What you need to know about nerve entrapment

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What is nerve pinching?

Pinched nerves are a particularly common musculoskeletal condition. It is when a particular nerve fibre is put under pressure by other segments around it (bones, ligaments, joints, etc.). The pressurised nerve then becomes ‘pinched’ and inflamed.

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What causes nerve entrapment?

There are many possible causes of nerve entrapment. Often a sudden wrong movement causes the segments to move and the nerve to pinch. This sudden pain is typically felt in the lower back, i.e. the lower part of the spine, and can be accompanied by severe restriction of movement. This is known as hexenschuss, or witch’s shot.

However, nerve entrapment can also be caused by a slow-onset problem. In most cases, it is a background problem caused by prolonged overstrain, which results in nerve pinching. Overstrain can be caused by poor posture, prolonged sitting, repetitive monotonous movements, etc. It is very important to identify the underlying cause, as it is not possible to treat the nerve problem permanently as long as the underlying problem persists. The most common causes are disc wear, disc herniation, slipped disc or spinal stenosis, but chronic inflammation, autoimmune or cancerous conditions can also cause nerve entrapment.

What are the symptoms of nerve entrapment?

The main symptom of nerve entrapment is sharp, radiating pain. It can be so severe that it makes movement almost impossible, but other times it can be less severe. In addition to the pain, there is a tingling, burning, numbing sensation in the area affected by the pinched nerve, usually in the limbs. Muscle weakness and sensory disturbance are common accompanying symptoms .

Spinal nerve entrapment can cause urinary and faecal dysfunction or retention, and in severe cases paralysis . These symptoms should be reported immediately to a specialist as they are an indication for surgery!

In carpal tunnel syndrome, a specific symptom is that the pain and numbness occurs at night and is so severe that it wakes the patient up. And in piriformis syndrome, a strong muscle spasm around the thigh may accompany the pinching of the nerve.

When should you see a doctor for a nerve pinch?

Nerve pinching should not be taken lightly. It can be the cause of a serious problem, so be sure to consult a rheumatologist or specialist in orthopedics in the following cases:

• She is in a lot of pain, which makes her unable to move.
• Numbness, numbness, tenderness, radiating pain that does not subside after a few days of rest or exercise.
• For recurrent nerve entrapment.
• In case of urination or defecation problems (S.O.S!)
• In case of paralysis (S.O.S!)
• Known cancer.
• For osteoporosis.

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Diagnostics for nerve entrapment

Nerve entrapment is investigated and treated by rheumatologists and specialists in orthopedics. At the Budapest Musculoskeletal Private Outpatient Clinic , we have developed a special patient journey protocol to ensure thorough examination and effective, targeted therapies.

Our mission is to help our patients regain their freedom of movement as soon as possible, and to permanently and long term relief from painful complaints.

The cornerstones of a successful investigation based on the BMM patient journey protocol:

• Accurate history taking: by detailed questioning, many diseases can be ruled out or even suspected.
• A thorough physical examination by a specialist. The physical examination includes a movement and palpation examination. Based on these, a specialist will determine the need for any diagnostic imaging tests:
• X-ray examination can confirm bony lesions. X-rays are usually taken of the spine, hip joints, knees and feet. This is often necessary for isolating purposes related to diagnostics.
• The condition of the soft tissues, discs, articular cartilage, muscles and tendons is accurately assessed by the radiograph.
• In some cases, a CT (computer tomography) scan or MRI (magnetic resonance imaging) scan is also needed to make an accurate diagnosis.
• In the case of nerve involvement, neurophysiological testing, ENG or EMG is required to determine the extent of suspected nerve damage.

Diagnostics tests can help to visualise and measure anatomical structural changes and reveal the true cause of the complaint.

Neuroconductive neurophysiological examinations (ENG/EMG) are available at BMM’s clinics in Pest and Óbuda. The necessary X-ray examinations, ultrasound examinations, CT scans and MRI examinations are provided by our partner institutions at an external location for an additional fee.

Based on the tests, the specialist will make a diagnosis and recommend a personalised treatment plan. In our private practices, we also offer a wide range of treatments including injections, prescription of medication, physiotherapy (physiotherapy, manual therapy), therapeutic massage and physiotherapy. We accompany our patients all the way to recovery!

The key to success is doctor-patient cooperation and trust!

Treatment options for nerve entrapment

The effective treatment for nerve entrapment is determined by several factors:

• Location of the nerve pinch
• Duration of the nerve entrapment
• Presence and quality of accompanying symptoms
• The cause of nerve entrapment.

The most common site of nerve entrapment is the cervical or lumbar spine. When sharp pain indicating pinching occurs, rest is recommended as a first step. If the pain allows movement, a gentle walk and regular special stretching exercises are recommended in addition to weight bearing. If the pain does not subside or returns and there are accompanying symptoms, a rheumatologist or specialist in orthopedics should be consulted who can recommend targeted treatment. Depending on the symptoms and the underlying cause , a combination of medication, injections, physiotherapy and specific physiotherapy may be considered. In some cases, however, surgery may be an option (e.g. disc herniation, tumour), which may require the involvement of a neurosurgeon.

In the case of carpal tunnel syndrome, a combination of physiotherapy and physiotherapy can improve the condition, but in most cases an intervention is required for a full recovery. Depending on the location of the problem, surgery is performed by a surgeon specializing in hand surgery or an orthopaedic surgeon.

For piriformis syndrome, a combination of special physiotherapy, physiotherapy massage and physiotherapy treatments, possibly with anti-inflammatory and muscle relaxant drugs, usually provides a permanent solution.