Pinched Nerve: More Than a Pain in the Neck

May 17, 2005 02:08 PM

By Jim Brown, Ph.D., author, Tennis: Steps to Success -3rd Edition (Human Kinetics Publishers)

Here is a magic formula for avoiding what most tennis players call a pinched nerve:

  1. Select the right parents.
  2. Don't wear out your body too early.
  3. Lead a life sheltered from turning, twisting, and lifting.

"In other words," says orthopaedic surgeon Dr. Angela Smith, past-president of the American College of Sports Medicine, "there is not much you can do to protect yourself from this degenerative condition. It's simply going to happen to some people."

The term "pinched nerve" is commonly used by the public, but physicians are more likely to talk about spondylosis, ankylosis, and radiculitis than they are a pinched nerve. More important than the correct terminology is the process that causes pain to start in the neck or back and to radiate through the shoulders, arms, and legs.

As we get older, the disks that make up the vertebral column lose some of their height and shape. As the vertebrae move closer together, bone spurs (overgrowths of bone tissue) develop, grow, and cause a stiff bridge between joints. The bony or fibrous tissue and the bulging disks provide less space for the nerves of the spinal column. The end result is pain at the site and pain that can radiate into the arms and down the legs. As much as 75 percent of the pain associated with a pinched nerve occurs in the extremities. Things get worse when muscles react by contracting violently, causing even more pressure on the nerves.

More Common in Back Than Neck
"Even though many people associate this condition with the neck," explains Atlanta physician Richard Hawkins, M.D., "it is more common with the lower back." There is a shooting pain that travels to a specific part of the leg. The physician and the patient can actually follow the pain pathway. If the nerves in the area of the neck are affected, the pain will shoot down the arms. Pinched nerves in the neck could also be the result of an impact or repeatedly bending the neck."

When nerves of the neck are impinged upon, there will be limited neck motion and pain that extends over the top of the shoulders and even to the chest. It can be mistaken for the symptoms of a heart attack, and the person could also have headaches, dizziness, or difficulty in sleeping.

"When the pain extends into the legs," continues Hawkins, "the athlete will not be able to participate in sports. "Walking, running, standing, twisting, or lifting will make the pain worse. The primary symptom of a pinched nerve is pain. In some cases, part of the limb can lose sensation. In severe episodes, muscle atrophy can develop."

Good News
About the only good news regarding pinched nerves is that 90 percent of those affected will improve with rest, heat, limited activity, and over-the-counter anti-inflammatory drugs. Physicians may recommend stronger medication, collars, cortisone injections, and traction. Surgery to fuse the disks, remove them, or to take out the spurs is possible, but performed infrequently.

Sports medicine physicians encourage athletes to begin rehabilitation as soon as the pain will allow it. The condition can recur, but a debilitating attack can be avoided by using some of the treatment methods already mentioned. If surgery is needed, it may take three months before a player can return to training or competition.

© 2005 HMS Publishing, Inc.
Jim Brown will be contributing new content to this site on a monthly basis. If you have a question for Dr. Brown please feel free to email him at