Pinched Nerve vs Herniated Disc: Key Differences & Treatment Methods

Are you trying to figure out if your back pain is from a pinched nerve or a herniated disc? Knowing the difference between these two conditions is important for getting the right treatment. In this article, we will explain what a herniated disc and a pinched nerve are, describe their symptoms, and discuss ways to relieve the pain.

The difference between a pinched nerve & a herniated disc

A pinched nerve is quite literally a nerve that is being pinched, squeezed, or compressed in some way. This usually happens when

A herniated disc is when the gel-like center of a disc pushes out of a gap in the outer layer of that disc. This often is symptomless, but can also cause symptoms through compression of a nerve or if the gel-like center irritates a nerve.

If you are experiencing back pain, a pinched nerve or a herniated disc are both common causes. Distinguishing between them is important however, because although they both may cause similar types of pain their treatment strategies may vary.

What is a pinched nerve?

A pinched nerve occurs when adjacent structures, such as a vertebra (the bones that make up the spine), a disc (the cushioning pads that sit between the vertebrae), bone spurs (bony growths that jut out from a bone, like skin calluses) or swollen tissues, compress a nerve.

This compression can put strain onto the nerve, causing pain and other symptoms.

The pain may extend down the legs to the toes, feeling like an electrical current. Pinched nerves can occur in various parts of the body, not just the back. For instance, carpal tunnel syndrome is a common example of a pinched nerve in the wrist, where the median nerve is compressed¹.

What is a herniated disc?

Herniated is related to the word hernia, which is the protrusion of an organ through a gap in the structure which holds it in place. Disc is another term for the cushion-like pads that are found between the bony segments of a spinal column. A herniated disc therefore refers to the protrusion of the disc

If you imagine your spine as a stack of doughnuts, then each doughnut represents a vertebra and the jelly filling is the disc. Now if the jelly escapes and oozes out, that is similar to what happens if you have a herniated disc. A herniated disc can cause back pain, and also commonly patients also feel pain in the leg.

Can a herniated disc cause a pinched nerve?

A herniated disc can cause a pinched nerve, leading to significant discomfort known as nerve root pain, or radiculopathy.

Radiculopathy broadly refers to the range of symptoms produced by the pinching of a nerve root in the spinal column². When a disc herniates, it can narrow the spaces where nerves exit the spine, called foramina. This narrowing, known as foraminal stenosis, compresses the nerve, causing pain, numbness, and tingling³.

The most common cause of this nerve compression is a bulging or fully herniated disc. This can happen in different parts of the spine and may be related to conditions like disc bulging, ligament thickening, or spinal instability. This compression can occur at various points where the nerve travels, leading to the symptoms of radiculopathy.

Comparing symptoms: Pinched nerve vs herniated disc

The key difference in symptoms between a pinched nerve and a herniated disc lies in the pain distribution. A pinched nerve produces a sharp, burning sensation that is usually localized. Movements that stretch or compress the affected nerve can worsen this pain.

In contrast, a herniated disc tends to cause more diffuse pain, often radiating down the limbs, depending on the disc's location and the extent of the herniation. Sometimes, a herniated disc may not cause any immediate symptoms.

What are the symptoms of pinched nerves?

The symptoms of a pinched nerve depends on its location. If the pinched nerve is in your neck, you might experience arm weakness, pain radiating down your arm, or tingling and numbness in your fingers. If the pinched nerve is in your lower back, pain can travel from your buttocks down to your thigh, calf, or foot, causing leg pain. The pain tends to follow the path of the nerve⁴.

The symptoms associated with a pinched nerve in the lower back can range from low intensity to chronic pain:

• Mild discomfort that may come and go.
• Throbbing pain that can be persistent or intermittent.
• Numbness or a "pins and needles" sensation in the affected area.
• Muscle weakness in the affected limb.

What are the symptoms of herniated discs?

The symptoms of a herniated disc also vary depending on its location, like a pinched nerve.

If the herniated disc is in your neck, you might experience pain radiating down your arm, as well as numbness, tingling, or weakness in your shoulder, arm, or hand. When the herniated disc is in your lower back, the pain can travel from your buttocks down to your thigh, calf, or foot, following the path of the affected nerve. This pain can be sharp or dull, persistent or intermittent, and may be exacerbated by actions or positions such as sitting or standing.

The symptoms associated with a herniated disc can differ in intensity and commonly manifest as:

• Electric or burning pain which is localized to the back or around the chest or abdomen.
• Chronic pain which may radiate down into the legs.
• Numbness and tingling which may be experienced at or below the level of the herniation.
• Weakness of the muscles in the legs, and problems with walking may occur.

A herniated disc can also cause:

• Pain that worsens with movement, such as bending or lifting.
• Sciatica, a condition where pain radiates along the sciatic nerve from the lower back down to the leg⁵.

Some individuals may have a herniated discs without any noticeable symptoms.

How to treat a pinched nerve vs how to treat a herniated disc

Treatment options range from conservative methods to surgical interventions for severe cases. It is important to seek early medical consultation to develop a personalized treatment plan and prevent further pain.

Initial treatment for both a herniated disc or a pinched nerve typically involves non-surgical approaches, such as:

• rest
• pain medication for relief
• physical therapy exercises
• chiropractic adjustments
• acupuncture
• steroid injections.

If these methods do not provide sufficient relief, surgery may be considered as a last resort to alleviate the pain. Early and appropriate treatment is essential for effective pain management and recovery for both a herniated disc and a pinched nerve.

Treatment options for a pinched nerve

When addressing a worsening pinched nerve, initial relief efforts typically begin at home. Resting the affected area allows your body's natural healing mechanisms to activate.

Here are the key treatment methods:

• Rest: Allow the affected area to recuperate. Although try to maintain some gentle activity, such as a daily walk.
• Non-prescription drugs: Use pain relievers like ibuprofen for temporary relief.
• Splints or braces: Limit motion and provide support, especially for conditions like carpal tunnel syndrome.
• Physical therapy: Enhance muscle strength and flexibility to free trapped nerves.
• Medications: Employ anti-inflammatory drugs and steroids to reduce pain and swelling.
• Lifestyle changes: Adapt daily activities to avoid aggravating the nerve.

If conservative treatments are insufficient and severe pain persists, surgical intervention may be necessary. Surgery aims to remove bone spurs or herniated disc tissue that compresses the nerve and is considered only after other methods have failed or if nerve pain causes acute pain, weakness, or impaired functionality.

Treatment options for a herniated disc

A herniated disc can cause significant distress, and initial treatment strategies often align with those for a pinched nerve, prioritizing non-invasive methods. A herniated disc is likely to heal itself over time.

Non-surgical treatment is preferred to manage herniated disc symptoms due to the risks involved with surgery. Here are several non-surgical methods:

• Activity and education: Learning about your body and your pain is often the first step on your journey to recovery, and will allow you to understand how to use physical activity and exercise to reduce your symptoms and make you stronger and more resilient over time.
• Physical therapy: Strengthen muscles, improve flexibility, and promote good blood flow. The best part is that any movement is good for you, so choose something that you enjoy.
• Stress management: Practice mindfulness and relaxation techniques to minimize pain, because stress negatively impacts healing and can also heighten the sensitivity of your nervous system to pain, a state known as central sensitization⁶.
• Weight control: It’s not all about the number on the scales, but chat to your doctor or a nutritionist if you have questions about your weight and overall nutrition. Decreasing the load on your spine might make a difference.
• Medications: Use anti-inflammatory drugs to reduce swelling around nerve roots, analgesics to manage pain, and muscle relaxants to ease muscle spasms.

Common surgical procedures include:

• Microdiscectomy: This procedure is used if a fragment of disc is compressing a nerve. The surgeon uses a microscope for better visibility and precision tools to remove the fragment. Patients typically go home the same day or the next.
• Anterior Cervical Discectomy and Fusion (ACDF): This procedure treats herniated discs in the cervical spine (the neck). The surgeon makes an incision in the front of the neck to remove the affected disc and may perform a fusion to maintain spinal stability.

Seek out medical attention to identify the right cause of your symptoms

Consulting a medical professional is essential for understanding your pain and determining its root cause. Your recovery journey begins with a thorough physical examination and a review of your medical history. During the physical examination, physicians tend to search carefully for signs of neural discomfort or spinal issues. They may ask you to perform certain movements to help pinpoint the exact source of your pain.

Preventing future back issues

In your journey to overcome back pain, prevention is key. Maintaining proper posture protects your lumbar spine from stress. Regular physical activity will improve or maintain your overall health and wellbeing, which can also help to reduce pain.

At MoreGoodDays®, we've crafted a program grounded in scientific research to support you in dealing with chronic back pain. Our approach helps dispel common myths about back pain, focusing on understanding its root causes, identifying triggers, and learning to alter your body's reaction to pain using neuroplasticity principles.

We provide tailored coaching and a range of tools to guide you in managing pain, supporting mental health, and enhancing your overall quality of life.

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