What is Radiculopathy?
Radiculopathy is commonly referred to as a pinched nerve. Specifically, radiculopathy is the pinching of a nerve root in the spinal column and can have varying symptoms depending on where it occurs in the spine. The cervical and lumbar spine are the most vulnerable to radiculopathy. It rarely occurs at the level of the thoracic vertebrae.
How Common is Radiculopathy?
Up to one-third of Americans have sciatic pain—a type of radiculopathy caused by compression of the sciatic nerve—making it the most common back pain syndrome in the United States.
Sciatica causes pain that radiates down into the leg and foot. Radiculopathy of the cervical spine (the upper portion of the spine) is also common, particularly among caucasians in their 40s and 50s. Cigarette smokers are at greater risk of developing cervical radiculopathy, and having had lumbar radiculopathy makes subsequent cervical radiculopathy more likely.
A variety of injuries and disorders can contribute to radiculopathy. Putting undue strain on the back, such as lifting heavy objects or lifting them incorrectly, can cause radicular pain. Twisting the back and sitting or standing in an unnatural position can also encourage the condition.
People with a family history of spinal disorders and those who’ve been injured in a car crash, fall, or other accident are more likely to develop radiculopathy. And sometimes people develop radicular pain related to an otherwise unrelated primary condition, such as a tumor or infection.
Some of the more common spinal conditions that can cause a pinched nerve are:
Symptoms of Radiculopathy
Patients with radiculopathy have varying degrees of back pain that interferes with their quality of life. They may also have weakness, numbness, or a tingling sensation, diminished grip strength or reflexes, limited range of motion, loss of coordination, or pain in the neck, arm, hand, leg, or foot.
Radicular pain doesn’t feel like a classic backache. It feels more like a mild electrical shock. A minority of patients have brief periods of pain relief, but many people with radiculopathy find it difficult to focus on anything else.
Treatment for a Pinched Nerve Root
Treatment of radiculopathy is aimed at restoring lost functionality, reducing pain, and preventing progression of the disorder. Before determining whether surgery is needed to address radiculopathy, your doctor may suggest one or more of the following conservative treatments.
- Spinal Decompression: Placing the spine in traction by means of a system of weights and pulleys can relieve pressure and encourage blood flow to compromised areas.
- Physical Therapy: Physical therapy for radiculopathy focuses on strengthening the muscles that support the back, stretching to promote flexibility and range of motion, and improving posture to distribute body weight more evenly.
- Medication: Over-the-counter or carefully prescribed pain medication might offer some relief as other therapies are initiated.
- Injections: Injections are both a treatment and a diagnostic tool: if injection of an anesthetic (or an anesthetic mixed with a corticosteroid) relieves your pain, it probably originates in the nerve that was blocked by the anesthetic.
When is Radiculopathy Surgery Needed?
If pain persists despite lifestyle changes, medications, and other interventions, you and your physician might decide to proceed with spinal surgery to relieve pain associated with radiculopathy.
The type of surgery needing performed depends on the underlying cause of the radiculopathy.
- ACDF: In a patient with cervical disc herniation, the disc might be removed and replaced with a bone graft, followed by fusion of that segment of the spine.
- OLLIF: A patient with lumbar radiculopathy caused by a calcified ligament might have part of a vertebra removed to relieve pressure on the nerve root.