Exhaust Conservative Options Before Undergoing Pinched Nerve Surgery

By Patrick Foote

Spinal pinched nerve surgery is an operation to alleviate an impingement of a spinal nerve root, a condition known as spinal nerve compression. In almost every case, surgical treatment of a pinched nerve is considered the last resort. This is because of the risks inherent to any surgical procedure, and because of the fact that most people are able to manage the symptoms associated with a pinched nerve through conservative, nonsurgical treatment.

What Is A Pinched Nerve?

‘Pinched nerve’ actually is a layman’s term, not a medical term. Many people use it to describe the sharp pain associated with a muscle strain, as when someone sleeps with his or her head at an awkward angle and wakes up with neck discomfort or stiffness. However, the actual, physical ‘pinching’ of a spinal nerve root might take place in the form of constant compression by or intermittent contact with an anatomical abnormality. These abnormalities can occur at any level of the spine, but are most frequently found within the flexible, weight-bearing neck (cervical) and lower back (lumbar) regions.

The causes of a pinched nerve in the spine are often related to the degenerative effects of aging. Within the spine are several anatomical components that tend to deteriorate with use over time. These components include:

— Facet joints – The hinge-like structures where vertebrae meet and articulate.


— Intervertebral discs – The spongy wedges of cartilage that act as cushions between the vertebrae.

— Ligaments – Connective tissue that contributes to spinal movements and helps stabilize the vertebrae.

Although all of these components are vulnerable to the effects of a traumatic injury, age-related degeneration is more likely to lead to spinal nerve compression. Degenerative spine conditions include:

— Osteoarthritis of the spine – Deterioration of the cartilage lining the facet joints; can cause the growth of osteophytes, or bone spurs.

— Degenerative disc disease – A loss of water content and height within an intervertebral disc; can lead to bulging or herniated discs.

— Spondylolisthesis – Gradual, progressive slippage of one vertebra over another.

— Ligamental ossification or calcification – A gradual reduction in elasticity within a ligament.

These conditions will not necessarily produce chronic pain and other symptoms on their own, although some discomfort and stiffness may arise. The real problem occurs when these tissues make contact with a nerve root or the spinal cord, which can give rise to debilitating pain, tingling, numbness, or muscle weakness in the extremities.

When to Consider Pinched Nerve Surgery

In most nerve compression cases, the pain and other symptoms can be managed using a regimen of conservative methods, including non-steroidal anti-inflammatory drugs (NSAIDs), exercise, stretching, and other nonsurgical treatment. If the symptoms remain debilitating – or worsen – over a treatment period of weeks or months, surgery might become an option. However, before consenting to pinched nerve surgery, it is important to exhaust all conservative options. Patience is also vital, because proper symptom management might require a combination of conservative treatment methods, and a patient may have to try several different forms of treatment to find the right mix. Even when it appears that all conservative methods have failed, a patient should seek a second or even a third opinion before settling on surgery as a solution.

About the Author: Patrick Foote is the Director of eBusiness at Laser Spine Institute, the leader in endoscopic spine surgery. Laser Spine Institute specializes in safe and effective outpatient procedures for the treatment of

pinched nerves

and several other spinal conditions.



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