What is Radiculopathy?
Radiculopathy is a pinched nerve in the spine. It
occurs when surrounding bones, cartilage, muscle, or tendons deteriorate or are
injured. The trauma causes these tissues to change position so that they exert
extra pressure on the nerve roots in the spinal cord.
When the nerve roots are compressed, they become
inflamed. This results in numbness, weakness, and pain. The condition can usually
be reversed with timely and appropriate treatment.
Types of Radiculopathy
Types of radiculopathy are defined
by the location of the compressed nerve:
- Lumbar radiculopathy is pressure on the nerve root in the lower back. It can
cause sciatica, or shooting pain in the legs. Incontinence, sexual dysfunction,
or severe paralysis can also occur in severe cases.
- Cervical radiculopathy is pressure on the nerve root in the neck. It can cause
painful burning or tingling in the neck, shoulder, and arms.
radiculopathy occurs when there are pinched nerves in the middle portion of
the spine. This causes pain in the chest and torso. It is uncommon and can be
mistaken for shingles.
What Causes Radiculopathy?
Radiculopathy occurs when a nerve is compressed by surrounding tissue. It
is sometimes caused by a herniated spinal disc. This occurs when the outer rim
of the disc weakens or tears. The nucleus then pushes outward and exerts pressure
on a nearby spinal nerve.
Bone spurs can also cause radiculopathy. This is when extra bone forms
around a disc after it weakens or collapses. These spurs can stiffen the spine
and narrow the space where nerves are located, causing them to be compressed.
Pressure from a herniated disc, surrounding tissue, muscle, or tendons
can cause inflammation. This interferes with nerve function. This compression
can occur spontaneously. It can also result from trauma or other conditions
that affect the spine. These include injury, osteoarthritis, and obesity. Age
is another factor. Poor posture or stress from repetitive activities can also
Who Is at Risk for Radiculopathy?
changes in your disc and vertebrae occur as you age. Radiculopathy usually
affects people between the ages of 30 and 50 (Cleveland
like rheumatoid arthritis, diabetes, and obesity can increase the risk of
radiculopathy. Bone spurs can sometimes occur because of trauma or
osteoarthritis. The condition can also be caused by repetitive hand, wrist, and
shoulder movements. Pregnant women are also at a higher risk. It can be
What are the Symptoms of Radiculopathy?
of radiculopathy can range from mild to severe. The type and location of pain
depends on the location of the pinched nerve root. Cervical radiculopathy usually
affects the lower arm more than the neck area. Lumbar radiculopathy causes more
discomfort in the lower leg than in the back area.
of radiculopathy can incude:
- a sharp back pain
that travels down to the foot
- a sharp pain that worsens with abdominal pressure
from sitting or coughing
- numbness of the skin in the leg or foot
- weakness and tingling in the neck and arm
- weakness and tingling in the back and leg
- changes in sensation
- loss of reflexes
- shoulder pain
- arm pain
- pain that worsens with neck or head movement
How Is Radiculopathy Diagnosed?
Several tests can be used to identify and diagnose radiculopathy’s cause.
After an initial physical examination, X-rays can show bone alignment or
narrowing of the discs. Magnetic resonance imaging (MRI) examines soft tissue,
the spinal cord, and nerve roots. A computed tomography (CT) scan looks at the
fine details of the bones, including bone spurs.
An electromyogram (EMG) can measure the electrical impulses of the
muscles when at rest and during contractions. This helps to find evidence of
damage. A nerve conduction study (NCS) measures the ability of nerves to send
How Is Radiculopathy Treated?
Typically, the first step in treating radiculopathy is conservative
Some medications can be effective in treating the
pain and inflammation of radiculopathy:
anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
- muscle relaxants
- prescription opioids
for severe pain
- spinal corticosteroid
injections into the affected area
Physicians sometimes recommend surgery when radiculopathy
doesn’t improve within a specified period of time. This is typically after
about six to 12 weeks of conservative treatment. Surgery also may be considered
in cases where multiple nerves are affected or where nerve function is
diminishing despite treatment.
Surgery can be used to free the affected nerve from
pressure. This may require a discectomy. This procedure involves removing bone
spurs or part of a herniated disc. During this procedure, a section of the
vertebrae may need to be removed or fused together.
Activities that aggravate the pain should
usually be limited. Physicians can prescribe a splint, brace, or soft collar to
immobilize the affected area. This helps to facilitate rest. In extreme cases,
bed rest or traction may be necessary.
Physical therapy can teach patients how to
strengthen, stretch, and protect the affected area.
For some patients, weight loss may help
reduce pressure on the affected area.
What Is the Outlook for Radiculopathy?
Most cases of radiculopathy improve with a few days or weeks of
treatment and rest. Radiculopathy caused by a herniated disc usually improves
without surgery. However, recurrence of radiculopathy is possible. It can
happen whether or not surgery was used for treatment.
While some causes of radiculopathy are not avoidable, there are some
ways to reduce the risk. Maintaining good posture and a healthy weight reduce chances
of developing radiculopathy. To prevent complications, use safe techniques when
lifting heavy objects. When doing repetitive tasks, take frequent breaks.
Staying physically active can also help. Develop a regular exercise
program that incorporates strength and flexibility exercises.