Radiculopathy

Spinal Radiculopathy

Radiculopathy, or nerve root irritation, happens when there is pressure on a nerve. Causing pain and numbness, radiculopathy affects nerve roots in the upper back (cervical spine), mid-back (thoracic spine), and low back (lumbar spine). Learn more about spinal anatomy.

What Causes Radiculopathy?

Our spine allows us to move and turn our heads as well as bend and twist our bodies. But, like a door hinge we use repetitively, the spine suffers wear and tear over time. As the spine becomes worn, bone spurs and bulging discs (cushions between vertebrae) can form, putting undue pressure on spinal nerves.

Nerves are your body’s alarm system: signaling when something is wrong. With radiculopathy, the nerves send the brain a false alarm. An individual may feel pain in their leg, hand, arm, or side when there is nothing wrong with those parts of the body. Instead, there is something wrong with their spine. Another example of this is a pinched cervical nerve, which causes pain or numbness in the arms when the problem is actually in the cervical spine (upper back).

Types of Radiculopathy

Cervical (Upper Back & Neck) Radiculopathy

The most common causes of cervical radiculopathy are herniated discs and spinal stenosis (narrowing of the spine). According to the American Academy of Orthopedic Surgeons, cervical radiculopathy can also be caused by wear and tear in the spine and the development of age-related arthritis. In younger people, cervical radiculopathy is most often caused by a sudden injury resulting in a herniated disc.

Cervical radiculopathy is characterized by pain, weakness, or numbness in the neck, biceps, triceps, and forearm—as well as the interscapular area (between the shoulder blades). The nerves exiting the cervical spine branch out to give movement and sensation to the shoulder, arm, hand, and finger muscles. When a cervical nerve root is irritated by compression or inflammation, referred pain can radiate along the nerve’s pathway and into the arm and hand.

Thoracic (Mid-Back) Radiculopathy

Thoracic radiculopathy, occurring in the mid-back, causes pain that can be misleading to physicians. Thoracic nerves do not extend to the limbs, but instead, to the torso. Because of this, patients often report pain or numbness in the ribs, abdomen, or side—which is similar to a gallbladder attack or shingles. The American Academy of Neurology describes it as “…burning, shooting or tingling radiating to one half of the chest wall. It can often be confused with pain from an abdominal or cardiac source.” In rare, unfortunate cases, patients have surgery on their abdomen because a physician did not properly diagnose radiculopathy.

Causes of thoracic radiculopathy include bulging discs, degenerative disc disease, osteoarthritis, bone spurs, and—in older patients—the effects of diabetes.

Lumbar (Lower Back) Radiculopathy

Lumber (low-back) radiculopathy causes sciatica: pain and numbness in the lower back, buttocks, legs, and feet. Often, this type of pain is deep and steady and is intensified by long walks or sitting for prolonged periods.

Sciatica is caused by compression, inflammation, or injury to a spinal nerve in the lower back. With this condition, leg pain is usually worse than low back pain. According to researchers at the University of Utah, patients with sciatica often experience prolonged disability. About 20 percent require surgery due to intractable symptoms. Physical causes of lumbar radiculopathy include a herniated or bulging disc, stenosis (narrowing) of the spine, diabetes, or scar tissue from previous low-back surgery.

Treatment for Radiculopathy

Most people who experience radiculopathy recover without invasive procedures or intervention. Non-steroidal anti-inflammatory (NSAID) medications like ibuprofen, Advil, or Motrin can be used to control pain. Your physician may also prescribe oral steroids or physical therapy to ease the pain while the spinal nerves recover. Disc herniations often shrink on their own and, in many cases, patients recover completely.

When radiculopathy pain is persistent and severe, steroid injections or surgery are required. The goal of these treatments is to remove pressure from the affected spinal nerve. This can be achieved with a laminectomy (removing a small portion of the bone covering the nerve) or discectomy (removing the protruding portion of the disc).

Surgery to relieve cervical and lumbar radiculopathy has a high success rate. Successful surgery for thoracic radiculopathy is slightly lower since the procedure is more complex. After surgery for radiculopathy, recovery time is usually two to four weeks with no required physical therapy. In general, patients requiring surgery for radiculopathy obtain good results without long-term restrictions or disruption to everyday activities.