What is Radiculopathy and How Do I Treat It?
What is Radiculopathy?
Radiculopathy is basically when a nerve root is pinched in the spinal column and the symptoms that follow. That means whenever a nerve is pinched anywhere in your spine, from your neck to your lower back, the resulting symptoms are called radiculopathy.
What are the symptoms of Radiculopathy?
The symptoms of radiculopathy are different based on the location of the spine. A common complaint of many people is a pain in the neck, and the nerves in the neck being pinched are often the reason for that.
Pinched Nerve in the Neck
When the nerves in your neck are compressed this is called cervical radiculopathy, and may cause pain in the neck, shoulder, arm and possibly weakness / numbness.
Your spine has 24 vertebrae stacked on top of each other that allow your to bend, and twist your neck and back. The first 7 vertebrae make up the cervical part of the spine, which is your neck area.
Cervical radiculopathy, or a pinched nerve in your neck, often happen because of degenerative disc disease with age which may result in a herniated disc.
The tingling pins and needles sensation can extend to your fingers / hand, and weakness in muscles may be present in your arm, shoulder or hand.
Lumbar Radiculopathy or Lower Back Pinched Nerve
Radiculopathy that moves down the legs, calf and feet would be described as Sciatica. The sciatic nerve is the longest nerve in the body, and runs down the back of each leg to your foot, so the pain radiating follows this path. The pain levels are usually deep and steady, and flare up with certain activities like sitting or walking.
Sciatica is an extremely common pain to experience in the lower back, resulting from a pinched nerve in the back. The pain in this case is typically worse in the leg area rather than the lower back area. There are also cases where the lower back pain is worse than leg pain due to different spinal vertebrae pinching a different nerve area. Remember, there are 24 vertebrae, so there’s plenty of places a nerve can become compressed and cause your pain.
What Causes Radiculopathy?
As we’ve said, it’s often a degenerated spinal disc which can bulge out beyond the barrier and press on your nerve. This sends pain signals to your brain in the effected area such as in the neck, lower back, or legs. There are also cases called spinal stenosis, which narrows the bone canals in the spine causing a pinched nerve.
The way to determine exactly what the cause of your back or neck pain is an MRI scan, which is perfectly suited to viewing the inner workings of the spine. You can see a disc herniated with an MRI, as well as the severity levels.
The benefits of an MRI over a CT scan or X-Ray are that it doesn’t use and radiating energy, and uses radio waves to detect the your spine and surrounding tissues. MRI’s create a three dimensional image of your spine so you can see the overall picture of how your discs are doing.
Pinched Nerve Treatment
Initially you’ll want to attempt to treat pinched nerve pain with non-invasive medicine. These include non steroidal anti-inflammatories (NSAIDs) which decrease inflammation and help control pain. Ibuprofen is another medicine that can be tried to see if it will help relieve your pain.
Physical Therapy for a Pinched Nerve
Physical therapy is often coupled with pain medication to increase your mobility and strengthen muscles to stabilize your spine. Yoga types of exercising are usually helpful if guided by a knowledgeable instructor.
Sleeping Position to Help with a Pinched Nerve
Depending on where the compressed nerve is, altering your sleeping position can help relieve pressure on your back or neck. Laying on your back with a pillow underneath your knees helps relieve pressure on the back, and using an appropriate pillow is the best for neck pain.
Epidural Injections for Back Pain
The next level of pain treatment after physical therapy, oral medications, and lifestyle modification is an epidural steroid injection. This type of injection spreads an anti inflammatory steroid around the effected nerves, which can treat the pain symptoms for a few weeks, all the way up to a year. These are a quick and relatively low risk pain management option for neck or back pain. They can be repeated if it is an effective treatment.
Surgery for a Pinched Nerve
The option used to treat severe cases that are causing a detriment to someone’s life is a surgical treatment. If you have a herniated disc the surgical options available include a laser spine surgery, which uses heat from a laser to decompress the bulging disc. This procedure involves no cutting, and has a quick recovery process as compared to more complex surgeries such as spinal fusion.
Another option is a microdiscectomy, or an endoscopic discectomy. An endoscope is a small hollow tube like a needle, but slightly larger to allow for thin surgical tools to be fed through, as well as providing a camera to see the area in the body being operated on. This tool reduces the size of incision and makes the procedure minimally invasive.
Discectomy removes a piece of the spinal disc that is herniating and causing you pain, which immediately relieves the pressure from your nerves.
There are other surgical options, and more types of medications you can try, but if you’re experiencing severe back pain or neck pain it’s best to consult a doctor to see what kind of treatment plan works best for you.