The spinal cord gives off pairs of nerves, one each side, at every level between each pair of vertebrae. These nerves leave the spinal canal, which holds and protects the spinal cord, through channels at the side of the vertebral canal called “neural foramina”, which are scallop-shaped channels in the vertebrae above and below the nerve. As we get older, the intervertebral discs between the vertebrae start to undergo a process of degeneration.
What happens then is just like a car tyre going from fully inflated to flat. The vertebrae also start to change shape a little bit and small spikes of bone, called “osteophytes”, start to grow from their edges and the combination of the loss of intervertebral disc height and osteophyte formation can cause narrowing of the neural foramina, so the nerves leaving the spinal column can become pinched. When this happens they become swollen, which in turn causes pain. If this happens in the arm we call it “brachalgia” and when it happens in the leg we call it “sciatica”.
Neuralgic pain from a trapped and swollen nerve root is extremely painful. Conventional painkillers rarely help with it, even in large doses, and even special nerve pain medications, such as Gabapentin and Pregabalin, sometimes don’t help very much with it either. It can be one of the most painful conditions patients can ever suffer.
Only two treatments generally help with neuralgic spinal pain – steroid injections right onto the affected nerve root, or surgery, with operations such as foraminotomy, spinal decompression and various forms of spinal fusion.
Most patients with neuralgic pain from trapped nerves can be managed well, often for the rest of their lives by occasional spinal steroid injections around the nerve roots, which is something we specialise in. If you think you might have a trapped nerve please get in touch with us.