A pinched nerve can cause significant pain in the leg and, if left untreated, can lead to permanent nerve damage and loss of function. The "pinch" is actually compression of a nerve. Usually, the pain associated with the pinched nerve is experienced lower down the leg in the muscles and tissues that the nerve serves. Other customary symptoms include tingling, numbness and sometimes severe weakness if the nerve is so impinged that the impulses no longer reach the muscle. There are various causes of nerve compression including muscle spasms, spinal stenosis, a bulging disc, osteoarthritis, cancer, infection or trauma. Effective treatment is highly dependent on correctly identifying and alleviating the cause of the compression.
Early Interventions
Conservative treatment should be initiated immediately after symptom onset. The Merck Manuals Online Medical Library suggests ice packs in the first 24 to 48 hours to calm inflammation and numb the acute pain. Moist heat after the first 48 hours soothes tight muscles and relaxes tension. Many people find that alternating between rest and normal movement allows the body time to heal without additional stress. Some pinched nerves respond well to gentle massage. Use of over the counter pain relievers and anti-inflammatory medications are also helpful. Above all, any activity that sparked the pain should be ceased and not restarted until symptoms are completely gone.
Physical Therapy
Some causes of a pinched nerve do not respond well to conservative treatment and require the interventions of a skilled physical therapist. The therapist will perform a complete physical assessment in order to isolate the cause of the nerve compression. The physical therapist can also prescribe a routine of stretching and strengthening to help relieve the pressure on the nerve and ease pain. Joint mobilizations or spinal traction are other available treatment options. According to C.C. Goodman and K.S. Fuller in "Pathology: Implications for the Physical Therapist," modalities such as electrotherapy, ultrasound and deep tissue massage may be utilized to further reduce symptoms of a pinched nerve.
Chiropractic
Occasionally, the nerve is compressed due to poor positioning of the vertebrae. Correction of the alignment of the spine releases the pressure on the nerve and improves symptoms. Spinal manipulation should only be performed by a professional due to the danger of permanent nerve damage if done incorrectly.
Surgical Interventions
Poor symptom relief with the less invasive treatments may lead a person to consult an orthopedic surgeon for more significant interventions. Many doctors begin treatment with medications to manage pain and decrease painful muscle spasms. Thorough testing is then done to pinpoint the source of pressure. Depending on the cause of the nerve compression, the physician may choose to perform cortisone injections, an epidural or a surgical procedure to resolve the issue. Surgical procedures for pinched nerves include laminectomy, discectomy, foraminotomy, vertebral fusion or insertion of an interspinous decompression device. If the pressure is found to be caused by a tumor or an infection, referral for appropriate treatment is provided.
References
- MayoClinic.com: Pinched Nerve Treatments and Drugs
- "Pathology: Implications for the Physical Therapist, 3rd Edition"; C.C. Goodman, K.S. Fuller; 2009
