FAQs on Radiculopathy
Radiculopathy is a medical condition that results from irritation or injury to a nerve root as it leaves the spinal canal through the intervertebral foramen. When the nerve is “pinched” or compressed in the cervical spine (neck), the result is symptoms of pain, tingling, and/or numbness felt in the shoulders, arm, and/or hand. With compression affecting the lumbar spine (lower back), the symptoms affect the buttocks, leg, and/or foot, usually on one side.
How does radiculopathy occur?
The intervertebral foramen (neuroforamen) are two openings on each side of the vertebra bone, and they are positioned between two vertebrae. These openings allow the nerve roots of the spinal cord to exit the canal and branch off to their specific body regions.
The motor nerves coordinate the control of body organs, and the sensory nerves carry signals back to the brain from various body areas. Any pressure where the nerve connects to the spinal cord can cause radiculopathy pain, weakness, and other symptoms.
What is the difference between cervical radiculopathy and lumbar radiculopathy?
Cervical (neck) radiculopathy symptoms include pain that affects the upper extremities, which can be dull and achy or sharp and burning, as well as muscle weakness, sensations of numbness, and tingling. Lumbar (low back) radiculopathy causes pain worse with bending forward and to the side, which radiates down the lower extremities.
How common is radiculopathy?
Lumbar radiculopathy occurs in around 4% of the general population, and both men and women can develop the condition. However, men are affected more than women during the fourth decade, whereas women are affected more than men during the fifth and sixth decades.
Up to 25% of patients develop symptoms that persist from longer than 6 weeks. Occurring at a lower frequency than the lumbar form, cervical radiculopathy occurs at a rate of 8 cases per 10,000 people. This is usually the result of a disc herniation or an acute injury in young patients, but in the older population, radiculopathy most often occurs from foraminal narrowing.
What causes radiculopathy?
Radiculopathy occurs from compression of a nerve root. Various conditions cause this to occur, such as:
- Degenerative disc disease (DDD) – With age, the intervertebral discs lose water content, shrink, and flatten. When no longer able to cushion the vertebrae properly, the bones rub against each other and the nerve root is pinched.
- Herniated disc – As the discs start to deteriorate from age and wear and tear, they lose the jelly-like material due to leakage through a crack in the outer layer. When this occurs, it is called a herniated disc. This can compress a nerve root as it passes through the neuroforamen.
- Facet joint arthritis and Spinal Stenosis – The tiny facet joints of the spine wear down and lose cartilage with age, injury, and wear and tear. This causes the bone to attempt to repair itself and form bony growths called bone spurs. When these form, they narrow the spinal canal, leading to compression of nerve roots.
Who is at risk for radiculopathy?
There are several risk factors for radiculopathy. These include:
- Heavy manual labor, which requires the lifting of more than 25 pounds
- Driving or operating vibrating equipment or motor vehicles
- Smoking cigarettes
- Certain conditions, such as giant cell arteritis, spinal infections, and synovial cysts
How is radiculopathy treated?
- Physical therapy – The therapist instructs the patient on exercises designed to stabilize the spine and promote a larger space for spinal nerves.
- Medication – To reduce swelling and pain, certain medications are prescribed, such as nonsteroidal anti-inflammatory drugs (NSAIDs).
- Epidural steroid injection – With this procedure, the doctor injects the epidural space with a steroid, with or without a numbing agent. This space lies between the epidural layer and the spinal cord. ESI efficacy rate is reported as 85-90%, according to recent clinical studies.
- Facet joint injection (FJI) – Usually given in a series of three, which are spaced 2-4 weeks apart, these injections involve the insertion of small needles into the facet joints using x-ray guidance. These facet joints are located between each vertebra, and they allow for spinal flexibility. The doctor injects a long-acting anesthetic agent and a steroid into these spaces. In a recent research study review, FJIs relieved both long- and short-term pain in study participants.