So you got a pinched nerve in your neck, now what?
I recently had a very painful pinched nerve in my neck at C5. Although this is an incredibly common injury, it took a while to figure out what the best path forward was, and what things I needed to change in order to get back to normal life. I learned a lot along the way, and so now you’ve got those learnings too.
It took roughly 2 full months from me waking up with intense pain in my neck, shoulders, and right arm, to being virtually pain free and feeling back to normal.
How did it happen?
If you’re in your 40s and have used a computer most of your life, you’re going to hear that this injury is very common. You probably know people who’ve had to deal with it. You kinda maybe tried to “have good posture” for a week or two at various points in your career, but between the phone, the laptop, that second monitor you had for a while, your neck has had the awful job of holding that big head of yours up for YEARS, and when you slouch, it gets even heavier. The disc between your vertebrae is bulging out from all the stress, and the nerve that’s trying to squeeze through that tiny opening back there has had enough. You woke up one day and realized your neck hurt a lot. Congratulations, you have a pinched nerve.
What to do first
Healthcare in the United States is awful, but if you’re lucky enough to have it, get straight to your primary care doctor and work on treatment. This blog post is not a substitute for medical advice or treatment, I’m just sharing what has helped me and not helped me, in case you want some pointers.
With the help of my doctors, I was able to get the right meds, x-rays, an MRI, Physical Therapy, and frequent consultations, which were all essential in combating this injury.
Manage the pain
You can’t think about anything, let alone do anything, if you’re in agony. For me, Ibuprofen was the key for immediate pain management AND helping combat inflammation. You’re probably not taking enough, though. The maximum dose of Advil for example, is 800mg, 4 times per day. The 800mg tablets are either prescription-only or behind the counter depending on where you live. I bought two giant bottles of 200mg pills and took 4 for each dose. This was and continues to be the most effective way to treat this problem.
Thanks to my doctors, I was also able to use much more powerful medicines for pain management, including something specifically to help with sleep. During the worst phase of it, even when heavily medicated, I was sleeping terribly and waking up at 3am in intense pain. I was taking blistering hot showers 4-6 times a day in addition to muscle relaxers, Ibuprofen, and more, just to get through it. Every doctor visit or consultation resulted in me increasing my dosage until I could finally get the pain under control. This isn’t a long-term strategy, but you absolutely have to get the pain managed before you can get better.
For immediate short-term relief, I also loved using a Theragun. This is certainly optional, and it doesn’t really provide a long-term solution, but there were many mornings that were made 100X better with just a few minutes of the Theragun directly on the neck and shoulders to relieve tension while the meds kicked in.
Stop the inflammation
A pinched nerve is essentially an inflamed, agitated nerve, that is pissed off about its living situation and it won’t stop screaming at you about it. Managing the pain is crucial, but to fix this issue you have to get that nerve to chill out. I was prescribed several different medicines to stop the inflammation. Ultimately none of them worked for me as well as Ibuprofen, but who knows what will work for you. Get prescriptions, take them, and keep at it until you find what works.
Fix your sleep
Being in pain all day sucks, so your body REALLY needs to heal at night. Try to manage your pain the point that you can sleep as close to a regular night’s sleep as possible. It’s not necessary at all, but I found it very handy to track my sleep using an Apple Watch. It’s enlightening to see how much of the night I wasn’t sleeping. It’s also reassuring to see how solidly you ARE sleeping when you get things right.
For me, the biggest improvement in restorative sleep was ensuring my head, neck, shoulders, and spine were in a good position all night. Two things dramatically improved this. First, sleep with a pillow under your knees. This will help flatten your lower spine and makes a huge difference.
Second, you need a better pillow. Yep, you’re going to be a “special pillow” person now. I got this one, which looks totally insane, but has been instrumental in keeping my neck in exactly the right position all night long. I can even sleep on my side now, something I wasn’t able to do for two full months.
Fix your work setup
Everyone is rightfully picky about their work setup, so instead of any product recommendations, I’ll keep this to some basic rules:
- With your head looking straight forward, with great posture, your eyes should land on the top third of your monitor. If you’re using a laptop, get that thing WAY up in the air on a stand or whatever. Figure it out.
- Trackpad / mouse: I went full split-custom-keyboard-with-tenting, but no matter what you choose for your keyboard, try to keep your trackpad as close to the middle of your hands as possible. I had my trackpad to the right of my keyboard, and that little movement all day long was a killer. Try not to do that.
- Stand up. I have a very nice adjustable standing desk, and guess what? I was mostly sitting down on a tall stool. Just stand, it’s infinitely better for you.
Fix your feet
I’m often barefoot at home, and that’s not so great for my feet, back, or posture. I had previously picked up a pair of Birkenstocks and the high arch and soft cork footbed… awwwww yeah. I’m never going back. Now, if I’m cooking or cleaning up in the kitchen for a while, I can immediately feel it in my back. Get your feet right, you’re on your way to getting your back right.
Strengthen your back
Your back is not strong enough for modern life. This is true for virtually all of us. The MOST important thing for long-term health of your neck and spine is to strengthen your back, neck, shoulders, and core. Seems obvious right? It takes a lot of musculature to hold you in place the right way. I was cycling a lot prior to this injury, and I stupidly felt like that had provided decent fitness. Without a strong core, back, and shoulders, you’re going to pinch that nerve again. FIX YOUR BACK! Things that have and continue to work for me:
- Start with the basic stretching that your doctor gave you. Don’t throw that paper away, get started on mobility and range of motion now.
- Do some light yoga that’s focused on your neck and shoulders. I did these two almost every day for a few weeks.
- Weighted shrugs (dumbbells, heavy books, kettle bells, whatever you got)
- Dumbell arnold press
- Kettlebell swings (ONLY when your pain is gone, don’t rush stuff like this)
- Overhead press
- Lat pulls
- Ring rows
- You get the idea. There are lots of exercises that will help, but you have to DO them for it to work.
Fix your driving
Driving sucks anyway, but driving with a pinched nerve is near impossible. Even though I’m mostly “healed” now, driving can still cause me pain. Things that help:
- Stick a thin pillow between your shoulder blades while you drive. The shape of your car seat is pushing your shoulders forward so you need to counteract that.
- Keep another pillow or something similar on the console and adjust your elbow to a height that feels natural. You’ll be in lots more pain if your elbow is too high or too low.
- Lean your seat forward. This is a tough one, and may depend on which nerve is inflamed. I found that a few clicks back from vertical is best for me.
My Physical Therapist has this silly but true saying… “motion is lotion”. If you’re all rigid and not moving around much because of this annoying issue, it will be harder to get better. Walk around, even just around the house at first. The more you move your body, the better. Your shoulders are crunchy and everything is sore. Keep moving. Your head hurts with those little movements it deals with as you stumble around… keep moving. Motion is lotion. The more you move, the more you’ll be able to move.
Your new normal, keep it going forever
After roughly two full months of dealing with this, I was finally able to go on a bike ride that was virtually pain free. This was the most important milestone for me and it was all I could think about during those painful weeks. The thing is, I’m not “done”. I’m not “back to normal”. This is my new normal. I have a bulged disc, I have a nerve that’s always on the verge of being pinched if it gets inflamed. I have to keep moving, I’m working regularly on strength training, and I’m managing any pain along the way with Ibuprofen. While I sleep with a funky pillow in bed, and two in my truck.
Mobility is a gift. We need to earn it to keep it or it will fade away. It takes work. Deal with it.
But what about…
Chiropractors? You may find it helpful. I had an awful experience with one and realized the tools and services they offer were unrelated to what I needed. They can’t diagnose you, they can’t give you an MRI, they can’t prescribe you medicine, and they can’t perform physical therapy. Probably skip it.
Massage therapy? Oh hell yeah. This is a trained professional who uses special kinds of massage to perform body work to relieve pain, work those tense muscles that are freaked out about all the pain signals they’re getting, and most of all, makes you feel 10000000x better. I went twice a week at first, then once a week, then twice a month and I’ll probably stop in a few weeks. Massage Therapy is not cheap and it’s not likely to be covered by your medical insurance, but if you can do it, do it.
Acupuncture? I wish I'd tried it! It seems like it would be helpful, I just didn't have a recommendation I trusted, so I never went.
Supplements? LOL — I maybe read too much early on in my quest for “fixing this pinched nerve” and found many articles (and papers!) that talked about the benefits of certain supplements. Some of them are very likely to be good long-term options (like fish oil). But honestly, the benefits of moving your body regularly are like 10,000x more beneficial than any vitamin supplement you're going to buy. Skip ‘em.
It sucks so badly to be in pain and not able to do what you want to do, but you’ll get through it.