What is radiculopathy?
Radiculopathy is the result of a spinal nerve root injury. Nerve roots split off the spinal cord and exit the spine between the vertebrae. Radiculopathy happens when a specific nerve root is damaged or pinched. It most commonly occurs in the neck—cervical radiculopathy—and lower back—lumbar radiculopathy. Other names for radiculopathy include pinched nerve and nerve root compression. In the lower back, it is commonly called sciatica.
The symptoms of radiculopathy vary depending on the area of the spine it affects. Symptoms can include pain, weakness, numbness, tingling, and abnormal sensations, such as pins and needles.
Herniated discs and spinal stenosis are the most common causes of radiculopathy. Typically, these are both the result of wear and tear—or degeneration—of the spine. Other causes include bone spurs and spinal injury.
People at risk of developing radiculopathy include those with degenerative joint diseases, which increases with age. The risk also increases when people are obese or they engage in repetitive lifting, pushing or other actions that can injure the back.
Radiculopathy treatment depends on the severity of the symptoms. Most cases will improve over time without treatment, usually within 6 to 12 weeks. Anti-inflammatory medicines, muscle relaxants, and physical therapy can help manage the symptoms in the meantime. When symptoms persist long-term without improvement, doctors may recommend surgery.
See your doctor if you have symptoms of a pinched nerve that don’t go away after several days. It’s important to rule out other causes of your symptoms, such as peripheral neuropathy. This can be challenging because the symptoms often overlap. It may be necessary to consult a spine specialist to reach a diagnosis.
What are the symptoms of radiculopathy?
Radiculopathy symptoms can vary depending on the affected area of the spine.
Common symptoms of cervical radiculopathy
The cervical nerve roots mainly control movement and sensations in the upper limbs. The most common symptoms of cervical radiculopathy include:
- Sharp or burning pain that radiates or travels down the shoulder or arm, which may worsen with certain neck movements and improve when the hands are resting on the head
- Tingling and other abnormal sensations, such as pins and needles, in the hand or fingers
- Weakness, numbness, or loss of reflexes in the shoulder, arm or hand
Common symptoms of thoracic radiculopathy
Radiculopathy is least common in the nerve roots of the chest. The most common symptoms of thoracic radiculopathy include:
- Numbness that wraps around the trunk
- Pain that travels around the body from the back to the front and may worsen with coughing or sneezing
Common symptoms of lumbar radiculopathy
The lumbar nerve roots are the most common site of radiculopathy. They control movement and sensations in the lower limbs. The most common symptoms of lumbar radiculopathy include:
- Sharp or burning pain that travels down the buttocks and back of the leg or even down to the foot, which may worsen in certain sitting positions
- Tingling and other abnormal sensations, such as pins and needles, in the legs or feet
- Weakness, numbness, or loss of reflexes in the legs or feet
The symptoms of radiculopathy can also be present with other conditions. See your doctor if symptoms persist despite home treatments. It may be necessary to order imaging exams to figure out the underlying cause of your symptoms.
What causes radiculopathy?
There are two main causes of radiculopathy. The first is spinal arthritis that results in narrowing of the spinal canal. The other is disc herniation, or a slipped or ruptured disc. These conditions put pressure on the nearby nerve root. In most cases, these conditions are the result of degeneration, or wear and tear, that develops with age. However, injuries can also cause them. Less common causes of radiculopathy include bone spurs, spinal infections, and tumors.
What are the risk factors for radiculopathy?
People are at highest risk of developing radiculopathy if they have risk factors for degenerative changes in the spine. This includes the following risk factors:
- Age, with most degenerative changes occurring in people over 50 years
- Family history of degenerative conditions
- Obesity and being overweight, which puts extra pressure on the spine
- Repetitive motions that put stress on the spine, such as heavy lifting, pulling or twisting
Reducing your risk of radiculopathy
You may be able to lower your risk of radiculopathy by changing risk factors that are under your control. This includes:
- Getting regular physical exercise, particularly exercises that strengthen the back and core and maintain flexibility
- Limiting repetitive activities involving the back
- Maintaining a healthy weight
- Practicing good posture and proper body mechanics during exercise, sports, heavy lifting, and other activities that put strain on the back
- Quitting smoking
If you are concerned about the health of your spine and back, talk with your doctor about your risks. Your doctor may have specific recommendations based on your personal history and circumstances.
How is radiculopathy treated?
Most people with radiculopathy will find their symptoms improve over time without invasive treatment. There are several strategies for managing symptoms that are bothersome. This includes:
- Medications to reduce inflammation, relax muscles, and relieve pain
- Physical therapy to strengthen the muscles supporting the spine and maintain range of motion
- Steroid injections into the spine
If necessary, losing weight can help ease the pressure on the affected root nerve. For people with cervical radiculopathy, wearing a soft collar may provide relief by limiting neck movement and supporting the muscles. The goal with symptomatic treatment is to allow the nerve time to recover.
If symptoms persist for several weeks, your doctor may suggest surgery. There are several surgical options depending on your symptoms and the cause and location of the pinched nerve.
What are the potential complications of radiculopathy?
Radiculopathy isn’t life threatening, but it can cause problems with daily living. This includes dealing with problems from weakness and lack of sensation. You may find that walking and balance are difficult with lumbar radiculopathy. Cervical radiculopathy can lead to problems doing tasks that require motor control and sensation in your hands and fingers. You can best manage these issues by seeing your doctor to get an accurate diagnosis of the problem.