Introduction
It is also known as Nerve compression syndrome, compression neuropathy, nerve entrapment, or a “pinched” peripheral nerve. It is caused when a peripheral nerve loses mobility, flexibility, or becomes compressed by surrounding tissues. A nerve entrapment can cause neuropathic / neurogenic pain that can be either acute or chronic in nature. Nerves extend from the brain and spinal cord, sending important messages throughout the body. In a case of pinched nerve, the body may send warning signals such as pain. Don’t ignore these warning signals. Damage from a pinched nerve may be minor or severe. It may cause temporary or long-lasting problems. The earlier the diagnosis and treatment for nerve compression done, the sooner will be the relief. The damage from a pinched nerve cannot be reversed in some cases. But treatment usually relieves pain and other symptoms.
Signs and symptoms
- Pain in the area of compression, such as the neck or low back
- Radiating pain, such as sciatica or radicular pain
- Numbness or tingling
- “Pins and needles” or a burning sensation
- Weakness, especially with certain activities
Causes
Pinched nerve occurs when there is “compression” (pressure) on a nerve. The pressure may be the result of repetitive motions. Or it may happen from holding the body in one position for long periods, such as keeping elbows bent while sleeping.
Other causes may include:
- Injury
- Rheumatoid or wrist arthritis
- Stress from repetitive work
- Hobbies or sports activities
- Obesity
Pathophysiology
A nerve entrapment can be both ischemic or mechanical in nature. Repetitive injury and trauma to a nerve may result in microvascular (ischemic) changes, oedema, injury to the outside layers of the nerve (myelin sheath) that aid with the transmission of the nerve’s messages, and structural alterations in membranes at the organelle levels in both the myelin sheath and the nerve axon. Focal segmental demyelination at the area of compression is a common feature of compression syndromes. Complete recovery of function after surgical decompression reflects remyelination of the injured nerve. Incomplete recovery in more chronic and severe cases of entrapment is due to Wallerian degeneration of the axons and permanent fibrotic changes in the neuromuscular junction that may prevent full reinnervation and restoration of function
Diagnosis
Physical examination including neurological exams
Electrodiagnostic testing (EDS)
Nerve conduction studies
Treatments
Treatment may include:
NSAIDs – Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen may reduce swelling.
Oral corticosteroids – to reduce swelling and pain.
Narcotics – These are used for brief periods to reduce severe pain.
Steroid injections – These may reduce swelling and allow inflamed nerves to recover.
Physical therapy – helps stretch and strengthen muscles.
Splint – A splint or soft collar limits motion and allows muscles to rest for brief periods.
Surgery – Surgery may be needed for more severe problems that don’t respond to other types of treatment.
Prognosis
Damage from a pinched nerve may be minor or severe. It may cause temporary or long-lasting problems. A proper diagnosis and treatment will help find relief in many cases. In some cases, the damage from a pinched nerve cannot be reversed. But treatment usually relieves pain and other symptoms.
Complications
Disease & Ayurveda
A direct correlation is not there in the Ayurvedic texts for Pinched nerve but the condition can be compared with Vaatadoshakopa. All the movements including nervous & locomotor system in the body are included in the functions of Vaata dosha. Vaata can be vitiated in two conditions, like in dhaatukshaya(degeneration of body tissues) or aavarana(obstruction of the channels due to kapha or aama).When the Vaata dosha is vitiated, these systems are affected directly as in the case of a pinched nerve, especially due to aavarana.
Nidana
Aavarana (obstruction of channels in the body)
Purvaaroopa
Not mentioned
Samprapti
Not mentioned
Lakshana
There can be one or more signs and symptoms attributed to Vaatadosha namely
Ruk – Pain
Supti – Numbness
Sosha – Wasting of tissues
Sparsajnata – loss of tactile sensation
Kampa – shivering
Bheda – piercing type of pain
Swaapa – loss of sensation
Divisions
Not mentioned
Prognosis
Saadhya in new & uncomplicated cases
Chikithsa
Samana
Lepanam with Rookshana dravyas
Swedanam especially pindaswedam
Upanaham
Sodhana
Asthapanavasti
Anuvasanavasti
Agnikarma and treatment of wound in suitable cases
Commonly used medicines
Rasnerandadi kashayam
Maharasnadi kashayam
Varanadi kashayam
Guggulutiktakam ghrutam
Ksheerabala tailam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
No home remedy is proven to cure pinched nerve. Applying heat bags on the area, taing enough rest and ice packs may help reducing the discomforts.
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, sesame oil, fresh fruits & vegetables
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active
Yoga
Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
The effect of insulin-like growth factor I (IGF-I) was tested on regeneration of the rat sciatic nerve after a crush lesion. IGF-I was administered via miniosmotic pumps to the dorsal root ganglia or locally around the crus lesion. Regeneration of sensory fibers was measured after 3 or 4 days superfusion by pinching. IGF-I stimulated regeneration in both administration paradigms. Regeneration was inhibited if the nerve was perfused with specific antibodies to native IGF-I. The results suggest that endogenous extracellular IGF-I plays an important role during regeneration of peripheral nerve fibers.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com
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