Radiculopathy is the term used to describe the symptoms of nerve root irritation, which can include pain, numbness, tingling and weakness. Sciatica refers to a common type of radiculopathy that results in pain from the back to the buttocks and or legs.
Nerve roots are the paired bundles of nerve fibers that extend from the spinal cord through openings on the side of each vertebra. The nerves that extend from each area of the spinal cord are connected to specific parts of the body. Those in the cervical spine, for example, extend to the upper chest and arms; those in the lumbar spine the hips, buttocks and legs. These nerves carry electrical signals to and fro the brain, creating sensations and movement.
Radiculopathy is often caused by direct pressure from a herniated disc or degenerative changes in the spine that cause irritation and inflammation of the nerve roots. Radiculopathy usually creates a pattern of pain and numbness that is felt in your arms or your legs in the area of the skin that’s supplied the by the sensory fibers of the nerve root, and weakness in the muscles that are also supplied by the same nerve root.
Symptoms
- The most common symptom of lumbar radiculopathy is sciatica, or pain that radiates from the back into the buttocks and legs. Sensory symptoms are more common than motor symptoms, and muscle weakness is usually a sign that the nerve compression is more severe. The quality and type of pain can vary, from dull, aching, and difficult to localize, to sharp, burning, and easy to pinpoint.
- Cervical radiculopathy typically manifests as pain, numbness and weakness that extend from the neck into the shoulders, arms and/or hands. Other symptoms can include neck pain and headaches near the back of the head (occiput); arm reflexes also may be impaired.
- Radiculopathy can create hypersensitivity to touch as well as numbness in the area of skin that’s served by the affected nerve root. If you are experiencing any of these symptoms, particularly muscle weakness, please see your doctor. The longer the source of nerve irritation remains untreated, the greater the potential for long-term or permanent nerve damage
Diagnosis
- complete physical examination, including your back for flexibility, range of motion, and the presence of certain signs that suggest a particular nerve root is being affected.
- MRI or CT/CAT scan. An MRI scan is very useful for determining where the nerve roots are being compressed because this type of a scan is designed to show the details of soft-tissue structures, such as nerves and discs. A CT scan is often used to evaluate the bony anatomy in the lumbar spine, which can show how much space is available for the nerve roots. The nerve roots exit the spinal canal through a bony tunnel called the neuroforamen, and it is at this point that the nerve roots are especially vulnerable to compression.
Treatment
Not everyone who experiences radiculopathy requires surgery. Your neurosurgeon will take into consideration a number of factors including symptoms, risk of further nerve damage and your general health to determine the best individual treatment plan for you.
The goal of surgery is alleviate your symptoms and prevent further damage by removing the source of pressure on the spinal nerve roots.
The benefits of spine surgery, however, must be weighed against the risks. Your surgeon will be able to discuss the risks and benefits of surgery with you, and the likely results of operative versus non-operative treatment.
