Nerve compression

About every third of over 30-year-old people have neck and shoulder region pains and even 80% have back pains at some point in their life. Pains fixated only in the neck or back usually can’t be treated surgically. If radiating pain to the limbs, tingling or numbing also occur, a nerve root compression may be in question.

With some nerve root compressions, surgery results in a very good outcome. Most typical patients like this are patients suffering from nerve root or spinal cord compressions in the lumbar spine or in the cervical vertebrae. The problems of these patients can be well handled and treated at the private practitioner’s reception as well. Also, it is possible to perform a surgery in privately owned Mehiläinen.

Symptoms of nerve root compression

The reason for the nerve root compression may be the narrowing of the nerve root canal caused by a herniated disc or degenerating bones. With a herniated disc the symptom may have started suddenly during the last few days. A nerve root compression caused by degenerating bones on the other hand may have had symptoms for even years.

In both cases the symptoms are however similar: The compression of the nerve typically causes pain, at times also numbing or weakening strength on the ending of the nerve in question. The worst symptom is usually concentrated quite accurately in the area of one nerve root level. For example, a bulging disc between the fifth and sixth vertebra in the cervical spine typically causes radiating pain through the upper- and forearm all the way to the thumb and index finger area. A herniated disc in the lower back typically radiates pain along the sciatic nerve through the thigh and outer area of the calf to the toes.

A herniated disc as a cause of nerve compression

The cause of a nerve compression can be a herniated disc, which makes it possible for the core mass of the soft spinal disk to get access to press down on the nerve root. The symptom starts suddenly after a couple of days.

Degeneration of the nerve root canal

A nerve root compression in the cervical spine may have been causing worsening symptoms for even years, when the reason for it is the narrowing of the nerve root canal, lateral stenosis, due to degeneration of the bones. It is not rare, that the patient has had shoulder aches at the start, which has been examined and possibly treated as shoulder related problems. On the other hand, the patient’s symptom may have been interpreted as a ’tennis elbow’. Only after the treatments turn out to be ineffective, may the thought go to the cervical spine and nerve root compression.

Examining a nerve compression

The identification of nerve root compression states starts with carefully examining the patient. If the examination raises a suspicion of a compression state, the right diagnosis can be gotten with an MRI scan of the cervical spine. Sometimes, an electromyoneurography (EMNG) test performed by a clinical neurophysiologist may be needed along with the MRI scans, especially if the MRI scan shows changes in many levels and the level causing the symptoms needs to be confirmed. At times, a regular X-ray is needed to check the condition of the bone structures.

Some of the patients at the neurosurgeon’s reception have already been thoroughly examined by other doctors, such as neurologists or physicians and the neurosurgeon is asked for an opinion about a possible surgery. On the other hand, it is also possible to come to a neurosurgeon’s consultation in an earlier stage to ponder about whether radiating pains in the legs or arms are due to a nerve compression.

Surgery of nerve root compressions

A decompression surgery for the compressed nerve roots performed by a neurosurgeon is now-days done with the help of a microscope. In the surgery, a disc or a bone spur, which is compressing the nerve root is removed. The surgery doesn’t interfere with the nerve root or the spinal cord. The correctly selected surgical treatments for nerve root compressions will help the patient significantly. Especially the pain symptom often eases fast. A lot of the times, the patient will tell about the pain being left behind on the operating table. However, the weakening strength or permanent numbing caused by the nerve root compression go away more slowly. These symptoms indicate, that there has been a prolonged or a strong compression state on the nerve root. At times, especially after continuing for months, these symptoms won’t be healed despite the nerve root’s successful decompression surgery.

Most of the surgeries done in the cervical spine area are done from the front of the neck, where the distance to the spinal disc area is the shortest. Only some of the cervical spinal stenosis are cut through the back of the neck, while all herniating discs in the lower back are cut through the back. After a herniating disc surgery, the patient is usually monitored for one night and can then go home the next day. The recovery time is about one month depending on the patient’s job. After the recovery time the patient can usually go fully back to work, as well as hobbies.

Symptoms of a nerve root compression in the neck:

  • radiating pain, for example to the upper arm or the thumb becoming numb
  • weakening strength
  • aches between shoulder blades
  • in certain head positions the aches in the arm may ease
  • aches or numbing in the arm, which wake you up during the night
  • pain killers aren’t much help

Specialists and locations

Jukka Aho
Marjukka Aho
Fysiatrian erikoislääkäri
Antti Aitasalo
Työfysioterapeutti, fysioterapeutti
syyskuu 2021viikko 37