When you think about a pinched nerve, the first thing that comes to mind might be an arm or leg that feels numb or painful- and you’d be right that these are common ways the condition manifests. But the nervous system impacts your whole body, and there are other signs of pinched nerves you may not realize are related. Headaches and migraines are often connected to back and neck problems, including pinched nerves, especially when they are chronic. If you are experiencing headaches, don’t brush them off as normal. Find a specialist who can determine the root cause of your headaches, including whether or not a pinched nerve could be involved.
How Your Spine Can Cause Headaches
Understanding the relationship of your spine to other parts of the body, including the nervous system, is the first step in understanding how a pinched nerve can result in headaches.
Your spine begins at the bottom of your brainstem and stretches down to your pelvic area, but it is divided into three primary sections. The upper portion of the spine, the cervical spine, begins at the bottom of your brain stem and past your shoulders. This area contains something called the trigeminocervical nucleus- an area where sensory nerve fibers, stemming from the trigeminal nerve and the upper spinal nerve, converge. The trigeminal nerve is responsible for pain sensation in the face, including the top of the head, forehead, eye, and temples- all the areas most likely to experience headache pain.
When a pain sensation is sensed by the upper cervical spine nerves, it is transferred to the trigeminal nerve fibers in the trigeminocervical nucleus, leading to pain in various regions of the head. This can occur as a response to several factors, such as injuries, degenerative conditions, or tumors.
A headache that is caused by issues in the upper spine is known as a cervicogenic headache.
What Is a Pinched Nerve?
Nerves are fibers that send messages between your brain and all the other parts of your body. They travel along pathways in order to transmit signals, and when the nerve or pathway is damaged, they cannot effectively communicate, causing a range of issues. One way that this communication can be disrupted is when the nerve is compressed in some way.
A common place for compression to occur is where a nerve branches off of the spinal cord, often in response to a ruptured disc or other tissues pressing on the nerve. When this occurs in the cervical spine, it is known as cervical radiculopathy and can cause pain throughout the shoulder, arm, and upper back, as well as weakness, tingling, or numbness. This is often similar to the feeling of your foot or hand “falling asleep” after you have been in one position for too long and will usually only impact one side of your body.
Cervicogenic Headaches
In addition to shoulder, arm, and upper back pain, a pinched nerve in the neck can often cause headaches. These may appear on only one side of your body and can include pain that spreads from the back of your skull to your shoulder blades, forehead, brow, or eye. Symptoms of a cervicogenic headache can mimic migraines, but the source of the pain, in this case, is the neck and not the brain. Rather than sensory input triggering symptoms, turning your neck or staying in one position for a long time may be the triggers.
Cervicogenic headaches can come and go, lasting anywhere from a few hours to a few weeks at a time. Additional signs that a pinched nerve is to blame include the following:
- Muscle spasms
- Pain when moving the neck
- Same-side shoulder and arm pain, tingling, or numbness
- A loss of strength, sensation, or coordination
In most cases, symptoms resolve on their own as inflammation and muscle spasms resolve and relieve pressure on the nerve. But if a more serious issue, like a ruptured disc, is at play, the problem will likely recur.
While anyone can pinch a nerve in their neck, it is most common in people who smoke cigarettes, have pinched a nerve prior, lift heavy objects, drive equipment that vibrates, play golf, or often jump off diving boards.
Causes of Pinched Nerves
A pinched nerve may be the root cause of your headaches, but it is important to find the root cause of the pinched nerve and treat that issue in order to prevent future symptoms.
Trauma and Injuries
The fastest way to pinch a nerve is for the upper cervical spine to shift suddenly out of alignment. This often happens in response to trauma like a car accident or any other injury. Even something as simple as lifting a heavy box incorrectly or pulling and twisting your body in an unnatural way can cause these issues.
Wear and Tear
As we age, the spine suffers from wear and tear, particularly the discs. These small, gel-like discs sit between each vertebra (the bones that stack to make up the spine) in order to absorb shock and prevent bone from rubbing against itself during movements. Over time, these spinal discs lose water content and flatten, as well as become more fragile with age. The vertebrae then move closer together, while the disc material may degenerate or spread to the surrounding spinal canal and compress nerves.
Arthritis
The most common disorder that can lead to a pinched nerve is rheumatoid arthritis, a form of arthritis that causes chronic inflammation in the joints. The swelling can pressure nearby nerves.
Lifestyle
Any tasks that require repetitive motions, like typing on a keyboard or chopping vegetables in a kitchen, can cause stress on the wrist and hand that causes carpal tunnel syndrome. This tendon inflammation pressures the median nerve in your arm.
People who work in places where they often lift heavy objects, drive vibrating vehicles, or are physically exerting themselves may also be at higher risk of a pinched nerve through trauma. Certain athletes are also at this higher risk.
Poor Posture
While you may think of posture as standing up straight, there is more to it, and it usually relates to sitting. Slouching over a desk, leaning down to look at a phone, and other sedentary activities very commonly contribute to poor posture. When the head is not positioned directly above the shoulders, there is a huge amount of stress placed on the neck, which can cause misalignments and, ultimately, nerve issues.
Sleep Problems
Anything from sleeping in an odd position to using pillows of poor quality can lead to neck problems. Stomach sleeping is the most stressful position for your neck, and pillows should offer enough support for your position. Back sleepers may require less support than those who sleep on their side or stomach, though the neck and spine should still always be in a neutral position.
Diagnosing a Pinched Nerve
While pinched nerves may resolve themselves at home with rest and gentle pain management, it can be important to visit a healthcare provider to rule out any serious causes or to address conditions that will cause the problem to recur. You’ll share with this provider what symptoms you are experiencing, along with some medical history and information about your lifestyle and activities, for them to understand the risks.
They will likely also perform physical exams of your neck, arms, shoulders, wrists, and hands. This is to look for muscle weakness and assess changes in reflexes, as well as to ask about the sensations you feel when they apply pressure to certain nerves. With this information, they can begin to make assumptions about what nerves are impacted and what the cause may be.
A pinched nerve itself will not show up on diagnostic scans. However, they may be helpful in understanding the state of your spine and other causes of the compression. You may undergo one or more of the following imaging tests:
- X-ray: Looking at the bones can help to identify narrowing and changing alignment of the spinal cord or any fractures that have occurred.
- CT Scan: A computed tomography scan creates three-dimensional images, offering more detail of the spine than an x-ray.
- MRI: A magnetic resonance imaging machine will be able to show damage to soft tissue that may be causing nerve compression, as well as highlight any damage to the spinal cord.
- Electromyography (EMG): An EMG measures electrical impulses of the nerves and is used alongside nerve conduction studies to assess if the nerves are working normally. This can help a provider determine if nerve damage is being caused by pressure or another condition, like diabetes.
Treatment for Pinched Nerves
The first line of treatment for a pinched nerve will be conservative, non-invasive medical management. This may include:
- Time and Rest: This will usually take care of a pinched nerve with no underlying conditions. A few days or weeks of avoiding strenuous activity and taking care to rest will often help the pain resolve completely.
- Ice and Heat: Ice can help with pain and swelling, while heat will soothe muscle spasms and pain. You can apply either one for about 20 minutes at a time throughout the day in order to find some instant relief as well as speed the healing process.
- Over-the-Counter Pain Relievers: Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) can help both pain and swelling. These are available with no prescription and carry less risk of addiction than other pain medication, though they should still be used in moderation.
- Splints and Collars: A soft hand splint or neck collar can limit motion, allowing you to heal and avoid irritating a nerve.
- Corticosteroids: If over-the-counter medication is not effective, you may be prescribed injections or oral versions of this strong anti-inflammatory medication.
- Physical Therapy: Stretches and light exercise may help ease pressure on the nerves and offer relief. These exercises should be done as a part of a formal physical therapy plan to ensure they do not worsen the condition.
The last resort for treating a pinched nerve is surgery if all other options have not relieved the pressure. Some surgeries that can be used include:
Anterior cervical discectomy and fusion (ACDF)
Surgeons remove disc or bone spurs that are compressing nerves from the spine, then stabilize that area of the spine with a fusion. The fusion joins vertebrae together to form a single, solid bone.
Artificial disc replacement (ADR)
An injured disc is removed from the spine and replaced with an artificial version- like a knee or hip replacement. This new disc allows for more flexibility in the spine and removes any damaged discs that are crowding the nerve.
Posterior cervical laminoforaminotomy
The lamina is the arching bone backside of the spinal canal. In this surgery, it is thinned down to allow better access to the damaged area. Bone spurs can then be removed, along with any tissues that are compressing a nerve.
Surgery for Carpal Tunnel Syndrome
There are two surgical options to relieve compression in the carpal tunnel: an endoscopic, minimally invasive surgery or an open surgery. Both cut the ligament around the carpal tunnel to relieve pressure on the median nerve.
Any of these surgeries require a recovery time of a few days to a few weeks, and a return to prior activity levels may take three to four months. Your surgeon will work with you on recovery plans and timelines.
Seeking Care for Cervicogenic Headaches
If you are suffering from chronic headaches and aren’t sure of the cause, or you think you may have suffered a pinched nerve, you may need to be assessed by a professional. This can help you to rule out any serious conditions and develop a plan for relief. At AICA Conyers, our staff includes chiropractors, physical therapists, orthopedic doctors and surgeons, neurologists, and more who can work together to address pinched nerves and related conditions. This comprehensive approach ensures that a treatment plan is created specifically for your needs and that you will be able to move towards a future without headaches or pinched nerves. Contact us today to schedule your first appointment!