Spinal Problems Radiculopathy

Nerves leave the spinal cord and travel to other parts of the body, providing feeling and muscle movement. Radiculopathy is the irritation of a nerve root near the spine (the radicular nerve), which may be pinched, inflamed, or ineffective due to lack of blood flow.

Symptoms of radiculopathy include:

  • Numbness, tingling, or burning in the skin that the nerve supplies
  • Pain in the area where the nerve goes
  • Weakness in the muscles that the nerve serves.

Radiculopathy occurs most often in the neck (cervical radiculopathy) or the lower back (lumbar radiculopathy). It rarely affects the thoracic spine (mid-back). In addition to causing back pain, radiculopathy may cause pain to radiate down the arm or leg.

What Causes Radiculopathy?

Anything that presses on a nerve root (pinching or rubbing against the nerve) or inhibits blood flow to a nerve can cause radiculopathy. Common causes include:

  • Bone spurs
  • Herniated discs
  • Infections
  • Spinal stenosis
  • Tumors.

Each nerve goes to a specific muscle group and sensory area, so a doctor can often determine the location of the irritated nerve root by evaluating symptoms in other parts of the body.

Lumbar Radiculopathy

A pinched or irritated nerve in the lower back will cause symptoms in the buttocks, legs, and feet. Lumbar radiculopathy symptoms include:

  • Decreased knee and ankle reflexes
  • Leg pain or weakness
  • Loss of feeling in the feet or toes
  • Weakness in the buttocks and hips.

Lumbar radiculopathy that causes pain down the back of the leg may also be called “sciatica.”

Cervical Radiculopathy

When radiculopathy occurs in the neck,, the affected areas are usually in the arms and hands. Symptoms of cervical radiculopathy depend on which nerve root is irritated, and can radiate along the length of the arm and extend into the fingers.

Treatment Options for Radiculopathy

The first treatment choices for radiculopathy are often medication and physical therapy. Undertaking an appropriate exercise program and improving your body mechanics—such as working on your posture—can help take pressure off the affected nerve.

For those with cervical radiculopathy, cervical collars (also known as neck braces) can support the neck and limit motion while the neck is healing. Neck braces should only be worn for short periods of time to avoid loss of strength in the neck muscles. Also, a special cervical pillow may help ease pain at night for better sleep.

Other treatment options that may take pressure off the nerve include traction, spinal decompression, or chiropractic work.

If more conservative measures don’t work, your doctor may suggest a nerve block. During this procedure, a small amount of cortisone is injected into the bony spinal canal in an effort to control inflammation and ease pain. The pain relief is only temporary. The injection does not always work and is often solely used in an effort to postpone surgery.

Doctors will generally only consider surgery for radiculopathy if multiple nerves are irritated, other treatments do not work, and/or nerve function is being lost.

Resources

Cordingley, G. (2005). Cervical radiculopathy: Diagnosing a pinched nerve in the neck. Retrieved March 26, 2010, from http://www.cordingleyneurology.com/cervicalradicdx.html

Skelton, A. (2010). Lumbar radiculopathy: Proper diagnosis key to effective treatment of back and leg pain. Retrieved March 26, 2010, from http://www.spineuniverse.com/conditions/back-pain/low-back-pain/lumbar-radiculopathy-proper-diagnosis-key

University of Maryland Spine Program Staff. (2007). A patient’s guide to cervical radiculopathy. Retrieved March 26, 2010, from http://www.umm.edu/spinecenter/education/cervical_radiculopathy.htm

Verkuilen, P. (2005). Lumbar and cervical radiculopathy. Retrieved March 26, 2010, from http://www.spine-health.com/conditions/pain/lumbar-and-cervical-radiculopathy