When the spinal nerves are pinched due to a breakdown of the bones or cartilage surrounding the nerve it is called radiculopathy. This can occur in the neck (cervical), mid back (thoracic) or low back (lumbar). It is more common in the neck and low back. Radiculopathy can occur as a result of a disc herniation or bone spurs. It can also be a result of osteoarthritis, obesity, poor posture or due to an injury.
Risk factors include:
- Excess weight: causing more stress on the spine
- Usually affects people between the ages of 30-50
- Trauma – sports related, motor vehicle accidents, work causing repetitive movement
- Pregnancy – placing increased weight on the spine
Symptoms of Radiculopathy
- Pain in the neck, shoulder and arms
- Weakness and tingling in the neck, shoulder and arms
- Pain that is worse with neck or head movement
- Sharp pain that travels down the back into the foot
- Sharp pain that is worse with abdominal pressure, sneezing or coughing
- Weakness and tingling in the back and legs
- Loss of reflexes
How is Radiculopathy Diagnosed?
After an examination and a review of your past medical history your spine surgeon or his physician assistant will order x-rays and an MRI to determine exactly which level of your spine in affected. In some cases your spine surgeon may order a nerve study called an electromyography (EMG). This tests the specific nerves to determine which nerves are being affected. After diagnostic testing is completed your physician will determine your treatment plan.
Treatment Options for Radiculopathy
Non-surgical treatment options for radiculopathy include physical therapy, exercise, medication, chiropractic therapy, massage therapy, acupuncture, and/or application of heat or cold compresses. Occasionally steroids are injected around the nerves in the spinal column (epidural steroid injections – ESI) easing the pain and reducing the inflammation.
The steroid injections are done by Orlando Orthopaedic Center’s Pain Management Physicians. This is done in an outpatient surgical suite under fluoroscopy (specialized x-ray machine), which allows the steroid medication to be injected around the spinal nerves that are being affected. This may relieve the pain completely. If the pain is not relieved surgery may be indicated.
When non-surgical treatment fails patients might be a candidate for a laminectomy or a discectomy. For more information on laminectomy or discectomy click here. The spine surgeon will make the decision on which type of surgery will benefit the patient most.
Who Should Consider Surgery?
Surgery should be considered for individuals who have failed conservative treatment with medications and injections, or those with symptoms that are so severe that they are starting to lose significant function and are at risk for permanent nerve damage.
All risks and benefits of spine surgery should be considered before making a decision. The spine surgeon will discuss all available options and treatments.