Pinched Nerve in the Upper Back: Symptoms, Causes, Prevention & Treatment
A pinched nerve occurs when muscles, tendons, bones, cartilage, or other tissues press too hard on a nerve. This can lead to pain, tingling, numbness, or weakness in areas where the nerve travels.
A pinched nerve can occur in many places throughout the body, including the upper back or under the shoulder blade. Spinal nerves can also be pinched as they exit the upper spine.
The symptoms of a pinched nerve in the upper back include:
- Decreased sensation or numbness
- Aching, burning, or sharp pain, which may spread outward
- Tingling sensation (“pins and needles”)
- Muscle weakness
- Feeling that part of the body has “fallen asleep”
The location of the symptoms depends on which nerve is affected. A pinched nerve under the shoulder blade or upper back can cause symptoms in the arms, legs, chest, belly, or other areas.
The symptoms do not always occur in the upper back. For example, they may only show up in the arms or chest. Also, a pinched nerve in the neck or shoulder can cause tingling or other symptoms in the upper back.
If a nerve is pinched for only a short time, it can usually recover with no lasting damage. If the pressure is ongoing or severe, permanent damage may occur. This can happen with chronic conditions such as osteoarthritis or degenerative disc disease.
See your doctor if the symptoms last for several days and don’t go away with rest and self-care.
As a nerve travels throughout the body, it can be compressed by tissues that surround it. Sometimes more than one nerve is affected.
In some cases, muscles, or tendons press on part of the nerve to cause symptoms. Other times, bone, or cartilage can pinch a nerve. For example, a herniated disc can compress the root of a spinal nerve.
Several conditions and factors can lead to a pinched nerve in the upper back, including:
- Injury to the bones, cartilage, muscles, tendons, or other tissues
- Spine conditions such as herniated disc or degenerative disc disease
- Overuse or repetitive motions
- Excess body weight (obesity) can compress the nerves
- Poor posture, especially for extended periods
You can’t always prevent a pinched nerve, as in the case of injuries or trauma. You also can’t prevent age-related changes to the spine that may cause a spinal nerve to be pinched. However, the following actions may help reduce your risk of developing a pinched nerve:
- Maintain good posture while sitting, standing, and moving
- Add strengthening and flexibility exercises to your regular exercise program. Yoga and Pilates are both good options for developing strength, flexibility, and good posture.
- Take frequent breaks when doing repetitive activities to stretch and rest.
- Maintain a healthy weight.
To help determine which nerve or nerves are affected, your doctor will ask about your symptoms and give you a physical examination. Your doctor may also order one or more tests to determine if you have a pinched nerve and to rule out other possible causes. These tests may include:
- Nerve conduction study. Electrodes placed on the skin are used to determine whether electrical signals flow normally through the nerve.
- Electromyography (EMG). A needle electrode is inserted through the skin into a muscle to test whether a nerve leading to the muscle is damaged.
- Ultrasound. This test uses high-frequency sound waves to create images of body structures. It can be used to look for compressed nerves, such as in the shoulder.
- X-ray or CT scan. These tests use small doses of radiation to produce images of your body. This can be used to detect injuries to the bones, including problems with the vertebrae.
- Magnetic resonance imaging (MRI). This test uses powerful magnets to create detailed images of your body. It can be used to look for a herniated disc or other spinal conditions.
- Bone Density Scan (DEXA Scan). This test can show irregularities in bone growth and help determine if there is a calcium or other mineral depletion as a result.
Treatment for a pinched nerve in the upper back depends on which nerve is pinched and how severe the symptoms are. Treatment may include:
- Rest. Your doctor may ask you to stop doing activities that caused the symptoms or make them worse.
- Physical therapy. A physical therapist can teach you strengthening and stretching exercises to relieve pressure on the nerve. They may also use massage or other types of body work to enhance the healing process.
- Chiropractic care. Chiropractic care is effective in the management and treatment of pinched nerves. A misaligned vertebrae may be compressing the nerve, and a chiropractic adjustment may help relieve that.
- Medications. Your doctor may suggest that you take an over-the-counter non-steroidal anti-inflammatory drug (NSAIDs), such as ibuprofen or naproxen, to reduce nerve pain in the upper back and other areas.
- Steroid injections. These medications may be used to control upper back nerve pain and inflammation.
- Surgery. In more severe cases, surgery may be needed to take pressure off the pinched nerve. Surgery is more likely to be needed if there is a spine condition such as a herniated disk or bone spurs.