Pinched Nerve in Neck


Symptoms of cervical nerve pinch occur when the nerve that is exiting from the cervical region of the spinal column is being pressed on. The sign that may present varies depending on the cervical nerve that is affected [1].

What is Pinched Nerve in Neck?

A pinched nerve happens when a surrounding tissue applies pressure on the nerve. Some of the tissues that may cause the pressure include tendons, muscles, cartilages and bones. This condition may occur at different sites of the body and the pressure will affect the function of the nerve and may cause pain, numbness or weakness. Figure 1 shows a nerve that is pressed on as it exits the spinal column [1, 2, 3].

There are 24 vertebrae in the spinal column that are placed on top of each other. Inside the spinal cord is the spinal canal where the spinal cord is located. There 3 regions in the spinal column and the cervical region start comprised of the first 7 vertebrae from the base of the skull. The nerve branches exits from the column through the foramen. It is through this area that the nerves may be pressed on [4].

Pinched Nerve in NEck


ICD10 Code

The ICD-10-CM diagnosis code used for individuals with a pinched nerve in the neck is M54.12 [5].


Causes of Pinched Nerve in Neck

There a number of spinal conditions that may lead to a pinched nerve in the cervical region.

Osteophytes Formation

Osteophytes, or bone spurs, are smooth structures that have formed from the spinal column. These formations are considered to be the radiographic markers of degeneration of the spine. The osteophytes are usually the formed due to the calcifications of the ligaments that holds the spinal vertebrae together. As the bone spurs protrude through the foramen, these may pressed on the nerves that exits through the opening [6, 7].

Disc Herniation

There are small, round, flat discs that serve as a cushion between the vertebrae of the spine. These discs may be damaged due to normal wear and tear, traumatic injury or some pathologic conditions. If these discs are damaged, these may bulge abnormally or break open. The bulging of the disc may press on a nerve and affect its function [6, 7].

Body Movement and Positioning

Repetitive neck motions such as bending twisting may cause the nerve to be compressed. Holding the neck in a certain position for an extended period of time increases the risk for the said event to occur [1].

Symptoms

The symptoms that are experienced varies depending on the cervical nerve that is affected. An individual with mild nerve compression may not feel anything but as it progresses, he will feel pain in the shoulder or arm area. The pain may be described as tingling, radiating, sharp or burning. It may resolve itself even without treatment but it may persist for a long time [3, 7].

Other signs of cervical pinched nerve may include:

  • Neck pain and headaches
  • Feeling of “pins and needles” in the shoulder area
  • Weakness of the muscles innervated by the affected nerve

Cervical nerve compression may lead to certain conditions such as tennis elbow, carpal tunnel syndrome and peripheral neuropathy [1].


Diagnosis

Health History and Physical Examination

The diagnosis of a pinched nerve in the neck can be established through the data obtained from health history, physical examination and other diagnostic tests. The focus of the history is characterize the pain that is felt by the patient. The location, quality and intensity of the pain must be identified. For the physical examination, the physician will try to identify certain neck movements that will intensify or relieve the pain [8, 9].

Additional Diagnostic Tests

After obtaining all these information, a physician may request further tests to find the pinched nerve and identify the cause. An x-ray taken to the cervical region will be able to show the growth of osteophytes that may have pressed on the neck area. A Magnetic Resonant Imaging (MRI) and Computed Tomography scan (CT scan) will show any tissue such as muscle, ligament or tendon that is applying pressure on the nerve [8, 9].

Electromyography (EMG)

A nerve conduction examination such as an electromyography (EMG) may also be asked by the physician in order to confirm the diagnosis of a pinched nerve. The extent of the damage to the nerve will also be identified through the EMG [9].

Treatment of Pinched Nerve in Neck

Nonsurgical Treatment

Most of the time, a physician may suggest rest for the painful area. It may be necessary to restrict or limit any activities that will intensify the pain. A splint or brace may be required to immobilize the area. Physical therapy exercises will be able to improve the strength of the muscles the affected area. Medications may also be prescribed to reduce the pain and inflammation in the affected area. Examples of medications that may be prescribed include Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. The patient may have to come back for a follow-up to verify if the advised treatment were successful in reducing the pain [2].

Surgical Treatment

Nonsurgical treatment options are commonly advised first but if there is no improvement after the initiation of treatment, the physician might recommend a surgical procedure. The surgery will depend on the area of the nerve that is being compressed and may include removal of bone spurs or a herniated disc in order to reduce the pressure [2].


References

  1. (2014, September 1). Pinched (Compressed) Nerve. Retrieved from WebMD: http://www.webmd.com/pain-management/guide/compressed-nerves
  2. Mayo Clinic. (2016, March 1). Pinched Nerve. Retrieved from Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/pinched-nerve/basics/definition/con-20029601
  3. com. (2016). Pinched Nerve. Retrieved from Spines.com: http://www.spines.com/conditions/pinched-nerve
  4. Rodway, I. (2015, June). Cervical Radiculopathy. Retrieved from OrthoInfo: http://orthoinfo.aaos.org/topic.cfm?topic=a00332
  5. (2015). Radiculopathy. Retrieved from ICD10Data: http://www.icd10data.com/ICD10CM/Codes/M00-M99/M50-M54/M54-/M54.1
  6. Schneider, J. (2010, December 14). Osteophytes and Back Pain. Retrieved from Spine-health: http://www.spine-health.com/conditions/arthritis/bone-spurs-osteophytes-and-back-pain
  7. Healthwise Staff. (2014, June 4). Herniated Disc and Pinched Nerve. Retrieved from WebMD: http://www.webmd.com/back-pain/herniated-disc
  8. Roland, J. (2015, January 21). Is a Pinched Nerve Causing Your Shoulder Pain? Retrieved from Healthline: http://www.healthline.com/health/pinched-nerve-shoulder-pain#Overview1
  9. Taylor, D. (2015, April 30). Pinched Nerve. Retrieved from eMedicineNet: http://www.medicinenet.com/pinched_nerve_overview/page5.htm

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