Radiculopathy (Pinched Nerve) Treatment

Radiculopathy, more commonly referred to as a “pinched nerve,” is a common spine condition that can occur in the neck, mid, or lower back. Fortunately, the majority of pinched nerve cases can be managed and resolved with nonsurgical treatments, and most patients will not need surgery.

Dr. Tara Swim, our board certified physiatrist at Augusta-Aiken Orthopedic Specialists, provides nonsurgical treatment options for spine conditions like pinched nerves. Dr. Swim completed fellowship training in interventional spine treatment at the Cleveland Clinic. She approaches treatment by seeking to understand each patient’s needs and goals to determine the plan that will work best for that patient. Nonsurgical treatment is always our first course of action for pinched nerves, but if it does not sufficiently relieve symptoms, Dr. Swim will refer patients to our board certified spine surgeons, Dr. Justin Bundy and Dr. Ty Carter.

Symptoms of Pinched Nerves

Pinched nerves occur when the bones and tissues surrounding the nerve apply pressure to it. This can be caused by an injury like a herniated disc, or degenerative changes to the spine over time.

Where you experience symptoms will depend on the location of the pinched nerve. Generally, symptoms of pinched nerves include:

• Pain in the affected area
• Numbness and/or weakness in one of the limbs
• A tingling sensation in one of the limbs

If the pinched nerve is located in your neck or upper back, you may experience these symptoms radiating down one of your arms. If the pinched nerve is in the lower back, you may feel these symptoms in the buttock and radiating down one of the legs. If you are experiencing these symptoms, seek qualified medical attention for an accurate diagnosis and treatment plan.

Exam & Diagnosis of Pinched Nerves

To evaluate and diagnose a patient, Dr. Swim will complete a few different steps.

• Medical History - Dr. Swim will start by discussing the patient’s medical history, including questions like:
• When did the symptoms start?
• Where the pain is located and what do the symptoms feel like?
• Were there any activities that could have caused the symptoms?
• Have you tried anything that alleviated the pain?
• Is there anything that makes your pain worse?
• Have you ever had a pinched nerve before?
• Physical Exam - A physical exam might include having the patient move the spine in certain ways to see if pain gets better or worse, testing reflexes, testing strength and testing sensation.
• Imaging Tests (if needed) - Imaging tests are often not needed to diagnose a pinched nerve unless a serious problem is suspected, but if a patient has already had x-rays or MRIs done, Dr. Swim will review during the initial appointment. If imaging tests are needed, they can be ordered.

After completing the evaluation and discussing the patient’s needs and goals, Dr. Swim will recommend a treatment plan.

Treatment Options for Pinched Nerves

Initial treatment options for pinched nerves are conservative, and our treatments are designed to help patients avoid or delay the need for surgery whenever possible. Dr. Swim understands that patients may have different goals depending on their activities, occupations, and age, and tailors the plan to those goals. She sees patients of all ages and activity levels.

Nonsurgical treatments for pinched nerves may include:

Activity Modification

First, Dr. Swim will usually recommend activity modification for a period of time to see if symptoms improve. This includes avoiding any activities that may have contributed to the pinched nerve, as well as any activities that might make symptoms worse.

Exercise & Physical Therapy

At physical therapy, patients will perform exercises that strengthen and stretch the muscles in the area of the pinched nerve to attempt to alleviate pressure on the nerve. Dr. Swim can also recommend at-home exercises if physical therapy is not covered by the patient’s insurance, or if there are issues with getting to and from appointments.

Medications

Nonsteroidal anti-inflammatory medications like ibuprofen or naproxen may be recommended to help with pain and discomfort. In some cases, oral steroids or non-opioid pain medications may be prescribed.

Epidural Steroid Injections

If a patient’s symptoms are not relieved through activity modification, physical therapy, and medication, Dr. Swim may recommend epidural steroid injections as another option for avoiding surgery. These injections can help to alleviate pain and inflammation in the affected area.

While not a surgical procedure, Dr. Swim performs epidural steroid injections at our outpatient surgical center in a procedure room equipped with x-ray guidance tools. The injection is administered with the patient lying on his/her stomach, and a lidocaine injection is given first to numb the area. Dr. Swim uses the x-ray guidance to determine where to place the needle for the steroid injection before injecting the medication. Patients may feel slight pressure, but it should not be painful. It is also normal to experience a brief reproduction of symptoms when the needle is placed and the medication is injected.

After receiving the steroid injection, the patient’s symptoms are monitored, and they will meet with Dr. Swim again before being cleared to go home. It is recommended that patients have someone drive them to and from the injection procedure, as sometimes the limbs can feel a bit shaky or unstable right after the injection. Lightheadedness is also common.

Upon returning home, patients are advised to take it easy for a few days. Showering is permitted, but do not submerge the injection area in water for 24-48 hours. Patients can keep their regular physical therapy appointments and can return to work if their jobs don’t involve physical labor. Dr. Swim generally advises avoiding starting any new activities for 2 weeks, at which point there is a follow-up appointment, even if the patient is feeling great. Patients are generally back to normal activity within 6-12 weeks.

Some patients do well with the initial injection and do not need another, but if the pain returns, a second or third injection can be done.

Surgery

If epidural steroid injections do not provide sufficient relief of symptoms, Dr. Swim will refer patients to Dr. Bundy or Dr. Carter to explore surgical options.

Pinched Nerve Treatment in the Augusta-Aiken Community

At Augusta-Aiken Orthopedics, we provide both surgical and nonsurgical treatment options for spine conditions like pinched nerves. Dr. Tara Swim, a board certified physiatrist with fellowship training in interventional spine care, provides nonsurgical treatment options to help patients with pinched nerves. If symptoms persist with nonsurgical treatment, our board certified spine surgeons, Dr. Justin Bundy and Dr. Ty Carter, will discuss surgical options.

If you would like to schedule an appointment, please call one of our offices at 706-863-9797 (Augusta) or 803-649-2250 (Aiken). You can also request an appointment via our online form.

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