What Is a Pinched Nerve? 4 Things Older Adults Should Know

The painful health issue can be more common in people 50 and older

Jessica Migala, AARP

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Published September 06, 2024

Photo Collage: AARP (Source: Shutterstock)

If you’ve ever felt a shooting pain zing down your arm or leg, you may have wondered if you pinched a nerve.

Though the term is often used to describe any sort of nerve inflammation or irritation, a pinched nerve, by definition, occurs when tissues that surround a nerve — be it bone, cartilage, muscle or tendon — put too much pressure on the nearby nerve, causing pain, numbness and other unbearable symptoms.

You can feel a pinched nerve in many areas of your body — from your arms and hands (ever had carpal tunnel syndrome?), to your legs and feet. And it just so happens that the things that make your body more prone to a pinched nerve are more likely to occur as you age.

Here are four things that adults age 50-plus should know about a pinched nerve, including how to treat one at home and when you should see a doctor.

1. Several different issues can lead to a pinched nerve

At each vertebra in your spine, a pair of nerves branches off to supply power and sensation to different parts of your body, says Zachary McCormick, M.D., a board-certified specialist in pain medicine and physical medicine and rehabilitation at University of Utah Health in Salt Lake City. Good nerve function, in part, requires that these nerves have enough space to come out of the spine — but a few things can complicate matters.

Take, for example, a herniated disk, which occurs when a disk — which is like a cushion between vertebrae in the spine — tears or bursts. The liquid-like center can rupture out of the disk and affect nearby nerves, causing irritation, inflammation and possibly mechanical compression of the nerve, says physiatrist William Pease, M.D., an orthopedic physician and professor of physical medicine and rehabilitation at the Ohio State University Wexner Medical Center in Columbus.

Other spinal conditions, including tumors, fractures and stenosis (when the space inside the backbone is too narrow for the spinal cord), can also lead to a pinched nerve.

Additionally, age-related changes can play a role. As we age, the anatomy of our spine changes, and older adults become more prone to additional underlying processes that cause pinched nerves. “Because of the wear and tear of living life, we all develop arthritis in the joints of the spine. This involves the joint growing in size and forming extra bone,” McCormick says.

What’s more, disks begin to compress and lose height, narrowing the channel where nerves live. This, combined with bone growth, can impinge on nerve roots (the area where nerves exit the spine), which can pinch or irritate a nerve, he says. “This is much more common in adults over 50,” he says.

Whether you’re prone to a pinched nerve depends on a lot of factors, including age, genetics, smoking and your history of injury. Having diabetes, excess weight or a job that requires repetitive motions can also increase your risk of a pinched nerve.

2. Most people pinch a nerve in the lower back

Though a pinched nerve can happen anywhere along the spine, the most common area is the low back, Pease says. The neck is another common site. These two areas are load-bearing, and excessive pressure can be placed on the disks as you lift or hold something heavy, which increases the risk of a pinched nerve.

3. Symptoms can interfere with everyday activities

One of the telltale signs of a pinched nerve, Pease says, is how a patient acts. If a patient waiting for him is standing up when he walks into the exam room, he suspects that sitting down is too painful, and he’s clued in to the cause.

“If you have a pinched nerve in your lower back, you’re most uncomfortable when sitting or bending forward because these two positions increase pressure on the disk,” he says. A muscle strain feels better when the person is sitting and leaning back into the back support, as this position takes stress off muscles that support the spine.

According to Cleveland Clinic, common symptoms of a pinched nerve include:

Tingling
Burning
Pricking or prickling
Itching
A “pins and needles” feeling
Numbness
The sensation that an extremity or body part is “falling asleep”

In short, a pinched nerve is often described as a sharp, shooting, burning and radiating pain that sometimes includes numbness, says Kavita Trivedi, D.O., associate professor of physical medicine and rehabilitation at UT Southwestern Medical Center in Dallas. If a nerve is badly pinched, there may also be weakness (in your arm, leg, hand or foot), McCormick says.

Diagnosing a pinched nerve involves a physical exam and possibly other testing, like magnetic resonance imaging (MRI) or electromyography (EMG), which measures muscle and nerve function.

4. Many pinched nerves can be treated at home

Pinched nerve treatment typically starts at home if symptoms are mild. “We try to do the simplest and safest things first,” McCormick says. And research shows this approach often works: The vast majority of pinched nerves in the neck get better within eight to 12 weeks on their own.

Here’s what to try:

Anti-inflammatory medications like ibuprofen (Advil) or naproxen (Aleve) can help address inflammation and swelling, Pease says.
Decrease activity levels to avoid aggravating the nerve. “You aren’t restricted to bed rest, but simply reduce the intensity of activity. It’s important for overall health to continue to move around and do everyday things,” Pease says.

If nerve pain lingers or severely affects your quality of life or ability to work, then reach out to your provider, who might recommend:

Physical therapy: “Sometimes, correcting postural or muscle imbalances is enough to take irritation off the nerves,” McCormick says.
Epidural injection: Bathing the nerve in a mixture of local anesthetic and cortisone reduces inflammation and stabilizes the nerve membrane to calm down irritation. “Patients feel dramatically better rapidly, though it does wear off,” McCormick says.

What about surgery? Surgery is not the go-to treatment for a pinched nerve, though sometimes it may be recommended. “Referrals to surgery usually happen if someone fails conservative treatment,” Trivedi says. Certain factors would make her refer a patient to a surgeon for evaluation more quickly, such as if there were significant weakness or a lack of a reflex.

What’s important, Trivedi says, is that you’re seeing someone who treats spinal issues, such as a physical medicine rehabilitation specialist. “Start with this type of doctor who will work through your symptoms with you, get the right diagnostic imaging, and try to manage and treat it without surgery. That’s the way to go first,” she says.

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