Radiculopathy is characterized by the injury or impairment of one or more nerves and their nerve roots that pass through the spine, leading to the appearance of symptoms such as pain, tingling, sensation of shock and weakness of the limbs, as in pain due to the involvement of the sciatic nerve, for example.
The nerves and nerve roots are part of the nervous system, and are responsible for carrying information between the brain and the extremities of the body, such as sensitivity, strength and movement. Generally, radiculopathy is caused by a compression of the nerve roots due to diseases such as herniated discs or spinal arthrosis, but it can also arise due to other causes such as inflammation, ischemia, trauma to the spine or infiltration by a tumor.
Any location of the spine can be affected, however, it is more common in the lumbar and cervical regions, and treatment is done according to its cause, which includes physical therapy, use of analgesic or anti-inflammatory drugs for pain and, in cases more serious, surgery.
Symptoms that may arise
The main symptoms of radiculopathy depend on the affected nerve, most of the time, affect the cervical or lumbar region, and include:
- Pain; Tingling; Numbness sensation; Decreased reflexes; Muscle atrophy.
In addition to being located in the spine, symptoms of radiculopathy usually radiate to locations on the body that are innervated by the compromised nerve, such as the arms, hands, legs or feet. This area that corresponds to the innervation of a nerve is called a dermatome. Find out more details about what dermatomes are and where they are located.
Pain and other symptoms usually worsen in situations where there is increased nerve compression, such as coughing. In addition, in the most severe cases, there may be a decrease in strength or even paralysis of the corresponding region.
A common example of radiculopathy is pain in the sciatic nerve, also called sciatica, which is usually caused by compression of the roots of this nerve still in the spine, but which can radiate along the entire path of the nerve in the leg. Learn more about identifying how to treat sciatic nerve pain.
Main causes
The main causes of radiculopathy are:
- Herniated discs; Spinal canal stenosis; Spinal arthrosis, also known as spondyloarthrosis; Spinal cord masses, such as tumors or abscesses; Infections such as herpes zoster, syphilis, HIV, cytomegalovirus or tuberculosis, for example; Diabetic radiculopathy; Ischemia, provoked by changes in blood flow, in vasculitis, for example; inflammations, such as those that occur in cases of acute and chronic inflammatory demyelinating polyradiculoneuropathy or in sarcoidosis, for example.
In addition, radiculopathy can be caused after an accident that causes severe trauma to the spine.
How to confirm
To diagnose radiculopathy, a doctor must identify the symptoms, perform a physical evaluation, detecting the main pain points, and order tests, such as radiography or MRI of the spine to detect changes in the spine, identifying the affected nerve and its cause.
The electroneuromyography (ENMG) exam can be useful in many cases, as it assesses the presence of lesions that affect nerves and muscles, being able to record the conduction of an electrical impulse in a nerve. This test is especially indicated when there are doubts about the cause of the symptoms, being able to confirm if there is even a nerve damage or if there are other types of neurological diseases associated. Learn more about how it is done and the indications for electroneuromyography.
How the treatment is done
The treatment of radiculopathy depends on its cause, indicated by the orthopedist or neurosurgeon, and includes physical therapy, with stretching exercises, manipulation of the vertebrae and muscle strengthening, for example, which can lead to the cure of symptoms or, at least, relieve them.
In addition, the doctor may recommend the use of analgesic drugs, such as Paracetamol, Dipyrone, Tramal or Codeine, or anti-inflammatory drugs, such as Diclofenac, Ketoprofen or Nimesulide, for example, to control pain and discomfort.
In people with chronic pain, other medications can also be associated to enhance the control of pain and other associated conditions, such as insomnia and depression, and they are: antidepressants, such as Amitriptyline; anticonvulsants, such as gabapentin and pregabalin; or muscle relaxants, such as cyclobenzaprine.
In more severe cases, the doctor may recommend surgery, especially for decompression of the nerve root.
