What to know about a pinched nerve in the upper back

• pain
• numbness or decreased sensation
• tingling or the feeling of pins and needles in the hands or feet, which can make them feel as though they have “fallen asleep”
• weakness in the muscles of the arm, shoulder, or hand

According to the American Academy of Orthopaedic Surgeons (AAOS), some people with this condition report that the pain decreases when they place their hands on top of their head. The AAOS say that this movement may temporarily relieve the pressure on the nerve root.

Due to the nature of nerves, the symptoms of a pinched nerve may not even occur at the location of the nerve injury. They can occur in areas that seem completely disconnected but are, in fact, linked. A tingling feeling in a person’s arm may be due to a pinched nerve in the neck, for example.

Doctors divide the spinal column into five segments based on the area of the body and the appearance of the spinal bones.

A person’s spine consists of 33 bones called vertebrae. These consist of 24 presacral vertebrae, five fused vertebrae in the sacrum, and four frequently fused vertebrae in the coccyx.

The presacral vertebrae have disks between them that act as shock absorbers when a person walks or runs. They also help hold the bones together.

Doctors divide the 24 presacral vertebrae among three regions of the spine in the following way:

• Cervical spine: the neck, consisting of the first seven vertebrae
• Thoracic spine: the middle section, consisting of the middle 12 vertebrae
• Lumbar spine: the lower back, consisting of the last five vertebrae

The spinal column contains and protects the nerves. The nerve roots emerge from openings between the vertebrae and branch out throughout the body. The nerves emerging from the cervical region connect to the upper body.

The most common causes of damage to a nerve in the upper back include:

Bone spurs

Bone spurs are smooth bony lumps that grow on the bones of the spine or around the joints. They usually occur in response to the disks in the spine collapsing and the vertebrae moving closer together.

Bone spurs can squeeze nearby nerves, causing a pinched nerve. Doctors may refer to bone spurs and disk changes as degenerative disk disease.

According to the AAOS, nearly half of all middle-aged and older people have worn disks and pinched nerves that do not actually cause painful symptoms.

Herniated disk

A person’s disks consist of a tough outer layer (annulus) that surrounds a jelly-like middle section called the nucleus. A herniated disk occurs when the nucleus ruptures and breaks through the outer layer into the spinal canal.

A herniated disk can happen due to degenerative disk disease. When the nucleus bulges out of the annulus, it can put pressure on the root of nerves. Depending on where this happens, it can cause symptoms of a pinched nerve in the upper back.

As well as discussing a person’s medical history with them, a doctor may choose to run some tests to diagnose a pinched nerve and rule out other possible causes.

To diagnose a pinched nerve in the upper back, a doctor will first perform a physical exam. If they cannot make a diagnosis based on this exam, they may then use imaging techniques, such as X-rays, CT scans, or MRI scans. The doctor may also perform an electromyography (EMG) test to measure the electrical activity of muscles.

There are several treatment options for a pinched nerve in the upper back, and the appropriate option depends on the severity of a person’s symptoms.

Most of the time, doctors will recommend nonsurgical treatment, reserving surgery for more serious cases. Initially, a doctor may simply suggest rest.

Nonsurgical

• Neck brace: Depending on the location of the pinched nerve, a doctor may suggest wearing a soft cervical collar for short periods to allow the muscles in a person’s neck to rest.
• Pain medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) may help provide relief if the pain is due to nerve irritation or inflammation.
• Steroid injection: Steroids can reduce local inflammation, relieving the pressure on a nerve. A doctor may inject steroids close to the affected nerve.

Surgical

If a person does not get relief from nonsurgical options, their doctor may recommend surgery to treat the pinched nerve.

Surgery may involve removing bone spurs or a part of a herniated disk in the spine. The chosen procedure will depend on where the pinched nerve is in the upper back and what symptoms a person is experiencing.

Helpful stretches and exercises

Sometimes, stretches and exercises may help relieve the symptoms of a pinched nerve in the upper back.

Yoga or pilates can lessen pressure in the area, which could alleviate the symptoms. It is important that people avoid overstretching, as this could make the condition worse. If any pain or discomfort occurs, a person should stop immediately to avoid further damage.

A doctor may also suggest physical therapy, as a combination of massage, exercise, and gentle stretching may help eliminate the symptoms and pain associated with a pinched nerve.

Although it is not always possible to avoid a pinched nerve in the upper back, a person can take steps to minimize the risk of developing one.

• Posture: Poor posture can result in a pinched nerve in the upper back, so a person can ensure that they sit and stand correctly to try to avoid pinched nerves.
• Position: Spending too long in one position can worsen the symptoms of a pinched nerve. A person should take frequent short breaks and move around often.
• Rest: Rest is the most common treatment for a pinched nerve in the upper back, so a person should make sure that they are doing everything they can to rest the affected area.

Most of the time, the symptoms of a pinched nerve will resolve without medical intervention. However, if a person experiences prolonged pain or muscle weakness that does not ease, they should seek medical attention to ensure that no permanent damage occurs.

A pinched nerve in the upper back may cause pain, numbness, and weakness. Usually, nerve injuries do not cause any lasting problems, and people may be able to treat them at home with rest, stretches, and over-the-counter pain medication.

However, persistent symptoms of a pinched nerve in the upper back may require medical attention. People with persistent pain in the upper back should talk to their doctor.