Nerve Impingement (Radiculopathy)
What is Radiculopathy?
Radiculopathy is a condition in which injury that occurs near the root of a nerve located in the spine causes pain, tingling, weakness or numbness in other locations along the nerve pathway. Symptoms may be felt in the arm, shoulder, hand, wrist or fingers if the impingement is in the cervical vertebrae (neck), the chest or abdomen if the impingement is in the thoracic spine, or the legs and buttocks if the impingement occurs in the lumbar region (lower back). Symptoms result from pressure or compression exerted on the root of the nerve.
What causes Radiculopathy?
Any situation which exerts pressure on, compresses, or pinches a nerve located in the neck or along the spine can cause the symptoms associated with radiculopathy. This includes conditions such as spinal stenosis, degenerative disc disease, a herniated disc, bone spurs, a thickening of ligaments surrounding the nerve, scoliosis, tumor, or infection and can also be the result of a trauma or injury to the back or neck. Diseases which limit blood flow to the spinal nerves, such as diabetes can also increase risk of developing the condition. Heavy lifting or labor, as well as contact sports, can contribute to the development of radiculopathy, and there are indications that a family history increases the likelihood of developing the condition.
What are the symptoms of Radiculopathy?
The symptoms of radiculopathy include pain, tingling, numbness, weakness, and muscle spasms that can be felt in the shoulder, arm, wrist, hands or fingers (cervical radiculopathy), in the chest or abdomen (thoracic radiulopathy) or in the legs or buttocks (lumbar radiculopathy). When the pain radiates down the leg it is referred to as sciatica. Pain can range from a dull ache to a severe or burning sensation, and in some cases the pain is extreme enough that it limits mobility. There can also be localized back and neck pain and a hypersensitivity to touch. When muscle weakness is evident, it may indicate that there is nerve damage.
How is Radiculopathy diagnosed?
A medical professional will take a complete medical history and perform a physical and neurological exam. The doctor will ask the patient about the symptoms they are having, when the pain started, where it is located, and what increases or decreases the symptoms. The patient may be asked to move his or her back, neck, legs or arms to display what movements cause pain and when it disappears. An x-ray, CT scan, MRI (magnetic resonance imaging) or EMG (electromyography) may be ordered to rule out other causes of pain and to determine the exact location and extent of the injury to the nerve. Nerve conduction studies may also be performed.
When should I seek care for Radiculopathy?
You should seek medical attention if you experience any type of severe pain in your neck or back, pain that radiates down your arm, or any type of numbness, tingling or weakness, especially in the legs. A thorough medical evaluation is required to determine the cause of the symptoms and the extent of the injury. These symptoms can be the result of other medical conditions, some of which are severe. Even if your symptoms are not severe, you should seek a doctor’s advice if a period of rest and over the counter pain medications does not improve your symptoms after a short time.
What will the treatment for Radiculopathy consist of?
The first course of treatment for radiculopathy is typically a short period of rest aimed at relieving irritation on the spinal nerves. This may include limiting normal activities. Pain and anti-inflammatory medications may also be recommended. After a short period of rest, physical therapy is often recommended and may include stretching exercises, heat and cold therapy, and electrical stimulation, among other methods. If conservative methods fail to bring relief, epidural steroid injections or surgery may be recommended. Surgery is typically a last resort option and is only considered if other treatment methods do not alleviate the pain and discomfort after a few months.
Which muscle groups/ joints are commonly affected by Radiculopathy?
Radiculopathy originates in the nerves along the spine in the back or the neck. Symptoms, however, are experienced in the shoulder, arm, wrist, hand and fingers (cervical), in the chest or abdomen (thoracic) or in the legs or buttocks (lumbar).
What type of results should I expect from the treatment of Radiculopathy?
Most individuals will be successful in alleviating their symptoms of pain, weakness, tingling, numbness and muscle spasms with a short period of rest, followed by a regimen of physical therapy. Recovery may take up to twelve weeks or more, however, depending on the severity of the impingement. When surgery is warranted, it is typically successfully in diminishing pain and improving functioning of the affected areas.