Treatment for a Pinched Nerve

Head and neck pain, as well as arm numbness and tingling, can be caused by a pinched nerve in your neck. The formal name for this condition is cervical radiculopathy.

There are a few simple treatments for a pinched nerve. If these don't work, your healthcare provider may consider more aggressive options.

This article looks at how a pinched nerve is diagnosed and treated.

Pinched Nerve Diagnosis

When you have radicular pain in your neck, your healthcare provider will first look for red flags that could point to other more serious conditions.

These include:

• Difficulty walking or leg weakness
• Bowel or bladder problems
• History of fever, weight loss, cancer, or a weakened immune system
• Age younger than 20 or older than 50
• Severe, sudden onset of pain, which could point to damage or an abnormality of a cervical artery
• Other neurological signs like difficulty speaking or swallowing, which could indicate a stroke

If any concerning signs are present, your healthcare provider will order additional tests. You may need a blood test or you may be sent for imaging of your head and/or neck. In some cases, you may be referred to a specialist or sent to the emergency room. This will depend on what condition your healthcare provider suspects and how urgent it is.

Conservative Management for a Pinched Nerve

If your healthcare provider diagnoses a pinched nerve, you may be prescribed conservative management, which refers to non-invasive ways to ease your discomfort. This will give your nerve irritation some time to resolve.

Usually, you will receive a combination of medication and physical therapy. This treatment typically lasts for two to eight weeks.

Medications that may be prescribed include:

• A nonsteroidal anti-inflammatory (NSAID) like Advil (ibuprofen) or Aleve (naproxen)
• An oral steroid like prednisone to reduce inflammation if your pain is severe
• Antidepressants, such as amitriptyline to control pain
• Anti epilepsy drugs, such as Lyrica (pregabalin) or gabapentin to reduce pain

During this time, avoid activities that make your pain worse. But you'll also need to avoid staying in bed for long periods of time. Inactivity can delay your recovery and may lead to more problems—like muscle atrophy (loss of muscle). If you can, continue your daily routine, but limit activities that are uncomfortable.

You may also be referred for physical therapy. It will help you retain neck range of motion and strengthen your neck, back, and shoulder muscles. Your healthcare provider may also recommend using a cervical collar or pillow. Another possible therapy is cervical traction.

When Pinched Nerve Symptoms Do Not Go Away

If you still have pinched nerve symptoms, like headaches, after six to 12 weeks of conservative management, your diagnosis and treatment plan may need to be re-evaluated.

You may need an MRI or CT scan of your upper spine. A nerve conduction study (NCS) and electromyography (EMG) can also help find the source of your pain. These tests use electrodes to track the electrical signals in your muscles and nerves. Sometimes, the diagnosis is more complex and requires a consultation with a spine specialist. 

If your symptoms don't resolve after conservative management, other treatment options are available. Injections, for example, can help ease the pain. During this treatment, pain medications or anti-inflammatories, such as steroids, are injected into a space near the spine to ease the pain.

Surgery might be an option if your pain is not improving, you're experiencing worsening weakness (such as difficulty lifting your arm), and/or imaging tests show that your spinal cord is affected.

Discuss the need for surgery carefully with your healthcare provider. It is important to make sure the benefits outweigh any potential harms before moving forward with this procedure. 

Summary

Cervical radicular symptoms can have a number of causes. Your healthcare provider will want to rule out more serious problems, like stroke, before diagnosing a pinched nerve.

If you do have a pinched nerve, the first line of treatment is usually a combination of pain medication and physical therapy. If your pain is still present after six to 12 weeks, you may need to be re-evaluated. Imaging tests can help confirm other conditions, or you may need an epidural nerve block or surgery.

A Word From Verywell

If you've been diagnosed with a pinched nerve, don't worry. Most people who have a pinched nerve recover with conservative management. Sometimes symptoms recur, and a repeat course of medication and/or physical therapy is usually helpful. And persistent cases can be effectively treated with interventions like injections or surgery—these treatments are typically beneficial.