Radiculopathy: what is it, symptoms and how to treat it
The radiculopathy is characterized by the injury or by the commitment of one or more nerves and of their nerve roots that cross the vertebral column, causing the appearance of symptoms such as pain, tingling, sensation of shock and weakness of the limbs as occurs for example in the pain due to the commitment of the sciatic nerve.
Nerves and nerve roots form part of the nervous system, and are responsible for bringing information between the brain and the body’s extremities such as sensitivity, power and movement. Generally, radiculopathy is caused by a compression of the nerve roots, due to diseases such as a herniated disc or osteoarthritis of the spine, but it can also arise due to other causes such as inflammation, ischemia, trauma to the spine or infiltration by a tumor .
Any region of the spine can be affected, without embargo, it is most common in the lumbar and cervical regions, and the treatment is given to the cause, which includes physiotherapy, use of analgesic or anti-inflammatory drugs for pain and, in the most serious cases, surgery.
The main symptoms of radiculopathy depend on the affected nerve, appearing most often in the cervical or lumbar region, these are:
- Sensation of swelling;
- Reduction of reflections;
- Atrophy of the muscles.
In addition to being located in the column, the symptoms of radiculopathy will spread to different regions of the body, which will depend on the nerve that is compromised, such as arms, hands, legs or pies. The area that receives fibers from a nerve root sole is called a dermatome. See what the dermatomas are and where they are located.
Generally, pain and other symptoms worsen in situations where there is an increase in nerve compression as well. In addition to this, in the most serious cases there may be a decrease in the force or, until, paralysis of the corresponding region.
A common example of radiculopathy is pain in the sciatic nerve, also called sciatica, which may be caused by the compression of the roots of this nerve in the column, but it can radiate throughout the entire tray of the nerve in the leg. More information on how to identify and treat sciatic nerve pain.
Is the radiculopathy curable?
Yes, the radiculopathy has a cure. In general, this situation will be resolved with time and without requiring surgery, being cured with the realization of several physiotherapy sessions, however, this will depend on what the cause of the problem is.
The main causes of radiculopathy are:
- disc hernias;
- Spinal canal stenosis;
- Osteoarthritis of the spine, also known as spondyloarthrosis;
- Mass in the medulla like tumors or abscesses;
- Infections such as herpes zoster, syphilis, HIV, cytomegalovirus or tuberculosis;
- Diabetic radiculopathy;
- Ischemia caused by changes in blood flow or by vasculitis, for example;
- Inflammation as occurs in cases of acute and chronic inflammatory demyelinating polyradiculoneuropathy or in sarcoidosis, for example.
Furthermore, the radiculopathy can be caused after a serious spinal trauma, as can occur during an accident.
how to diagnose
In order to diagnose radiculopathy, the doctor will have to identify the symptoms, perform the physical evaluation, detecting the main points of pain, and will request exams such as radiography or magnetic resonance imaging of the spine to detect changes in the spine, identifying the affected nerve and its cause.
The electroneuromyography exam (ENMG) can be useful in many cases, as it evaluates the presence of lesions that can affect the nerves and muscles, being able to record the conduction of an electrical impulse in a nerve. This exam is indicated especially when there is doubt about the cause of the symptoms, being able to confirm even a lesion in the nerve or if there are other types of associated neurological diseases. See how electromyography is performed.
How is the treatment performed?
The treatment of radiculopathy depends on the cause, being indicated by the traumatologist or by the neurosurgeon, and includes the performance of physiotherapy with stretching exercises, manipulation of the vertebrae and muscle strengthening, which can help to cure or relieve symptoms. Asimismo, las personas con sobrepeso, another good strategy that can help to alleviate the compression is adelgazar.
In addition, the doctor may recommend the use of analgesic drugs (paracetamol, dipyrone, tramal or codeine) and anti-inflammatory drugs (diclofenac, ketoprofen or nimesulide).
Treatment for chronic radiculopathy
In addition to analgesics and anti-inflammatories, in people with chronic radiculopathy, it is possible for the doctor to combine other drugs to enhance the control of pain and other associated conditions, such as insomnia and depression, these are: antidepressants, such as Amitriptyline; anticonvulsants such as gabapentin and pregabalin, or muscle relaxants such as cyclobenzaprine. In addition, it could also indicate the placement of corticosteroid injections to relieve pain.
In the most serious cases, the doctor may indicate the performance of a surgery, mainly to decompress the root of the affected nerve.
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