Nerve pain

or pins and needles in the arms or legs

Left part of K

Find out more about nerve pain or pins and needles in the arms or legs

Nerve Pain - Dr Alex Koefman, spinal surgeon Brisbane

Neurosurgeon Brisbane

Dr Alex Koefman about nerve pain

Nerve pain key points

  • Sciatica is a medical term for nerve pain down the back of the leg.
  • You can also get nerve pain down the front of the leg. We call it femoratica.
  • Neurogenic claudication is due to multiple nerves in the lower back being jammed causing aches and pins and needles down both legs, particularly bad when walking.
  • You can also experience nerve pain in your arms. It is called brachialgia.
  • Nerve pain is often treated with a simple steroids injection, pilates or physiotherapy.
  • There are only 3 reasons why you would need surgery to treat nerve pain and I’ll explain these below.

Nerve pain Brisbane

What is it?

When the nerves of the spine get irritated or squashed, nerve pain results. 

It is quite common.

  • When this nerve pain goes down the back of the leg it is called sciatica.
  • When it goes down the front of the leg it is called femoratica.
  • When it goes down the arm it is called brachialgia.

The spaces in the spine where the nerves run are very small to start with. Therefore, it doesn’t take much to irritate or squash them. Usually, a small bit of arthritic tissue is the cause. The resulting pain is disproportionate, however. For only a few millimetres, the resulting nerve pain can be horrific.

Dr Alex Koefman | Brain and Spinal Surgeon Brisbane
Dr Alex Koefman

Nerve pain specialist Brisbane

Pins and needles are similar to pain, also a sign of nerve root being irritated or squashed. Often patients have both. Usually, the pins and needles occur in the hands or feet and the pain spreads right down to the ankles or the wrists. 

Nerve pain symptoms

What are the symptoms?

It is usually only the nerves in the back and neck that cause nerve pain.

If it is in the back, there are only two nerves affected; the sciatic nerve or the femoral nerve.

  • If it is the sciatic nerve, you will experience pain in the back, radiating to the buttock, down the hamstring and into either the side or the back of the calf. Often there is numbness and pins and needles in the foot.
  • If it is the femoral nerve, the pain starts in the buttock and radiates around into the front of the thigh. Often there is numbness and pins and needles down into the front of the knee and into the shin bone.

If it is in the neck, the pain often radiates from the side of the neck, into the shoulder blade, and then down the side of the shoulder. There is often numbness and pins and needles in the hand.

Most of the time it is just one nerve affected.

There is another condition called neurogenic claudication. This only occurs in the lower back and involves compression of both the sciatic and femoral nerves inside the spine. For reasons that are not important here, it doesn’t cause actual nerve pain, but rather an aching feeling down both the front and back of the legs with pins and needles everywhere. Patients just say “I just feel it’s all over my legs, everywhere.” Also, it is classic in this condition to hear patients say it only gets worse when walking and better when resting.

Nerve pain causes

What causes it? Did I do something to cause it?

The most common cause is wear and tear changes in the spine. Often the nerve has been squashed by arthritic tissue or a bulging disc for a long time and it’s only when one day that you do something that jams the nerve further that the pain and symptoms all start.

It’s a bit like having your hand caught in the cookie jar: you don’t feel any pain until you start trying to yank your hand out, and your hand gets all battered, bruised and sore.

It’s very common to hear stories like:

  • “I was fine then I lifted something and twisted and bang! It all started”
  • “I just sneezed and wham!”
  • “I thought I felt funny and now I have this awful pain in my neck and arm”

It’s quite common, and usually not dangerous. Sometimes the pain can be so severe it feels dangerous. And sometimes the nerve is so irritated and squashed that the muscles supplied by the nerve stop working (a sensation of weakness in the hand or foot), but rarely is it an actual dangerous medical condition. 

Dr Alex Koefman | Brain and Spinal Surgeon Brisbane
Dr Alex Koefman

Nerve pain specialist Brisbane


The only time it is dangerous is if the bowel and bladder function is affected. This serious and dangerous condition is called cauda equina. I would need to see you immediately if this was the case. The other dangerous condition is if the weakness has happened quickly and is quite noticeable. Again, I should see you immediately if this is the case.

You can test yourself.

  • Sciatica weakness makes it hard to stand on your toes, or on your heels.
  • Femoratica weakness makes it hard to squat.
  • Brachialgia weakness (coming from the neck) makes it hard to do push-ups, lift things with your biceps and grip things with your hand.

Furthermore, the prognosis is good in most people. If you would like your situation fully assessed, then contact my team and I will go through this thoroughly with you

Nerve pain treatment in Brisbane

How is it treated?

Did you know that in most people with nerve pain, or pins and needles, the symptoms will burn out by about 1-2 months and they can return to normal activity? 

Often a simple steroids injection and pilates or physiotherapy help also.

Why would anyone need surgery then if this is the case?

Nerve pain surgery Brisbane

Do I need surgery?

Most people don’t need surgery. Even though it is keyhole surgery (1-inch incision in the back only), recovery is very rapid (usually go home the same day) and there is no need for any rods, bolts or screws, most people will be fine with pilates, physiotherapy and a steroid injection. 

There are only 3 reasons I operate for nerve pain:

  1. Sometimes the patient is in so much pain that they need it to end asap. In over 90% of cases a patient will wake up from surgery and the pain will already be gone. This is a very attractive option for some patients. Furthermore, the surgery does not weaken their spine and there are usually no restrictions post-surgery.
  2. Sometimes the weakness in the arm or leg is quite bad. Surgery gives the muscle the best chance of recovery by removing the compression off the nerve. Often patients don’t realise they have any weakness till I examine them closely.
  3. The third reason is if the symptoms have been dragging on and on and the patient can’t see any light at the end of the tunnel or just needs their life back on track. Again surgery will achieve this very quickly.

Ultimately it comes down to what your symptoms are, what I find on examination, what your scan looks like and what your current quality of life looks like. If you would like me to make this thorough assessment of your condition, please contact my team to book an appointment.

Nerve pain specialist Brisbane

What should I do now?

If you are unsure about what treatment option is best for you, contact my team and book an appointment with me. We will go over your personal case and help you to make an informed decision. 

Ready to make an appointment?

Alex consults at Queensland Neurosurgery & Spine Surgery (QNS).
Dr Alex Koefman

Ramsay Specialist Centre
Suite 325
Newdegate St
Greenslopes QLD 4120


(07) 3397 4185

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