Pinched Nerve
Radiculopathy
Radiculopathy, commonly called a pinched nerve, typically is treatable without surgery. Depending on the severity of the radiculopathy and other health conditions, doctors may recommend certain medications. Treatments for radiculopathy may include pain medication and wearing a cervical collar.
The spine is a stacked structure made up of 33 bones or vertebrae, which protect the spinal cord from injury or trauma.
The bones of the spine allow a person to stay upright, bend, and twist. They are held in place by a network of muscles, tendons, and ligaments. Nerves extend from the spine to other areas of the body, such as the arms and legs.
The spine curves in an S-shape, which is vital for spinal health. These curves are responsible for shock absorption, balance, and a range of movements.
Each region of the spine has a specific name and function. They are the:
- cervical spine or neck
- thoracic spine or mid back
- lumbar spine or lower back
- sacrum, connecting the spine to the hips
- coccyx or tail bone
Each vertebra is cushioned from its neighbor by an intervertebral disc. This protects the vertebrae from rubbing on top of each other.
When injuries occur, these intervertebral discs can become damaged and cause compression or irritation of a nearby nerve root. Depending on which nerve is compressed, a person can experience pain in a variety of locations throughout the body.
People can develop radiculopathy as the result of an injury, or it may occur for no apparent reason. Those individuals aged 30 to 50 years old are most likely to experience radiculopathy, in the cervical and lumbar spine areas.
Radiculopathy can be caused by a variety of conditions or injuries, including:
A compression fracture is a break in a vertebra (a bone in your spine). When broken, this bone collapses.
When a vertebra moves abnormally relative to the vertebra below
An uncommon but serious condition when nerve root compression affects the pelvic organs and lower extremities
Degenerative disk disease occurs when the cushioning in your spine begins to wear away. As people age, many experience some spinal degeneration. The condition doesn’t always cause symptoms, but when it does, neck and back pain can be intense. The right treatment can lead to pain relief and increased mobility.
The spine is made up of 26 bones, called vertebrae, and in between each are soft, pillow-like disks that act as cushions. The disks also keep the vertebrae in place and allow your backbone to move so you can bend and stretch. Over time, the disks can weaken or rupture, with the jelly-like center pushing out of the disk and irritating the nearby nerves. This is called a herniated disk.
What Causes a Herniated Disk?
A single excessive strain or injury can cause a herniated disk. However, age also can be a factor as disks naturally degenerate as one ages, and the ligaments that hold it in place begin to weaken. As this degeneration progresses, a twisting movement or relatively minor strain can cause a disk to rupture.
Bone spurs, or osteophytes, are extra growths of bone tissue that appear like smooth lumps on the outsides of the bones. They may cause symptoms if they irritate your soft tissues, interfere with the movement of a joint or put pressure on a nearby nerve.
The sciatica nerve controls muscles in the back of your knees and lower legs and provides feeling to the back of your thighs, part of your lower legs, and the soles of your feet. Pain, weakness, numbness, or tingling in those areas is a sign of sciatica, which is a problem with the sciatic nerve and a term used to describe a set of symptoms caused by an underlying medical condition. Sciatica is not a medical diagnosis.
Often the pain in the sciatica nerve, which can be a burning sensation or shooting pain, starts in the lower back and extends down your leg to your calf, foot, or even your toes. Some people also have numbness, tingling or muscle weakness in the affected leg or foot. You might have pain in one part of your leg and numbness in another part and, usually, it is on only one side of your body.
The level of pain is wide ranging, from a mild ache to a sharp, burning sensation or excruciating. Sometimes the pain can feel like a jolt or electric shock. Prolonged sitting can aggravate symptoms, which can also be worse when you cough or sneeze.
Causes of Sciatica
- Herniated disk
- Spinal stenosis - a narrowing of the spinal canal that puts pressure on the nerve
- Injury, such as a pelvic fracture.
Sciatica Risk Factors
- Age – Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.
- Obesity – Excess body weight, which increases stress on the spine, can contribute to the spinal changes that cause sciatica.
- Prolonged sitting – People who sit for extended periods or lead an inactive lifestyle are more likely to develop sciatica than those who are active.
- Diabetes – This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.
When to See a Doctor
Mild sciatica usually goes away over time with rest and over-the-counter pain relievers, such as ibuprofen. Call your doctor if self-care measures fail to ease your symptoms or if your pain lasts longer than a week, is severe or becomes progressively worse.
Get immediate medical care if:
- You have sudden, severe pain in your low back or leg and numbness or muscle weakness in your leg
- The pain follows a violent injury, such as a traffic accident
- You have a loss of bowel or bladder function
Your doctor will ask you questions about your symptoms, give you an exam and check you for numbness, weakness, reflexes changes, and pain. He or she will probably order X-rays or other pictures, such as a CT Scan or an MRI, to see whether you have a herniated disk. There are also nerve tests your doctor can order that can determine what nerves are involved, if there is nerve damage and how well your nerves are conducting feelings.
Treatment May Include
- Low-level of activity
- Nonsteroidal anti-inflammatory medication
- Physical therapy
- Surgery, if conservative treatment options do not reduce or end the pain altogether
Caused by altered nerve blood flow
A painful condition when the spinal canal narrows
Spinal tumors can form anywhere in and along your spinal column, which includes your vertebrae, spinal cord and the tissues surrounding your spinal cord. Most spinal tumors result from cancer metastasis — cancer that has spread from another area of your body to your spine.
Caused by an abnormal curve in the spine
Occurs when the cartilage that lines your joints is worn down or damaged and your bones rub together when you use that joint. It is a form of arthritis. A healthcare provider will help you find a combination of treatments to manage your symptoms.
Additional risk factors for developing radiculopathy include:
- aging
- being overweight
- poor posture
- improper lifting techniques
- repetitive motions
- a family history of degenerative bone conditions
Radiculopathy Symptoms
Because the nerves extending from the spinal cord travel to different parts of the body, people will experience different symptoms, depending on where in the spine the nerve compression occurs.
Cervical Radiculopathy
Cervical radiculopathy occurs when a nerve in the neck or upper back is compressed. The symptoms associated with cervical radiculopathy include:
- pain in the neck, shoulder, upper back, or arm
- weakness or numbness typically experienced on one side
Thoracic Radiculopathy
A person may experience pain in the chest and torso when the nerve compression or irritation occurs in the mid back region.
Thoracic radiculopathy is an uncommon condition that may be misdiagnosed as shingles, heart, abdominal, or gallbladder complications.
Symptoms associated with thoracic radiculopathy include:
- burning or shooting pain in the rib, side, or abdomen
- numbness and tingling
Lumbar Radiculopathy
A person may experience pain in the buttocks, legs, and hip region when the nerve compression or irritation occurs in the lower part of the back.
Lumbar radiculopathy is also known as sciatica, and symptoms include pain and numbness in the low back, hips, buttock, leg, or foot. Symptoms are typically made worse with long periods of sitting or walking.
In some cases, nerves affecting the bowel and bladder can become compressed, leading to bowel or bladder incontinence or loss of control.
Other generalized symptoms of radiculopathy may include:
- sharp pain starting in the back, extending to the foot
- sharp pain with sitting or coughing
- numbness or weakness in the leg and foot
- numbness or tingling in the buttocks or leg
- sensation or reflex changes, hypersensitivity
- pain in the arm or shoulder
- worsening pain with movement of the neck or head
Diagnosis
- radiologic imaging with X-ray, MRI, and CT scans electrical impulse testing called
- electromyography or EMG, to test nerve function
Treatment
Typically, radiculopathy is treatable without surgery. Depending on the severity of the radiculopathy and other health conditions, doctors may recommend certain medications, including:
- non-steroidal drugs, such as ibuprofen, aspirin or naproxen
- oral corticosteroids or injectable steroids
- physical therapy
- ice and heat application
In some cases, doctors may recommend surgery to treat the cause of the nerve compression.
Some surgical procedures include repair of a herniated disc, widening of the spinal canal space, removing a bone spur, or fusing the bones.
Each case is unique, and surgical recommendations will be discussed in detail. The choices will depend on the cause of the radiculopathy, the overall health of the person, and other individual factors.