Pinched Nerve vs. Strained Muscle: How to Tell the Difference

Experiencing pain in your neck, back, or limbs can understandably cause stress and concern, especially when you're unsure if it's a pinched nerve or a strained muscle causing the discomfort. 

Both issues are common, yet they differ in their causes, symptoms, and the way they impact your body. When you’re dealing with symptoms that point to either one of these issues, it’s wise to consult with a specialist, like the team here at Pain Management Specialists in Rockville and Frederick, Maryland. 

Stuart Hough, MD, and Ramani Peruvemba, MD, have extensive experience providing comprehensive care to help patients get relief from pain related to spinal conditions, nerve injuries, surgery, and cancer. 

Our highly skilled professionals can distinguish between pain caused by a pinched nerve or a strained muscle, so you can get an accurate diagnosis and appropriate treatment to relieve your pain. The right diagnosis and treatment means you can get back to your life and the things you enjoy.

At our interventional pain management practice, we specialize in treating pain from spinal conditions, nerve injuries, and more. Let’s dive into how you can tell the difference between a pinched nerve and a strained muscle.

What is a pinched nerve?

A pinched nerve happens when surrounding tissues put pressure on or irritate nerves. This is common in spinal issues such as when a spinal disc bulges (herniated disc) into the spinal canal and presses on a nerve.

When the nerve becomes compressed, it interrupts the nerve’s ability to send signals properly, resulting in pain, and often abnormal sensations such as stinging, numbness, or weakness along the affected nerve's pathway.

You often feel a pinched nerve in specific areas, such as the neck, back, or limbs. For example, a pinched nerve in the lower back may cause shooting pain down your leg (sciatica), while one in your neck may radiate pain to your shoulders or arms. The discomfort tends to be sharp or burning and can worsen with certain movements or prolonged positions.

What is a strained muscle?

A strained muscle, however, is an injury to the muscle fibers, often caused by overuse, overstretching, or lifting something too heavy. When a muscle is strained, the fibers are torn or damaged, which leads to localized pain, swelling, and difficulty using that particular muscle. Muscle strains are most common in areas like the lower back, neck, shoulders, and legs.

The pain from a muscle strain typically feels more like soreness or a dull ache and is often accompanied by stiffness or tenderness in the area. While it might limit your range of motion, the discomfort usually improves with rest, ice, and gentle stretching. Unlike nerve pain, a strained muscle generally won’t cause tingling or numbness.

Key differences in symptoms

While both a pinched nerve and a strained muscle can cause significant discomfort, certain symptoms can help you distinguish between the two:

Radiating pain vs. localized pain

A pinched nerve often causes pain that radiates along the nerve’s path, such as from the lower back down the leg. Muscle strains, however, usually cause pain localized to the muscle itself.

Tingling and numbness

If you're feeling tingling, burning sensations, or numbness, it’s more likely that a nerve is involved. These sensations are uncommon with muscle strains.

Weakness

A pinched nerve can lead to related muscle weakness. For example, a pinched nerve in the lower back may weaken leg muscles. A muscle strain may cause discomfort, but it typically won’t result in weakness.

Response to rest

Muscle strains often improve with rest, ice, and over-the-counter pain medications. A pinched nerve may not improve as quickly and might require additional interventions, such as physical therapy or nerve blocks.

When to seek professional care

If your pain is persistent, severe, or accompanied by numbness, weakness, or loss of function, it’s important to seek professional evaluation. Pinched nerves, if left untreated, can lead to long-term damage, including muscle weakness or nerve damage. Strained muscles typically heal on their own but may require care if the strain is severe or doesn’t improve with rest.

The team at Pain Management Specialists takes a comprehensive, patient-centered approach to pain management. We’re dedicated to helping you live with less pain, and we achieve this mission through advanced pain management treatment, including but not limited to nerve blocks, neuromodulation (Reactiv8), and radiofrequency ablation. 

Don’t let pain put a damper on your ability to enjoy life. Contact us at Pain Management Specialists today for expert care tailored to your needs.