Boise’s Pinched-Nerve Surgeon

Surgical Treatment Options for Pinched Nerves

A pinched nerve is more than just an annoyance. For some patients, it can mean burning pain that shoots down the arm or leg. For others, it’s weakness or numbness that makes it difficult to hold a coffee cup, stand for long periods, or even sleep comfortably through the night. When nerves in the spine are compressed, the impact can extend far beyond the immediate area, affecting the way a person functions day to day.

These issues are common and can be caused by many different spinal conditions, including herniated discs, arthritis, bone spurs, or changes that come with aging. The good news is that a pinched nerve is often treatable, and many people recover well with the right combination of care. Surgery isn’t always the first step, but when it becomes necessary, it can provide lasting relief and help restore quality of life.

At Kelly Bridges Neurosurgery, the focus is on listening to the patient’s story, carefully diagnosing the true cause of symptoms, and tailoring a treatment plan that makes sense for the individual. No two patients experience a pinched nerve in exactly the same way, so a thoughtful, personalized approach is key.

What Is a Pinched Nerve in the Spine?

A pinched nerve in the spine happens when something presses on or irritates a spinal nerve root. This condition can result in symptoms called radiculopathy. This pressure can come from several sources: a bulging or herniated disk, a thickened ligament, or bony overgrowth related to arthritis. The compression interferes with the nerve’s ability to send signals effectively, often resulting in sharp pain, tingling, or weakness that radiates along the path of the nerve.

The location of the pinched nerve plays a big role in how symptoms appear. In the cervical spine (neck), this can cause cervical radiculopathy, where pinched nerves can cause symptoms such as pain that travels down the arm and into the hand, sometimes mistaken for shoulder trouble or carpal tunnel syndrome. In the lumbar spine (lower back), nerve compression can cause lumbar radiculopathy —pain, numbness, or weakness that radiates down the leg. Leg pain is a common symptom of lumbar radiculopathy.

For some people, symptoms come and go. For others, they’re constant and life-altering. While a pinched nerve can sometimes resolve with rest and non-surgical care, persistent or worsening symptoms should always be evaluated by a spine specialist to ensure no lasting damage occurs.

Causes of Pinched Nerves

Pinched nerves can develop for a variety of reasons, often as a result of changes within the spine that put too much pressure on the spinal cord or nerve roots. This is often referred to as stenosis, which means narrowing.  Stenosis can affect the areas where the nerves travel. If severe, it can result in pinched nerves and associated symptoms. A common culprit includes a herniated disc, where the soft center of a spinal disc pushes out and presses on nearby nerves. Bone spurs, which are bony overgrowths that develop with arthritis or aging, can also crowd the space around nerve roots and lead to nerve compression. Other problems, such as degenerative disc disease with bulging discs, can result in stenosis and pinched nerves.

In addition to these spinal conditions, repetitive motions—such as frequent bending, lifting, or twisting—can irritate or compress nerves over time. Carpal tunnel syndrome is a well-known example, occurring when repetitive hand movements or swelling compress the median nerve at the wrist. Other factors, like rheumatoid arthritis or thyroid disease, can cause inflammation or swelling that affects nerve pathways. Carrying excess weight may also increase the risk of pinched nerves by adding stress to the spine and surrounding tissues.

No matter the cause, pinched nerve symptoms such as pain, numbness, tingling, or weakness should not be ignored. If you notice persistent or severe nerve symptoms, it’s important to seek medical treatment to prevent further nerve damage and to identify the underlying issue.

When Does a Pinched Nerve Need Surgery?

Not every pinched nerve requires surgery, and in fact, most do not. Many patients find relief through conservative treatments, which include rest, medication, physical therapy, or targeted injections. These conservative treatments can reduce inflammation and give the nerve time to recover. But when symptoms remain severe or do not improve over time, surgery may become the best option.

There are several important signs that surgery may be needed. If a patient develops weakness in the arms or legs, difficulty with coordination, or ongoing pain that doesn’t improve with conservative care, these are indications that the nerve is under significant stress. In rare but urgent cases, sudden changes in bladder or bowel control may suggest dangerous compression requiring immediate surgical attention.

The decision to proceed with surgery is always individualized. Dr. Bridges takes into account the severity of symptoms, the patient’s overall health, and how much the condition is interfering with daily life. The goal is not just to relieve pain but to protect long-term nerve health and preserve mobility and independence.

Diagnosis: Identifying a Pinched Nerve

A careful, patient-focused evaluation is the first step in diagnosing a pinched nerve. Dr. Bridges begins with a detailed discussion of symptoms—when they started, what makes them better or worse, and how they impact everyday life. This conversation helps guide the next steps and ensures that the evaluation addresses the patient’s biggest concerns.

A physical exam follows, testing strength, reflexes, and sensation to help determine which nerve may be involved. A pinched nerve is often diagnosed through a combination of physical exam findings and imaging studies. Imaging studies, such as MRI or CT scan, are often used to confirm the source of compression and to show whether surgery may be necessary. In some cases, electrical studies (EMG-NCV) can measure how well signals are traveling along the affected nerve.

Accurate diagnosis matters because not all pain that radiates into the arms or legs comes from a pinched nerve. By pinpointing the cause, Dr. Bridges can create a treatment plan that is both precise and effective, avoiding unnecessary procedures. She focuses only on what will truly help the patient.

Pre-Surgical Preparation

Preparing for spinal surgery to relieve pressure on a pinched nerve involves several important steps to ensure the best possible outcome. Your care team will guide you through the process, which often starts with adjusting or stopping certain medications—especially nonsteroidal anti-inflammatory drugs (NSAIDs)—to reduce the risk of bleeding during surgery. You may also be asked to avoid eating or drinking for a set period before your procedure.

Lifestyle changes can play a big role in your recovery. Quitting smoking and limiting alcohol intake before spinal surgery can help your body heal more efficiently and lower the risk of complications. It’s also essential to let your surgeon know about any medical conditions you have, such as diabetes or high blood pressure, and to provide a complete list of all medications and supplements you’re taking.

Before surgery, patients are guided step by step to ensure they feel prepared and supported. A companion is often encouraged to be present, both for reassurance and to assist afterward. The focus is always on making the process safe, comfortable, and as smooth as possible.

Depending on the type of surgery, you may be positioned on your back or stomach, and anesthesia will be administered to keep you comfortable throughout the operation. Taking these steps helps ensure that your surgery to relieve pressure on the affected nerve is as safe and effective as possible.

Surgical Treatment Options

When surgery is the right choice, the goal is simple: relieve the pressure on the nerve. The specific procedure depends on the underlying cause. A herniated disc may be treated with a discectomy, where only the portion of the disc pressing on the spinal nerve roots is removed. In cases of bone overgrowth or narrowing of the spinal canal in the lower spine, a laminectomy or foraminotomy may be performed to open more space for the nerve. 

These procedures are often performed through smaller incisions designed to reduce disruption to surrounding tissue. The approach is carefully chosen based on the patient’s condition, with the goal of relieving pressure on the nerve while protecting nearby structures. The surgeon makes a small incision and uses a small retractor to create a tunnel to the surgical site. The muscles surrounding the spine are carefully moved, while special techniques are used minimize tissue damage. Care is taken to protect soft tissue throughout the operation. The patient is typically positioned on their stomach during the procedure. In many cases, the use of smaller incisions and careful surgical methods can lead to less tissue disruption, smaller scars, and a smoother recovery process. In some situations, spinal fusion may be considered to help stabilize the spine after decompression.

These surgeries are designed to relieve pressure on the compressed nerve and target only the problem area while preserving as much of the spine’s natural stability as possible. For many patients, there is immediate improvement in radiating pain right after surgery, while other symptoms such as weakness or numbness may improve more gradually as the nerve heals.

Recovery varies, but most patients are encouraged to walk soon after surgery and gradually increase activity as tolerated. A brace and activity restrictions may be recommended for several weeks to protect the spine during healing. The long-term outlook is generally excellent, especially when combined with physical therapy and ongoing spine care.

Risks and Complications

While spinal surgery to treat pinched nerves is generally safe and effective, it’s important to be aware of the potential risks and complications. As with any surgical procedure, there is a chance of infection, bleeding, or an adverse reaction to anesthesia. Some patients may experience muscle weakness, numbness, or tingling after surgery—these symptoms are often temporary, but in rare cases, they can be long-lasting or permanent.

Other possible complications include nerve damage, spinal fluid leaks, or the need for prolonged bed rest during recovery. Advances in surgical techniques now allow some procedures to be performed with smaller incisions and less disruption to surrounding tissues, which can help reduce recovery time and certain risks. Most patients who undergo procedures to relieve pressure on the nerve experience significant improvement in their symptoms and are able to return to normal activities within a few weeks.

Working closely with your surgeon and following all post-operative instructions can help minimize risks. Physical therapy is often recommended after spinal surgery to help restore strength, flexibility, and function, and a physical therapist can guide you through a safe and effective recovery. Open communication with your care team is key to addressing any concerns and ensuring the best possible outcome.