How is a pinched nerve treated?

Medical management (non-surgical) is the first line of treatment for pinched nerves. This includes:

  • Time and rest: For many people, time takes care of a pinched nerve and it doesn’t need treatment. The pain should go away in a few days or weeks.
  • Ice and heat: Apply ice and heat as you would with any swollen area for temporary relief.
  • Over-the-counter pain relievers: Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) may help your symptoms. NSAIDs include ibuprofen and naproxen.
  • Splints and cervical collars (for wrist and hand or neck): Your provider may advise you to wear a soft hand splint or neck collar for a short time to limit motion as you heal.
  • Corticosteroids: Your provider may prescribe strong anti-inflammatory medications like prednisone to relieve pain. These can be taken orally (through the mouth) or injected directly into the affected area.
  • Physical therapy: Stretches and light exercise can help ease pressure on your nerves and relieve minor pain. Talk to your provider or physical therapist about what types of exercises are best for the type of pinched nerve you’re experiencing.

Surgery

Surgery is the last resort in treating a pinched nerve when non-surgical treatment hasn’t relieved pressure on nerves. Examples of surgeries that fix spinal nerve compression include:

  • Anterior cervical diskectomy and fusion (ACDF): Surgeons remove disk or bone spurs that have compressed nerves from the spine, then stabilize the spine through fusion. In fusion, the vertebrae are joined, eventually forming a single, solid bone.
  • Artificial disk replacement (ADR): The injured disckis removed from the spine and replaced with an artificial part, much like a knee or hip replacement. This allows more flexibility in the spine.
  • Posterior cervical laminoforaminotomy: The lamina is the arching bone backside of the spinal canal. The surgeon thins down the lamina for better access to the damaged area and removes the bone spurs and any tissues that are compressing the nerve.

After these surgeries, a full recovery of strength and motion may take several months. Most people can return to a desk job within a few days to a few weeks after surgery. Depending on your surgery, a return to full activities may take three to four months. Your surgeon will give you a general idea of your recovery time, and some people may take longer.

  • Surgery for carpal tunnel syndrome: To relieve nerve compression in your hand’s carpal tunnel, there are two surgical options: open (one 2-inch cut) and endoscopic (minimally invasive, with one or two ½- inch cuts). Both are done to cut the ligament around the carpal tunnel to take pressure off the median nerve. In the open surgery, the surgeon makes a 2-inch incision into your wrist and directly cuts the ligament. In the endoscopic, the surgeon makes one or two small cuts and a tiny camera guides the surgery. This should relieve your symptoms and the ligament will grow back together with more space for the nerve to pass through. Full recovery can take 10 to 12 weeks but you will be able to do limited activities (such as driving) very soon after the surgery.

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