Radiculopathy is a pinched nerve in the spine. It occurs with changes in surrounding bones and cartilage from wear and tear, or from injury. These changes may cause pressure on a nerve root. A nerve root is the part of each spinal nerve that exits your spinal cord and goes through an opening in your spine.
When your nerve roots are compressed, they may become inflamed, causing numbness, weakness, and pain. Timely and appropriate treatment can reduce these symptoms.
Symptoms of radiculopathy can range from mild to severe. The location of symptoms depends on which nerve root is affected.
There are three types of radiculopathy:
- Cervical radiculopathy is pressure on one of the nerve roots in your neck. It can cause weakness, burning or tingling, or loss of feeling in your shoulder, arm, hand, or finger.
- Thoracic radiculopathy happens when there’s a pinched nerve in the upper back portion of your spine. This causes pain in your chest and torso. It’s uncommon and can be mistaken for shingles.
- Lumbar radiculopathy is pressure on one of the nerve roots in your lower back. It can cause hip pain and sciatica, or shooting pain in your leg. Incontinence, sexual dysfunction, or paralysis can also occur in severe cases.
Symptoms vary depending on which type of radiculopathy you have. The symptoms may affect different areas of your back, arms, and legs, and can include:
- a sharp pain that may worsen with certain movements
- a shooting pain
- weakness and tingling
- loss or change in sensation
- loss of reflexes
Radiculopathy occurs when a nerve is compressed by surrounding tissue. It’s sometimes caused by a herniated spinal disc. This starts with a weakening or tearing of the outer rim of the disc. The nucleus, or inner part, then pushes outward and exerts pressure on a nearby spinal nerve.
Bone spurs can also cause radiculopathy. This is when extra bone forms on part of the spine. Bone spurs can develop because of trauma or osteoarthritis. These spurs can stiffen the spine and narrow the space where nerves are located, causing them to be compressed.
Radiculopathy may result from aging or trauma.
Many spinal changes happen as you age. Radiculopathy usually affects people between the ages of 30 and 50.
Conditions like osteoarthritis, rheumatoid arthritis, and obesity can increase the risk of radiculopathy. Other risk factors are poor posture, spinal abnormalities like scoliosis, and repetitive movements. Pregnant women have a higher risk. It can also be hereditary, so you are at increased risk if your family has a history of radiculopathy.
To diagnose radiculopathy, your doctor will first perform a physical examination. They may then run certain tests or scans such as:
- an X-ray to view bone alignment or narrowing of the discs
- an MRI scan to get images of soft tissue, your spinal cord, and nerve roots
- a CT scan to see the fine details of your bones, including bone spurs
- an electromyogram to measure the electrical impulses of your muscles when at rest and during contractions, which helps your doctor identify damage
- a nerve conduction study to measure the ability of nerves to send electrical signals
Your doctor may recommend home care, medications, surgery, or a combination of treatments.
You should limit activities that aggravate your pain. Your doctor can prescribe a splint, brace, or soft neck collar to immobilize the affected area. This makes it easier for you to rest the injured area.
Short-term bed rest or treatments with mechanical traction are options your doctor may suggest. Traction involves the use of weights or other special devices to relieve pressure on your spinal nerve by creating space between the bones of your spine.
Your doctor may also recommend physical therapy (PT). PT may include hot and cold therapy and other treatments. Your therapists can teach you ways to strengthen, stretch, and protect the affected area.
For some people, weight loss may help reduce pressure on the affected area.
Some medications can be effective in treating radiculopathy:
- nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil) and naproxen (Aleve)
- muscle relaxants
- oral corticosteroids
- prescription opioids for severe pain
- spinal corticosteroid injections into the affected area
Your doctor may recommend surgery if your condition doesn’t improve within a specified period. This is typically after about six to 12 weeks of conservative treatment. They may also suggest surgery if multiple nerves are affected or nerve function is diminishing despite treatment.
Surgery can free the affected nerve from pressure. One procedure is called a discectomy. This involves removing bone spurs or part of a herniated disc. During this procedure, a section of your vertebrae may need to be removed or fused together.
As with any surgery, there are risks like infection, bleeding, and complications from anesthesia. After recovering from surgery, some people may still have pain or other symptoms.
Most people with radiculopathy improve with conservative treatment such as medication and PT. Surgery is recommended for some people with radiculopathy. They, too, usually improve after a recovery period. Following treatment, most people are able to work and take part in other daily activities.
Reduce your chances of developing radiculopathy by maintaining good posture and a healthy weight.
Use safe techniques when lifting heavy objects to prevent injuries to your back. Remember to lift with your knees. That means you should bend your knees, not your back. Also ask for help when moving heavy or bulky objects.
When doing repetitive tasks, take frequent breaks.
Staying physically active can also help. Develop a regular exercise program that incorporates strength and flexibility exercises. Always talk to your doctor before starting an exercise routine. Good spine health can go a long way toward preventing radiculopathy.