Pinched Nerve / Peripheral Nerve Entrapment

Written by Dr. Jason Ngan, DC

What is Peripheral Nerve Entrapment / Pinched Nerve?

Peripheral nerve entrapment (aka pinched nerve) is a general term to describe a nerve that is being compressed by surrounding structures. Peripheral nerves are nerves outside of the brain and spinal cord.

Some common nerve entrapments are include piriformis syndrome, sciatica, pronator teres syndrome, meralgia paresthetica, carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, Morton’s neuroma, etc.

What Causes Peripheral Nerve Entrapment / Pinched Nerve?

Muscles, tendons, ligaments, cartilage, and bones put pressure on nerves and cause weakness, pain, numbness, and tingling. Some common examples are:

  • Herniated discs

  • Overgrowth of bone (such as from arthritis)

  • Overweight/obesity

  • Poor posture/ergonomics

  • Inflammation and muscle spasm from overuse or injuries

  • Fluid retention

What are the Signs and Symptoms?

Depending on the nerve being compressed it can present with different signs and symptoms. Some nerves only control movement, some nerves only control sensation (pain, touch, temperature), and some nerve control both movement and sensation.

  • Pain, numbness, tingling

  • Weakness

  • Worse with movement

  • Muscle atrophy (muscle loss) in severe cases

How is Nerve Entrapment Diagnosed?

Nerve entrapment can be diagnosed with a thorough medical history, physical examination, orthopedic testing, x-ray diagnostic imaging, CT scan, EMG/NCV, and MRI.

  • Muscle weakness.

  • Abnormal sensation (pain, numbness, tingling).

  • Diagnostic imaging looks for disc herniation, osteophytes (growth spurs), spinal canal stenosis (narrowing of spinal cord).

  • EMG/NCV checks for function of nerve and muscles.

What are the Treatment Options?

The source of the entrapment must be identified to properly treat pinched nerves. At Ngan Chiropractic, we offer a variety of treatments.

  • Chiropractic manipulation and mobilization

  • Flexion-distraction

  • Spinal traction

  • Soft tissue therapies

  • Gua-sha

  • Cupping

  • E-stim

  • Ultrasound

  • Ergonomic/postural counseling

  • Nerve flossing

  • Rehabilitative exercises

Other treatments that patients may seek (not provided at Ngan Chiropractic) include acupuncture, steroid injections, and surgery if severe.  

References

  1. Mangi, M.D., Zadow, S. & Lim, W. Nerve entrapment syndromes of the upper limb: a pictorial review. Insights Imaging 13, 166 (2022). https://doi.org/10.1186/s13244-022-01305-5

  2. Menorca RM, Fussell TS, Elfar JC. Nerve physiology: mechanisms of injury and recovery. Hand Clin. 2013 Aug;29(3):317-30. doi: 10.1016/j.hcl.2013.04.002. PMID: 23895713; PMCID: PMC4408553.

  3. Miner JR, Paris PM, Yealy DM. Marx, et al., editors. Pain Management. Mark: Rosen's Emergency Medicine. 7th ed. 2010.

  4. Schmid AB, Fundaun J, Tampin B. Entrapment neuropathies: a contemporary approach to pathophysiology, clinical assessment, and management. Pain Rep. 2020 Jul 22;5(4):e829. doi: 10.1097/PR9.0000000000000829. PMID: 32766466; PMCID: PMC7382548.