Radiculopathy

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Description:

RadiculopathyRadiculopathy or radicular syndrome (Commonly known as Sciatica pain) is the presence of pain or other symptoms that radiate down a person’s arms or legs. Symptoms may include one or all of the following: pain, burning, numbness, tingling, pins and needles, weakness and muscle cramps. Radiculopathy is usually caused by a pinched nerve or pathology in the spinal column. When the nerve affected is in the lower back area of the spine, symptoms go down the legs into the thighs, calves and sometimes into the feet.  If nerve affected in the neck area, the shoulders, shoulder blades, arms and hands are affected. Similarly, if the affected spinal nerves are in the upper to mid area, symptoms usually manifest in the chest or abdomen.

Symptoms:

  • Sharp shooting pains down extremity
  • Numbness
  • Tingling
  • Weakness
  • Muscle cramp
  • Aching
  • Burning

Seek immediate care if you experience:

– New bowel or bladder problems

– Progressive extremity weakness

– Is associated with pain or throbbing (pulsation) in the abdomen, or fever

– Follows a fall, blow to your back or other injury

 Causes:

It is often caused by direct pressure on the nerve, causing nerve root irritation and inflammation. This can be caused by:

  • Herniated discs
  • Central canal stenosis, direct pressure on the spinal cord
  • Foraminal stenosis, or narrowing
  • Degenerative Disc degeneration
  • Degenerative Joint Degeneration (Spondylosis)
  • Slippage of a vertebra from its proper alignment (Spondylolisthesis)

Screening and Diagnosis of Radicular pain:

Complete physical examination, especially flexibility, muscle strength, sensation and reflexes. X-rays and CT scan may be indicated to show the bony anatomy of the spine. An MRI scan may also be ordered, as they are of a higher diagnostic value, because useful of its usefulness in showing compression of nerve roots by giving a detailed picture of soft tissue structures. A nerve conduction study / electomyography can also help further test the condition of the nerve-muscle connection, and determine which nerve is affected.

Treatment:

Non surgical:

  • Physical therapy
  • Non-steroidal anti- inflammatory medications (NSAIDS), muscle relaxants, anti-seizure medications and in some instances pain medication.
  • Epidural steroid injection, to decrease nerve inflammation, thus decreasing symptoms.

Surgical intervention:

  • When conventional and conservative treatments fail to give acceptable relief, surgical intervention is at times necessary to relieve the pressure off of the spinal cord and/or the affected nerves. This can range from minimally invasive approaches, to disc replacement and fusion.