The backbone is made of many smaller bones called vertebrae, and through the canal in the centre of these bones runs the spinal cord. Many nerves emerge from the cord, between the vertebrae and supply various areas of the body. When these nerve bundles get pinched or damaged, the resulting effects are termed as radiculopathy.
Symptoms of Radiculopathy
Since the nerves coming from the spinal cord innervate different parts of the body, the symptoms experienced will be different depending on which nerve is affected.
When a nerve in the neck or upper back is compressed it is called cervical radiculopathy. The symptoms are pain in the neck, shoulder, upper back, or arm; weakness or numbness typically experienced on one side.
If nerve compression or irritation occurs in the mid back region it is called thoracic radiculopathy. The symptoms include pain in the chest and torso, burning or shooting pain in the rib, side, or abdomen; numbness and tingling.
When the nerve compression or irritation occurs in the lower part of the back it is called lumbar radiculopathy. The symptoms include pain in the low back, legs, and hip region. Symptoms typically worsen with long periods of sitting or walking.
In some cases, nerves affecting the bowel and bladder can become compressed, leading to bowel or bladder incontinence or loss of control.
Radiculopathy can have other generalised signs like sharp pain starting in the back, extending to the foot, sharp pain with sitting or coughing, a change in sensation or reflex, hypersensitivity.
Causes of Radiculopathy
Changes to the tissues surrounding the nerves can lead to radiculopathy. These tissues include bones of the spinal vertebrae, tendons and intervertebral discs. When the surrounding tissues like the vertebrae, intervertebral discs or tendons shift or change in size, they may narrow the spaces where the nerves exit the spine; this effect is commonly called spinal stenosis and can caused by gradual degeneration or as a result of a spinal injury.
One common cause of radiculopathy is a bulging or herniated disc. Spinal discs act as cushions between your vertebrae, if these discs slip out of place or become damaged they can press on nerve roots.
Another possible cause of radiculopathy is bone spurs. These are areas of extra bone growth. They can form in the spine due to inflammation from osteoarthritis, trauma or other degenerative conditions.
Sometimes, the thickening of the spinal ligaments, spinal infections and tumours may also lead to nerve compression and radiculopathy.
Diagnosis of Radiculopathy
A doctor can diagnose radiculopathy in a person after a thorough physical examination and by going over the symptoms stated by the patient. In addition to this, some imaging tests may be needed to confirm the site and extent of the radiculopathy, such as, X-ray, MRI, and CT scans. Other tests like electrical impulse testing called electromyography (EMG) may be necessary to test nerve function.
Treatments for Radiculopathy
In most instances, radiculopathy is treatable through non-surgical means. These include non-steroidal drugs, oral corticosteroids or injectable steroids that help reduce inflammation. Narcotic pain medications help manage pain, depending on severity. Physical therapy can help strengthen muscles or relieve pressure points. Application of cold or hot compress at the site of pinched nerve can also be helpful in some cases.
In more severe cases, doctors may recommend surgery to treat the cause of the radiculopathy. Some surgical procedures include repair of a herniated disc, widening of the spinal canal space, removing a bone spur or fused the bones.
Surgery is typically used to reduce the pressure on the nerve root by widening the space where the nerve roots exit the spine. This may involve removing all or parts of an intervertebral disc or vertebral bone. Endoscopic surgery is one of the minimally invasive spine surgery for nerve decompression or relieving spinal stenosis. Every case is different and treatment choices will depend on individual factors of each patient and the cause of the radiculopathy.
