Jordan Sudberg Explains the Difference Between a Pinched Nerve and a Strained Muscle

Whether it’s a shooting pain down your leg or a dull ache in your back after a tough workout, pain can disrupt your life in unexpected ways. But understanding where the pain is coming from—and what type of injury it reflects—is key to getting the right treatment.

Two of the most common sources of musculoskeletal discomfort are pinched nerves and strained muscles. While their symptoms can seem similar at first, they involve different tissues, causes, and treatments.

According to Jordan Sudberg, a leading pain management specialist and medical director at Spine and Sports Rehabilitation, confusing the two conditions is a frequent problem that can delay recovery.

“Pinched nerves and muscle strains both cause pain and limited mobility, but they’re fundamentally different issues. Misdiagnosing one for the other can lead to the wrong treatment plan,” says Dr. Sudberg.

In this in-depth post, Dr. Sudberg breaks down the differences between pinched nerves and muscle strains, how to tell them apart, and what you should do if you’re experiencing either type of pain.

What Is a Pinched Nerve?

A pinched nerve (also known as nerve compression or impingement) occurs when surrounding tissues—like bone, cartilage, muscles, or tendons—apply too much pressure on a nerve. This disrupts the nerve’s ability to transmit signals and leads to a range of neurological symptoms.

Common causes of a pinched nerve include:

• Herniated discs in the spine

• Bone spurs from arthritis

• Repetitive motion injuries

• Poor posture or ergonomics

• Trauma or inflammation

Pinched nerves can happen anywhere in the body, but they’re most common in the neck (cervical spine), lower back (lumbar spine), and wrists (carpal tunnel syndrome).

Symptoms of a Pinched Nerve

According to Dr. Sudberg, a pinched nerve often produces distinctive, nerve-related symptoms, including:

• Sharp, shooting, or burning pain

• Numbness or tingling (pins and needles)

• Muscle weakness in the affected area

• Pain that radiates (e.g., down the leg or arm)

• Worsening pain when sitting, sleeping, or moving a certain way

“Radiating or electrical pain that follows a nerve pathway is often the biggest clue,” says Dr. Sudberg. “If your symptoms include numbness or weakness, we’re likely looking at a nerve issue, not just a muscle problem.”

What Is a Muscle Strain?

A muscle strain (sometimes called a pulled muscle) happens when muscle fibers are overstretched or torn due to overuse, excessive force, or sudden movements. Unlike nerve pain, muscle strains involve the muscle tissue itself, not the nervous system.

Common causes of muscle strains include:

• Lifting heavy objects improperly

• Sudden acceleration during exercise or sports

• Repetitive motions without adequate recovery

• Inadequate warm-ups or conditioning

Strains can range from mild (Grade I) to severe (Grade III), depending on how much damage has occurred to the muscle.

Symptoms of a Muscle Strain

Muscle strain symptoms are more localized and often include:

• Dull, aching pain in a specific area

• Muscle stiffness or tightness

• Swelling or bruising

• Pain during movement or use of the affected muscle

• A “knotted” feeling in the muscle tissue

“With a muscle strain, the pain is usually tied to activity and improves with rest. There’s no tingling or shooting sensation, which you’d expect with nerve involvement,” explains Dr. Sudberg.

Diagnosis and Evaluation

When patients come in complaining of back, neck, or limb pain, Dr. Sudberg begins with a comprehensive physical exam, reviewing their medical history and daily habits. If symptoms suggest nerve involvement, he may order:

• MRI or CT scans to view spinal discs or bone structures

• EMG (electromyography) to test nerve function and muscle response

• Nerve conduction studies to identify damaged or compressed nerves

“Imaging and nerve studies can tell us exactly where the issue lies—and how severe it is,” says Dr. Sudberg. “From there, we tailor the treatment.”

Treatment Options

For Pinched Nerves:

• Rest and activity modification to reduce pressure

• Physical therapy to strengthen supporting muscles and improve posture

• Anti-inflammatory medications or corticosteroid injections

• Chiropractic care or decompression therapy

• Surgical options (like discectomy or laminectomy) in severe cases

For Muscle Strains:

• R.I.C.E. protocol: Rest, Ice, Compression, Elevation

• Over-the-counter pain relievers

• Gentle stretching and massage

• Physical therapy for moderate to severe strains

• Gradual return to activity once healing has progressed

“In both cases, early intervention is key. The longer a pinched nerve goes untreated, the greater the risk of permanent damage. And ignoring a muscle strain can lead to chronic instability or repeated injuries,” Dr. Sudberg warns.

Preventing Future Injuries

Dr. Sudberg emphasizes prevention as a crucial part of any treatment plan.

For muscle strain:

• Warm up properly before workouts

• Use proper lifting techniques

• Stay hydrated and maintain flexibility

For pinched nerves:

• Practice good posture, especially at your desk

• Avoid prolonged sitting or repetitive stress

• Use ergonomic furniture and sleep support

• Strengthen core and spinal support muscles

“Most of these issues are preventable with smart habits and regular movement,” says Dr. Sudberg. “It’s about body awareness and listening to your early warning signs.”

Final Thoughts: Listen to Your Body

Whether you’re dealing with a pinched nerve or a strained muscle, the key to recovery lies in understanding what’s really going on—and seeking the right kind of help. Misidentifying the cause of your pain can lead to wasted time, ineffective treatments, and prolonged suffering.

With experts like Jordan Sudberg, patients can expect not only a clear diagnosis, but a thoughtful and effective path to recovery.

“Pain is the body’s way of asking for attention,” Dr. Sudberg says. “The sooner we listen—and respond—the faster we can restore quality of life.”