Nerves travel through openings in your spinal vertebrae. While the bony structures protect the nerves, the small, tight spaces also make it easy for spinal problems to push against and pinch nerves.
Pinched nerves cause neck or back pain, as well as symptoms that travel down the length of the nerve, affecting your arms or legs. Getting a prompt and accurate diagnosis from spine specialist Richard B. Kim, MD, is essential for preventing a pinched nerve from developing permanent nerve damage.
In this blog post, we give you a summary of the different steps Dr. Kim takes to diagnose a pinched nerve.
Your diagnosis begins by learning about your medical history and the details of your symptoms. Then we perform a thorough physical exam, including testing your reflexes, sensation, and muscle strength.
A pinched nerve can weaken the muscles in your arms or legs. To test your overall strength, we may ask you to move your arms or legs or hold them in specific positions. You may also need to move your head and body so we can see what positions trigger pain.
Though symptoms such as pain and tingling that radiate down your arms or legs strongly suggest a pinched nerve, we need to do additional testing to verify the specific nerve and determine if it has diminished function.
Electromyography and nerve conduction studies show how well the pinched nerve is working. An EMG detects and records the electrical activity in muscles, while an NCS shows the electrical impulses as they travel through the nerve.
During your NCS, we place surface electrodes on your skin along the nerve being tested and over the muscle controlled by the nerve. One electrode sends out a mild electrical impulse that goes through the nerve.
The other electrodes along the nerve pick up the impulse as it goes through the nerve, showing its speed, as well as any problems in nerve transmission.
If the nerve is damaged, the signal will stop or change along the way. The electrode over the muscle shows how long it takes the muscle to respond to the electrical stimulation.
The EMG is done by placing a small needle into the muscle. The needle picks up muscle movement and sends it through a wire to a computer. Then we evaluate the activity that occurs while your muscle is at rest and when you tighten the muscle.
Diagnostic imaging plays an important role in identifying pinched nerves, as well as the root cause of the problem. We choose the best type of imaging based on the results of your exam and the duration and severity of your symptoms.
We also make imaging choices based on factors unique to your health. For example, MRI is a good choice for diagnosing pinched nerves but may not be the best option for every patient. Some patients can't tolerate being inside the device. And you can't get an MRI if you have some types of implanted medical devices.
The types of diagnostic imaging we may use include MRI, ultrasound, CT scans, and X-rays.
MRIs create images using a radiofrequency magnetic field, a technique that clearly shows pinched nerves, disc disease, and inflammation or infections in the spinal tissues. MRI is usually the preferred imaging for pinched nerves.
Ultrasound uses sound waves to produce real-time images of the nerves and other soft tissues in your neck and back. In some cases, ultrasound can pick up specific details in the nerves that we may not see with other imaging techniques.
A CT scan is a special type of X-ray imaging that shows soft tissues and bony structures in your spine. While a CT scan can help us diagnose problems in the vertebrae, discs, and spinal canal, it provides fewer details for the spinal nerves.
X-rays don't give us images of pinched nerves. However, they reveal structural changes in the vertebrae, allowing us to clearly see if you have a fracture, bone spur, or slipped disc.
If you need expert care for spinal pain or have questions about diagnosing pinched nerves, call Richard B. Kim, MD, or book an appointment online today.
