Herniated Disc? Spinal Stenosis? Pinched Nerve? Understanding the Connections for Neck and Back Pain

Read About Herniated Disc, Spinal Stenosis, Pinched Nerve Pain

Living with neck pain, back pain, or related symptoms like tingling or muscle weakness is difficult enough. But too often, an added source of stress is getting an accurate diagnosis and finding effective treatment for your pain. Understanding the sources of pain and what the underlying causes is can be a critical step on any pain relief journey. 

In many situations, after seeing a doctor or receiving an MRI report, patients can hear a veritable laundry list of terms and conditions. Among the most common of these include pinched herniated discs, pinched nerves, and spinal stenosis. It can be natural to have questions and wonder what the relationship is between these terms and how they vary. 

Every person is different and there can be a wide range of causes for neck or back pain, but very often these three conditions in particular are very closely related. If you are dealing with one or more of these problems, the following guide can help. 


What Is a Herniated Disc?

A herniated disc happens when a crack or tear develops in the tough outer layer of a spinal disc, causing the softer inner material to be pushed out. These flexible discs help the spine to bend and flex, but can begin to dry out and break down with age. 

A herniated disc is not necessarily painful, in fact, people can have this condition for years without knowing it. To cause symptoms, the herniated disc material must either irritate local nerves on the disc, or put pressure on surrounding nerve roots or the spinal cord. 

Herniated discs can occur at any level of the spine, but are most common in the upper (cervical) or lower (lumbar) regions due to the flexibility of these areas. Symptoms of a herniated disc include local neck or back pain, as well as tingling, numbness, and muscle weakness in the upper or lower extremities. 


What Is Spinal Stenosis? 

Spinal stenosis is a term for narrowing in the spinal column, particularly the narrow passages that the spinal cord and nerve roots travel through. This is generally an age-related condition that is caused by breakdown of connective tissue, joints, and discs in the spine. Specifically, underlying contributors to spinal stenosis can include:

  • Spinal arthritis
  • Bone spurs
  • Bulging and herniated discs
  • Degenerative disc disease
  • Spondylolisthesis, which is when a vertebra begins to slide out relative to the vertebra beneath it

Spinal stenosis is extremely common, and is another condition that may not necessarily be painful or symptomatic unless the nerves in the spinal column are affected. 


What Is a Pinched Nerve?

Pinched nerve is a general term for nerve compression. Although a pinched nerve can happen anywhere — think about the pins and needles you feel if you sit on your foot for too long — they are especially common in the spine. 

The spinal column needs to be rigid enough to hold up the body and protect the spinal cord but flexible enough to allow for movement. This combination means a very high amount of stress on parts, including the joints and discs, that also experience wear and tear from everyday movements. What’s more, the vital nerves in the spine are packed into a very tight space with extremely narrow openings. 

Added up, this means there are many things that can go wrong in the spine that can cause a pinched nerve, including displaced disc material like a bulging or herniated disc, spinal arthritis, bone spurs from bone on bone friction, and degenerative disc disease. 


What Is the Connection Between These Conditions?

These three conditions are often very closely related. For example, it is possible to have a herniated disc in the lower spine that contributes to spinal stenosis and causes a pinched nerve. In very many cases, a pinched nerve is the main cause of pain and symptoms. This means that effective treatment requires identifying the main factors causing nerve compression and taking steps to relieve this pressure. 


Diagnosing and Treating Your Neck and Back Pain

Whether you have received a diagnosis for a herniated disc, a pinched nerve, spinal stenosis, or all three, it is critical to work with your treatment team to positively identify the functional and physical causes of your pain. Diagnostic steps include a physical examination, movement tests, detailed questions about symptoms, diagnostic nerve blocks, and imagery such as an MRI or X-ray. 

Once the source of pain has been identified, patients should commit to a comprehensive plan of conservative treatment to relieve symptoms, improve mobility, and take pressure off of the affected nerve. Effective steps can include:

  • Improving posture
  • Undergoing physical therapy to strengthen supporting muscles and reduce painful movements
  • Using hot and cold compression therapy and over-the-counter pain medication
  • Eating a healthy, anti-inflammatory diet
  • Interventional pain management treatments such as epidural steroid injections to help reduce inflammation and pain around the pinched nerve

If a full course of conservative treatments are unable to effectively relieve nerve compression and related symptoms, minimally invasive spine surgery to remove displaced disc material that is narrowing the spinal column can become an option. 

No matter where you are in your treatment journey, the team at Physician Partners of America can help. We can assist in creating a personalized pain management plan that fits your treatment goals and lifestyle. You don’t have to let pain take you away from the quality of life you deserve. 

Contact us today to learn more.