Radiculopathy

Hundreds of pain syndromes or disorders make up the spectrum of pain. One cause of pain is radiculopathy. Commonly known as “pinched nerve” or sciatica, radiculopathy is a range of symptoms that result from pinched nerve roots in the spinal column. Any part of the back can be affected, with the most common forms being sciatica, cervical radiculopathy and thoracic radiculopathy.

Injuries to spinal discs or vertebrae can compress the nearest nerve root that extends from the spine to the body. Symptoms of radiculopathy include numbness, weakness and pain in any part of the back. Pain results from swelling and compression due to the injury to the vertebra and/or the surrounding network of muscles, tendons and ligaments.

Degenerative disc disease and osteoarthritis are the primary causes of radiculopathy. Other risk factors are accidents and injuries that cause damage and inflammation, as well as subsequent nerve root compression. The following injury types and conditions also increase risk:

• Spinal tumors
• Bone spurs
• Spinal stenosis
• Herniated discs
• Scoliosis
• Diabetes
• Compression fractures
• Spondylolisthesis

Depending on which nerve root is compressed, symptoms vary from one incident to the next. Compression of the nerve root in the neck or upper back causes neck, shoulder, arm and upper back pain and muscle weakness. Compression of the nerve root in the mid-back results in heart- and gallbladder-like complications, like numbness and tingling, a burning sensation or shooting pain in the abdomen, side or ribs.

Nerve roots in the lumbar region are compressed when pain occurs in the lower back and hips. Symptoms include reflex changes, numbness and/or tingling in the back or leg, sharp pain while sitting or coughing and weakness and/or sharp pain in the legs.

With the onset of back pain and other symptoms, see your healthcare provider for a physical exam and imaging tests such as an X-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI) scan or electrical impulse test (electromyography—EMG).

Most types of radiculopathy are treatable without surgery. However, in more extreme cases, surgery may be the only way to relieve pressure, such as repairing a herniated disc, removing a bone spur, bone fusion or a spinal canal space-widening procedure.

For the less severe cases, pain medications may be prescribed, such as gabapentin. Home remedies include over-the-counter anti-inflammatories and pain reducers (ibuprofen, naproxen and aspirin), ice and heat, and physical therapy.

Some cases of radiculopathy can heal quickly, especially those that can be treated with steroid injections. Minor cases can be managed with over-the-counter anti-inflammatory and pain medications, like ibuprofen, naproxen or aspirin, as well as ice and heat application. Physical therapy can also reduce pain.

For more severe cases that require surgery, pain medications will be prescribed to manage pain. Some cases can take months or years to resolve.