Pinched nerve is a lay term for a variety of disorders in which spinal nerve gets compromised. The spinal nerve is a composite of nerve roots which come together to form spinal nerve. Anywhere along the line of branching out of the nerve roots from the spinal cord to their compounding into spinal nerve they can be compromised. Pinched or more properly impinged. .The most common causes of compromised spinal nerve is nerve impingement in vertebral foramina ( bony canal through which nerves travel within the spinal vertebraes) or the area adjacent to it . Vertebral foramina is a anatomical space through which spinal nerves travel on their way to become peripheral nerves. Various events in the spine can compromise and pinch on the spinal nerve or nerve roots. Terminology can be confusing , but when the nerve roots get impinged it is called radiculopathy. Radiculopathy is usually assumed when patient exhibits radiating pain with or without numbness and pins and needles. The clinical nerve root test may or may not be positive. But certain pathological events must occur to trigger radicular pain . These can be divided into two types: inflammatory or compressive. The inflammatory type is due to the immune response of the nerve to proximity of extruded disc material.
The compressive type is due to nerve disc conflict where there is a direct contact- pressure of the extruded disc material to the nerve. These are usually more severe and take longer to heal. Yet another type of pinched nerve is frequently encountered . This one is due to nerve contact with a newly formed bony outgrowth( called osteophyte) either within the spinal foramen or immediately after the nerve exits the foramen. The osteophytes are usually the result of degenerative spinal disease which is called spondyloarthrosis. The reason it is called spondyloarthrosis is because the newel formed bony outgrowth is usually due to another pathology called facet arthropathy which is basically degeneration of facet spinal joints. In human spine anatomy is very complex and spec is very tight. In case of facet arthropathy if the bony outgrowth (osteophytes) develops in the part of the facet which forms the spinal foramen this osteophytes will narrow spinal canal and impinge on the nerve. Many other more complex reasons exist in the spine which can cause nerve impingement within the spine.
Usually patients refer to pinched nerve as some kind of trivial condition. Sometimes this impingement could be trivial event, however some of scenarios described above could occur in combination and cause more serious pathology potentially leading to surgery. Other locations where nerve pain referring down the leg can be found is further down in the pelvis inside the sciatic foramen.This one is called a piriformis syndrome. The piriformis syndrome is also a common cause of a pinched nerve. The piriformis syndrome could be a distinct condition, but most often is a sequel of disc disease at L4-l5 level. The distinct piriformis syndrome is usually connected to abnormal movement of the hip joint or pelvic floor syndrome. Treatment of pinched nerves varies greatly based on anatomical location , symptoms and clinical progression. These type of conditions should be dealt with only by experienced practitioners specializing in treatment of these conditions. Otherwise , grave potential consequences may follow.