Pinched Nerves, Sciatica and Nerve Pain

Numbness, tingling, burning or electric shocks running down an arm or leg can be scary, and it can make simple things hard: typing, holding a phone, sleeping on your side or walking without tripping. These symptoms usually mean a nerve is being squeezed or irritated somewhere along its path.

The key is finding where. A pinched nerve can start in the neck or lower back, or it can be trapped farther out at the elbow, wrist or knee. Dr. Betsy Grunch, a board-certified, Duke-trained neurosurgeon, treats both, so she can look at the whole nerve, from the spine to the hand or foot, and find the true source of your symptoms.

Pinched nerves in the spine

• Sciatica (lumbar radiculopathy): a pinched nerve in the lower back that sends pain, numbness or tingling down the buttock and leg, sometimes into the foot.
• Cervical radiculopathy: a pinched nerve in the neck that causes pain, numbness or weakness in the shoulder, arm and hand.
• Herniated disc: the most common cause of a pinched nerve in the spine.
• Foraminal stenosis: narrowing of the opening where a nerve leaves the spine.

Trapped nerves in the arms and legs

• Carpal tunnel syndrome: the median nerve is squeezed at the wrist, causing numbness and tingling in the thumb and first fingers, often worse at night.
• Cubital tunnel syndrome and ulnar nerve compression: the “funny bone” nerve is squeezed at the elbow, causing numbness in the ring and small fingers.
• Peroneal nerve compression: the nerve on the outside of the knee is squeezed, which can cause foot drop and numbness on the top of the foot.
• Radial nerve palsy: weakness lifting the wrist and fingers. Dr. Grunch evaluates this condition and refers surgical cases to an upper extremity specialist.

Other nerve problems

• Peripheral neuropathy: damage to many nerves, often starting in the feet.
• Brachial plexus injuries, traumatic nerve injuries and nerve tumors.
• Neuropathic pain: long-lasting burning or shooting pain from injured nerves.

Clues that help tell the difference:

• Neck or back pain along with arm or leg symptoms often points to the spine.
• Symptoms that follow one part of the hand, such as the thumb side or the small-finger side, often point to the wrist or elbow.
• Symptoms that are worse at night or when you bend your elbow or wrist are common with carpal and cubital tunnel syndrome.
• Foot drop with no back pain can point to the peroneal nerve at the knee.

Sometimes both are happening at once. Dr. Grunch uses your exam, imaging such as an MRI, and nerve tests (EMG and nerve conduction studies) to pinpoint where the nerve is trapped, so you get the right treatment the first time.

See a specialist soon if you have weakness, a weaker grip, foot drop, or numbness that doesn’t go away. Call 911 or go to the nearest emergency room if you have sudden weakness, new loss of bladder or bowel control, or numbness in the groin or inner thighs.

Many pinched nerves improve with rest, physical therapy, splints, medicine or injections, and Dr. Grunch will talk with you about what makes sense for you. When numbness, pain or weakness keeps going or gets worse, surgery can often correct the problem by giving the nerve more room.

• Microdiscectomy: removes a herniated disc pressing on a nerve in the lower back.
• Foraminotomy: widens the opening where a nerve leaves the spine, in the neck or lower back.
• ACDF and cervical disc replacement: relieve a pinched nerve in the neck.
• Carpal tunnel release: frees the median nerve at the wrist.
• Cubital tunnel release and ulnar nerve transposition: frees the ulnar nerve at the elbow.
• Peroneal nerve decompression: frees the nerve at the knee to help foot drop.
• Peripheral nerve decompression: for other trapped nerves in the arms and legs.

Carpal tunnel, cubital tunnel and peroneal nerve surgery are outpatient procedures, so most people go home the same day.

• One surgeon for the whole nerve: Dr. Grunch treats pinched nerves in the spine and trapped nerves in the arms and legs, so you don’t have to bounce between specialists to find the cause
• Duke-trained and board-certified by the American Board of Neurological Surgery, and a Fellow of the AANS, ACS and CNS
• Experience: more than 5,000 procedures, with 400 to 600 surgeries a year
• Minimally invasive spine surgery whenever it is a safe choice
• Close to home: offices in Gainesville, Sandy Springs and Riverdale

Learn more about Dr. Grunch’s training and credentials.

What does a pinched nerve feel like?

A pinched nerve can cause sharp or burning pain, numbness, tingling, a pins-and-needles feeling, or weakness. The symptoms usually follow the path of the nerve, such as down the back of the leg with sciatica or into certain fingers with carpal or cubital tunnel syndrome.

How do I know if my numbness is coming from my neck or my wrist?

It can be hard to tell on your own, and sometimes both are involved. Neck pain along with arm symptoms points toward the spine, while numbness in the thumb and first fingers that’s worse at night points toward carpal tunnel. An exam, MRI and nerve tests (EMG and nerve conduction studies) help Dr. Grunch find the true source.

Will a pinched nerve heal on its own?

Many do improve with time, physical therapy, splints, medicine or injections. If numbness, pain or weakness keeps going or gets worse, surgery can often correct the problem. Weakness or numbness that won’t go away should be checked soon, because nerves recover best when they are treated early.

When should I see a doctor for sciatica?

See a spine specialist if leg pain lasts more than a few weeks, keeps coming back, or comes with numbness or weakness in the leg or foot. Loss of bladder or bowel control or numbness in the groin is an emergency, so call 911.

How long is recovery from carpal tunnel surgery?

Carpal tunnel release is an outpatient surgery, so most people go home the same day. Many people notice less tingling soon after surgery, while grip strength and long-standing numbness can take longer to improve. Dr. Grunch or one of her physician assistants will give you a recovery plan.

If numbness, tingling or nerve pain is getting in the way of your life, Dr. Grunch can help you find where the nerve is trapped and what your options are. Call 470-293-9800 or contact us to schedule a visit at our Gainesville, Sandy Springs or South Atlanta (Riverdale) office. You can also ask general questions any time through our “Ask Us Anything” chat.

Related: All nerve conditions · All nerve procedures · Chronic pain and spinal cord stimulation · Neck pain and neck surgery · Lower back pain and back surgery

This information is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk to your provider about your symptoms.