Radiculopathy

Radiculopathy encompasses several symptoms, such as pain, numbness, tingling, or weakness in the arms or legs, caused by compression of a nerve root in the spinal column. Radiculopathy can occur in different regions of the spinal column, usually indicated by different symptoms.

Lumbar radiculopathy, also known as sciatica, is the most common type of radiculopathy and refers to a pinched nerve in the lower back, or lumbar region of the spinal column. Symptoms of lumbar radiculopathy frequently include pain and numbness extending from the spinal nerve root location on the lower back, down to the legs or feet. The pain and numbness usually worsens after sitting or walking for a long period of time. If radiculopathy affects the spinal nerves that control the bladder and bowel, this can result in incontinence, or loss of bladder or bowel control. A co-occurrence of lower back pain, incontinence, leg weakness, and loss of sensation around the buttocks may be indicative of cauda equina syndrome, which is rare but can result in permanent disability if not promptly treated.

Radicular pain is often sharp and spreads from the specific location of radiculopathy to other parts of the body. The pain has also been described as a burning or electric sensation that shoots down the leg or arm. Commonly, the pain is accompanied by feelings of numbness and tingling along the area of skin associated with the pinched nerve. Some people may also experience root signs, which include loss of sensation, muscle weakness, impaired reflexes, and chronic changes to soft tissue (i.e., trophic changes). Pain may increase when the affected individual is in certain positions or moves in a particular way. 

Radiculopathy can sometimes be considered a disability depending on the cause and severity of the pain. In some cases, individuals with radiculopathy may have difficulty completing their typical everyday activities.

Diagnosis begins with a review of medical history and symptoms. If radiculopathy is indicated, additional tests and imaging may be conducted. A physical exam may involve the individual moving their legs or arms to determine when the pain occurs and if there are any limitations in motion. A common test for cervical radiculopathy is the Spurling’s maneuver, during which the individual tilts their head to the side, backwards, and tries to pull their head back upright while a clinician pushes it down. With lumbar radiculopathy, a straight-leg-raise test is commonly performed, where the individual lays flat on their back as a clinician lifts the individual’s legs into the air one at a time. If an individual experiences pain during a maneuver test, radiculopathy may be the culprit. 

Radiculopathy refers to a set of symptoms that occur from spinal nerve root compression. Pain, muscle weakness, and numbness are symptoms, presenting either individually or in some combination. Radiculopathy most commonly occurs from compression in the neck (cervical) or lower back (lumbar) regions. Causes of radiculopathy include problems with the vertebrae or vertebral discs, such as disc degeneration, disc herniation, or age-related spondylosis. Diagnosis often requires a physical exam and imaging tests. Depending on the cause and severity of the radiculopathy, a clinician’s medical advice may include nonsurgical treatment options, like NSAIDs and physical therapy, or when necessary, surgical procedures to relieve the nerve compression.