages via your spinal cord to tell your muscles when to fire, and how much force to produce. It also receives messages from proprioceptors in your joints and muscles about your body’s position in space, and alerts about pain from overuse or trauma.

A pinched nerve is a spinal nerve root that has been compressed. It can cause pain, a burning feeling or a sensation of pins and needles in your legs, arms, feet or hands. Depending on its location, a pinched nerve can impair movement and cause muscle weakness. Compression of a nerve root can usually be treated and resolved with conservative care, and rarely requires surgery.

How Exactly Nerves Are Getting Pinched

Nerves travel in anatomical tunnels. Most of the time, these tunnels are located inside the muscles and are composed of the fascia. However, when the nerves cross in between muscular heads or from one muscle to the other, the fascia corridors are usually thicker and more tortuous. This is exactly where nerve compression can occur.

Another anatomical location for the nerve entrapment is called fibro-osseous tunnels (FOT). FOT is a muscular or fascial connection to the bone in which space and gliding are limited. These are the frequent places of nerve entrapments.

Pinched Nerve Symptoms

A compressed nerve in the neck or arm can lead to pain, tingling, numbness and sensations of pins and needles in the fingers, hands, wrists and elbows. Repetitive motions during physical activity may worsen the condition.

A compressed nerve in the lumbo-pelvic region can cause pain and dysfunction in the lower extremities. If the large sciatic nerve is involved, you may experience pain, numbness and/or tingling anywhere from the low back and buttocks, down the legs and into your ankles and feet.

Pinched nerves may be involved in multiple conditions:


  • Tennis elbow
  • Peripheral neuropathy
  • Carpal tunnel syndrome
  • Chronic back or neck pain
  • Piriformis syndrome
  • Hamstring syndrome
  • Other peripheral pain syndromes

In most cases, accurate diagnosis and conservative treatment can resolve a pinched nerve in a relatively short span of time.

Causes of Pinched Nerves

In younger people, a pinched nerve often arises from physical activity or postural issues. Older adults may experience pinched nerves in response to degenerative diseases of the spine or joints.


Common causes of pinched nerves include:


  • Poor posture when sitting and standing
  • Awkward sleeping position
  • Excessive use of electronic devices
  • Too much sitting
  • Poor lifting technique
  • Being out of shape and overweight
  • Degenerative conditions of the spine, like stenosis
  • Narrowing of the vertebral foramina within the spinal column
  • Herniated spinal discs
  • Repetitive overuse from sports or exercise
  • Inefficient motor patterns
  • Deficiencies in walking or running gait

Pinched Nerve Treatment at NYDNRehab

The sports physical therapy and chiropractic team at NYDNRehab has on-site access to some of the most advanced rehab technologies and innovative therapies in the world. Our clinic is the only private clinic in the US to house a wide array of research-grade technology for assessment and rehab.

  • Your healing journey begins with an accurate diagnosis, with the help of high resolution diagnostic ultrasound. Ultrasound imaging lets us view the nerves and structures of the body in real time, giving us an immediate and accurate diagnosis, so we can start your treatment plan right away.
  • We use unique and innovative therapies to help realign your spine and take pressure off nerves. Your plan of care may include chiropractic treatment, acupuncture or dry needling, therapeutic massage, dynamic neuromuscular stabilization (DNS) and/or shock wave therapy.
  • Our high-tech human performance lab lets us analyze your gait and biomechanics, to identify motor deficiencies that impact your nerves. Our assessment and treatment toolbox includes surface electromyography (SEMG), force plate technology, motion capture video, 3D gait analysis, Proteus Motion, Kineo Intelligent Load system, DD Robotech AI equipment, C.A.R.E.N. (computer assisted rehab environment) and much more.
  • Your treatment will include corrective exercises and neuromuscular feedback to correct and resolve motor deficiencies and postural defects. You may be given a physical therapy exercise plan to do at home.
  • One of the most effective ways to decompress the nerve is a nerve hydrodissection. A hydrodissection is a saline solution injection under ultrasound guidance, where a pressure created by the solution breaks up the adhesion between the nerve and the interface.
  • You may be a candidate for TeleHealth services, where you meet with your therapist online, saving you from having to visit the clinic.

At NYDNRehab, we don’t just focus on pain management. We get to the source of pain through quantitative analysis, and correct motor deficiencies, muscular weaknesses and postural problems that put pressure on your nerves and keep you from doing the activities you enjoy.

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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