Medically reviewed by Dr. David L. Greenwald, MD, FAANS, FACS — dual board-certified spine surgeon & neurosurgeon. Last reviewed October 2026.

Pain that shoots down a leg or arm, numbness, tingling, or weakness usually means a spinal nerve is being pinched or irritated. Pinpointing exactly which nerve — and what's compressing it — is the key to relief. As both a spine surgeon and a neurosurgeon, Dr. Greenwald specializes in the nerves, and treats the full range of neurological spine conditions across Phoenix, from sciatica and pinched nerves to radiculopathy, drop foot, and spinal cord compression.

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How a Spinal Nerve Gets Pinched

What Are Nerve & Neurological Spine Conditions?

Neurological spine conditions are problems that affect the nerves running through and out of your spine — either a spinal nerve root that gets pinched where it exits the spine, or the spinal cord itself when it becomes compressed. Unlike muscular back pain that stays in one place, nerve problems announce themselves by traveling: a sharp, electric pain that runs down a leg or an arm, numbness or tingling in the foot or hand, or a muscle that suddenly feels weak. That "radiating" quality is the signature of an irritated nerve.

The cause is almost always structural. A herniated disc, a bone spur, or a narrowed canal presses on the nerve, and because each spinal nerve supplies a specific part of the body, your exact symptoms reveal which nerve is involved. A nerve compressed in the lower back can send pain all the way to the foot; a nerve compressed in the neck can cause pain, weakness, or numbness in the shoulder, arm, or hand. The clinical names for these problems — sciatica, radiculopathy, pinched nerve, myelopathy — describe where and how the nerve is affected, but they share one root cause: pressure that needs to come off the nerve.

Because Dr. Greenwald is both a board-certified spine surgeon and a neurosurgeon, nerve involvement is never treated as an afterthought. The disc, the bone, and the delicate nerve itself are all evaluated by one specialist who understands how each one affects the others — which is exactly what nerve conditions demand.

Nerve & Neurological Conditions We Treat

Most people arrive describing their symptoms — "my leg is on fire," "my hand keeps going numb" — rather than a diagnosis. Part of our job is naming the problem precisely so it can be treated precisely. These are the main nerve and neurological conditions we care for:

Symptoms of a Pinched or Irritated Nerve

Nerve symptoms are different from ordinary aches because they travel along the path of the affected nerve rather than staying put. If your pain follows a line down a limb, or you have numbness, tingling, or weakness far from your spine, a nerve is almost certainly involved. The most common signs include:

• Radiating pain. A sharp, burning, or electric pain that runs from the lower back into the buttock and down the leg (sciatica), or from the neck into the shoulder, arm, and hand.
• Numbness or a "pins-and-needles" tingling. Often felt in the foot, toes, hand, or fingers — frequently in a specific zone that maps to the pinched nerve.
• Muscle weakness. A leg that feels like it might give out, a hand that drops things, or difficulty lifting the front of the foot (drop foot).
• Symptoms that worsen with position. Many patients notice their pain flares with prolonged sitting, standing, walking, bending, or a particular neck movement, and eases when they change position.
• One-sided symptoms. Because a single nerve root is usually involved, the pain, numbness, or weakness is often felt on just one side of the body.

The specific pattern matters more than the intensity. Where the symptoms land — which toes are numb, which movements are weak — tells an experienced specialist exactly which level of the spine and which nerve to investigate. Describing your symptoms carefully at your visit genuinely speeds the path to the right diagnosis.

What Causes Nerve Compression?

Nerve symptoms almost always trace back to something physically pressing on a nerve root or on the spinal cord. The usual culprits are age-related or injury-related changes in the spine:

• Herniated or bulging disc. When the soft center of a disc pushes through its outer wall, the displaced material — and the inflammation it triggers — can press directly on a nearby nerve root. This is one of the most common causes of sciatica and arm pain.
• Bone spurs (osteophytes). As joints in the spine wear, the body can form extra bone that narrows the space the nerve travels through.
• Spinal stenosis. A narrowing of the spinal canal or the openings where nerves exit, which crowds the nerves and the cord — a frequent source of leg symptoms in older adults.
• Degenerative disc disease. As discs lose height and flexibility over time, the openings for the nerves shrink and the spine becomes less stable.
• Slipped vertebra (spondylolisthesis). When one vertebra shifts forward over another, it can pinch the nerves passing between them.
• Injury or trauma. A car accident, fall, or sports injury can herniate a disc, fracture a vertebra, or directly injure the cord — causes we see often in our accident-related patients.

Identifying the true cause is essential, because other problems — hip arthritis, a shoulder condition, or peripheral neuropathy — can imitate a pinched spinal nerve. Treating the wrong source is why some patients bounce between providers without relief. Getting the diagnosis right the first time is the foundation of everything that follows.

How We Diagnose Nerve Conditions

Because nerve symptoms follow predictable patterns, diagnosis begins by matching your exact symptoms to the specific nerve involved. At Desert Spine and Pain, that evaluation is thorough and hands-on:

• History and focused exam. Dr. Greenwald listens to how and where your symptoms travel, then tests strength, sensation, and reflexes to map which nerve is affected. Where your numbness and weakness fall is often the single most telling clue.
• Imaging. An MRI shows the discs, nerves, and soft tissue in detail and usually reveals what is compressing the nerve; a CT scan or X-ray adds information about the bone, alignment, and stability.
• Nerve testing (EMG/NCS). When helpful, electromyography and nerve conduction studies measure the electrical function of the nerves and muscles. These tests help confirm that a nerve root is truly involved, gauge how affected it is, and distinguish a spinal nerve problem from a peripheral one.

The goal is not simply to confirm that "a nerve is pinched," but to identify precisely which nerve, at which level, and from what cause — because that is what determines the right treatment. As a neurosurgeon, Dr. Greenwald reads this nerve-level detail first-hand rather than relying on a second opinion to interpret it.

Treatment Options for Nerve Pain

Most pinched nerves improve without surgery. We begin with the least-invasive measures that can relieve the pressure and calm the inflammation, and we escalate only as far as your symptoms require. Depending on the diagnosis, treatment can include activity modification and physical therapy, anti-inflammatory medication, image-guided spinal injections to reduce nerve inflammation, and — when a nerve stays compressed despite conservative care — a small, targeted decompression to physically free it. For chronic nerve pain that persists, advanced options such as spinal cord stimulation can help quiet the pain signal itself.

How We Approach Nerve Conditions

Our philosophy is least-invasive-first. The large majority of nerve problems respond to conservative and interventional pain care, and we exhaust those options before ever discussing an operation. When a nerve does stay compressed and symptoms persist, the right procedure — often a small, muscle-sparing decompression performed with minimally invasive techniques — can relieve pain that nothing else has touched.

What sets this approach apart is the dual training behind it. Nerve conditions sit exactly at the intersection of the spine's structure and its nervous system, and Dr. Greenwald operates in both worlds. The same specialist who evaluates your nerve is the one who would treat it — so nothing is lost in translation between an orthopedic view of the bone and a neurological view of the nerve. Spinal cord compression (myelopathy) and spinal cord injuries are always evaluated promptly, because with the cord itself, timing protects function.

When to See a Specialist — and When It's Urgent

Mild, short-lived nerve symptoms often settle on their own. You should see a spine specialist when radiating pain, numbness, or tingling lasts more than a week or two, keeps returning, or interferes with work, sleep, or daily life — early evaluation gives the least-invasive options the best chance to work. Certain signs, however, mean you should not wait:

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Why Choose Our Nerve & Spine Specialists in Phoenix

Nerve problems are exactly where DSP's dual expertise matters most: your care is led by a specialist who is both a board-certified spine surgeon and a neurosurgeon, so the nerves are evaluated by someone who operates on them. We treat the full range of neurological spine conditions, lead with the least-invasive option that will work, welcome out-of-network patients, require no referral, and partner closely with personal-injury attorneys — with 24/7 concierge support — for accident-related nerve injuries.

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Nerve & Neurological Conditions: Frequently Asked Questions