The term 'pinched nerve' is often used to describe intense, sharp pain in the neck or other parts of the spine. In reality, however, spinal nerves are rarely physically pinched. Rather, they become irritated, squeezed or stretched by chemicals, producing the typical pain, also described as burning, electric, tingling and/or shooting in nature. What most people describe as a pinched nerve is usually a stiff, irritated, or inflamed spinal facet joint, which can be intensely painful and severely restrict range of motion, but is generally not considered a serious medical condition. There are many possible methods for getting rid of a pinched nerve in your neck, including certain self-care techniques and treatments by health professionals.
Part 1 of 3: Treating a pinched nerve yourself
Step 1. Wait and be patient
Pinched nerves in the cervical spine usually occur suddenly and are related to complex neck movements or trauma, such as whiplash. If it is caused by an unusual movement, the neck pain may disappear quickly and on its own without any treatment. So be patient (a few hours to a few days) and hope for the best.
- The risk of an injury to the neck is greater if the muscles are cooled and stiff. So don't move your neck too vigorously until the muscles have warmed up through normal blood flow or by covering them with a scarf or turtleneck (if the ambient temperature is cool).
- Continuing with normal neck movements despite the pain will allow a pinched nerve to recover naturally.
Step 2. Change your work or training schedule
If your neck problem is caused by conditions at work, talk to your boss about switching to another activity or changing your workplace so that your neck doesn't put more strain on it. Neck pain is relatively common in blue-collar jobs such as welding and construction, but so are office jobs, where the neck is constantly in a twisted or bent position. If the neck pain is caused by sports, you may be training too aggressively or not using good technique - in that case, consult a personal trainer.
- Complete inactivity (such as bed rest) is not recommended for neck pain - muscles and joints need to be kept moving and need adequate blood supply to heal.
- Improve your posture at work and at home. Make sure your computer monitor is at eye level as this will help prevent a strained/sprained neck.
- Examine your sleeping conditions. Pillows that are too thick can contribute to neck problems. Avoid sleeping on your stomach as this can cause your head and neck to twist.
Step 3. Take over-the-counter medication
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen and aspirin can provide a short-term solution for pain or inflammation in the neck. Keep in mind that these drugs can be taxing on the stomach, kidneys and liver, so it's better not to take them for more than two weeks at a time. Never take more than the recommended dose.
- The adult dosage is usually 200-400 mg, taken orally, every four to six hours.
- Alternatively, you can take over-the-counter pain relievers such as acetaminophen (Tylenol) or muscle relaxants (such as cyclobenzaprine) for the pain in your neck, but never take them at the same time as NSAIDs.
- Be careful not to take medication on an empty stomach, as they can irritate the lining of the stomach and increase the risk of an ulcer.
Step 4. Apply cold therapy
The application of ice is an effective treatment for just about all minor musculoskeletal injuries, including neck pain. Cold therapy should be applied to the softest part of your neck to reduce swelling and pain. Ice should be applied for 20 minutes every two to three hours for a few days, then reduce this frequency once the pain and swelling subside.
- Pressing the ice against your neck with a stretching bandage also helps fight inflammation.
- Always wrap the ice or frozen gel packs in a thin towel to prevent freezing of the skin.
Step 5. Optionally, take an Epsom salt bath
Soaking your upper back and neck in a warm Epsom salt bath can significantly reduce pain and swelling, especially if the pain is caused by overworked muscles. The magnesium in the salt helps the muscles to relax. Don't overheat the bath (to avoid burns) and don't soak in the bath for more than 30 minutes, as the salty water draws moisture from your body and can potentially dehydrate you.
If swelling is a particular problem in your neck, take a cold therapy after the warm salt bath until your neck feels numb (about 15 minutes)
Step 6. Try gently stretching your neck
Stretching your neck may improve the condition of your neck (by relieving pressure on the nerve or loosening the cervical facet joint), especially if you treat the problem early. Use slow, steady movements and take a deep breath as you stretch. In general, hold the stretch for about 30 seconds, repeating it three to five times a day.
- While standing, look straight ahead and slowly bend your neck to the side, bringing your ear as close to your shoulder as possible. After a few seconds of rest, stretch to the other side.
- It is recommended to stretch immediately after a hot shower or application of moist heat, as your neck muscles will be more flexible.
Part 2 of 3: Seeking medical help
Step 1. Find a medical specialist
Medical specialists such as an orthopedist, neurologist or rheumatologist may be needed to rule out the most serious causes of your neck pain, such as an infection (osteomyelitis), hernia, osteoporosis, spinal fracture, rheumatoid arthritis or cancer. These conditions are not common causes of neck pain, but if self-care and conservative therapies are ineffective, then more serious problems should be considered.
- X-rays, bone scans, MRI, CT scan, and nerve conduction studies are methods that specialists can use to help diagnose your neck pain.
- Your doctor may also order a blood test to rule out rheumatoid arthritis or a spinal infection, such as meningitis.
Step 2. Consider an injection into the facet joint
Your neck pain may be caused by chronic joint inflammation. An injection into the facet joint consists of real-time fluoroscopic (X-ray) guidance of a needle through the neck muscles in the inflamed or irritated spinal joint, followed by an anesthetic and a corticosteroid mixture, which quickly relieves both pain and inflammation on the spot. A facet joint injection takes about 20-30 minutes to perform and results can last from a few weeks to a few months.
- You should not have more than 3 injections into the facet joint in a six month period.
- Pain relief with these injections usually begins on the second or third day after treatment. Until then, your neck pain may get a little worse.
- Potential complications of facet joint injections include infections, bleeding, local muscle atrophy, and nerve irritation/damage.
Step 3. Talk to your doctor or physical therapist about traction
Traction is a technique to open the spaces between the vertebrae. Traction comes in many forms, from a therapist manually treating your neck to a traction table. There are also homemade traction devices. Never forget to treat the neck slowly. If any pain or numbness radiates to the arms, stop right away and see a doctor. Before using a traction device at home, it is best to seek advice from your doctor, chiropractor, or physical therapist so that they can help you choose the right one.
Step 4. Consider surgery
Surgery for neck pain is the last resort and should only be considered after all other more conservative therapies have proven ineffective and if the cause justifies such a invasive procedure. Some reasons for neck surgery include repairing or stabilizing a fracture (due to trauma or osteoporosis), removing a tumor, or repairing a hernia. If the nerves in your neck are really involved, you will also notice shooting pains, numbness and/or muscle weakness or decreased strength in your arms and/or hands.
- Spinal surgery may involve the use of metal rods, pins, or other devices for structural support.
- The repair of a hernia often involves the fusing of two or more bones (vertebrae), which usually results in a decreased range of motion.
- Possible complications of back surgery include local infection, an allergic reaction to the anesthetic, nerve damage, paralysis and chronic swelling/pain.
Part 3 of 3: Use alternative therapies
Step 1. Get your neck massaged
A muscle strain occurs when individual muscle fibers are stretched beyond their stretchable limit and then tear, leading to pain, inflammation and sometimes some degree of muscle spasm to prevent further damage. As such, what you call a "pinched nerve" could actually be a strained neck muscle. A deep tissue massage is helpful for mild to moderate strains because it reduces muscle spasms, counteracts inflammation and promotes relaxation. Start with a 30-minute massage, targeting your neck and upper back. Let the therapist massage as deeply as possible without making you cringe.
- Always drink plenty of water immediately after a massage to flush out the byproducts of inflammation (lactic acid and toxins) from your body. If you do not do this, you may suffer from headaches or mild nausea.
- As an alternative to professional massage therapy, you can use a tennis ball or vibrator on your neck muscles - or better yet, ask a friend to do this. Slowly roll the ball around the soft part of your neck for 10-15 minutes, a few times a day, until the pain subsides.
Step 2. See a chiropractor or osteopath
Chiropractors and osteopaths are spinal specialists who focus on creating the normal movement and function of the small spinal joints that connect to the vertebrae (the facet joints). Manual joint manipulation, also called an adjustment, can be used to loosen or reposition cervical facet joints that are misaligned (and cause inflammation and sharp pain, especially during movement). Pulling the neck can also help relieve your pain.
- While a single spinal adjustment can sometimes provide complete release of the pinched nerve, 3-5 treatments are more likely to be required before significant results occur.
- Chiropractors and osteopaths also use a variety of therapies that are more tailored to muscle strains, which may be more suitable for neck problems.
Step 3. Try physiotherapy (physiotherapy)
If your neck continues to cause problems (chronic) and is caused by weak muscles, poor posture or degenerative conditions such as osteoarthritis, then you should consider some form of rehabilitation. A physical therapist can show you specific and tailored trajectories and prescribe strengthening exercises for your neck. Physiotherapy usually takes 4-6 weeks, 2-3 times a week, before a positive result is seen in chronic back problems.
- If needed, a physical therapist can treat your sore neck muscles with electrotherapy, such as therapeutic ultrasound or electronic muscle stimulation.
- Good exercises for your neck include swimming, certain yoga poses, and strength training, but make sure the injury is resolved first.
Step 4. Consider acupuncture
In acupuncture, very thin needles are inserted into specific energy points within the skin/muscle in an attempt to reduce pain and inflammation. Acupuncture can be effective for neck pain, especially if performed when symptoms are first noticeable. Acupuncture is based on the principles of traditional Chinese medicine and works by releasing a number of substances, including endorphins and serotonin, which can reduce pain.
- It is also claimed that acupuncture stimulates the flow of energy (chi).
- Acupuncture is practiced by a variety of health professionals, including some doctors, chiropractors, naturopaths, physical therapists and masseurs.
- Avoid reading in bed propped up with various pillows - this can cause the neck to bend too much.
- Quit smoking as it interferes with blood flow, resulting in a lack of oxygen and nutrients in the back muscles and other tissues.
- Avoid carrying bags that distribute the weight unevenly across your shoulders, such as single-strap bags or shoulder bags, as they can strain your neck. Instead, use a wheeled bag or a traditional backpack with well-padded straps.