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Radiculopathy

In the course of treating patients injured in all types of accidents (work accidents, automobile accidents, slip and falls, and construction accidents) for over 25 years, one of the more common conditions that is diagnosed in my office is a condition known as radiculopathy. Radiculopathy is a condition due to a compressed nerve in the spine that can cause pain, numbness, tingling, or weakness along the course of the nerve. Radiculopathy can occur in any part of the spine, but is most common in the lower back (lumbar radiculopathy) and in the neck (cervical radiculopathy). It is less commonly found in the middle portion of the spine (thoracic radiculopathy).

Pinched Nerve Treatment

Radiculopathy is caused by compression or irritation of the nerves as they exit the spine. This can be due to mechanical compression of the nerve by a disc herniation, a bone spur (osteophytes) from osteoarthritis, or from thickening of the surrounding ligaments. Risk factors for this type of radiculopathy are activities that place an excessive or repetitive load on the spine. Therefore any patient involved in an accident that places stress on the spine can potentially develop a radiculopathy. Patients involved in heavy labor (workers compensation) or contact sports are also more prone to develop radiculopathy. A family history of radiculopathy or other spine disorders also increases the risk of developing radiculopathy. Other less common causes of radiculopathy are tumors, scoliosis, or diabetes.

The symptoms of radiculopathy depend on which nerves are affected. The nerves exiting from the neck (cervical spine) control the muscles of the neck and arms and supply sensation there. The nerves from the middle portion of the back (thoracic spine) control the muscles of the chest and abdomen and supply sensation there. The nerves from the lower back (lumbar spine) control the muscles of the buttocks and legs and supply sensation there. The most common symptoms of radiculopathy are pain, numbness, and tingling in the arms or legs. It is also possible for patients to have localized neck or back pain as well. Lumbar radiculopathy that causes pain that radiates down a lower extremity is commonly referred to as sciatica. Some patients develop a hypersensitivity to light touch that feels painful in the area. Less commonly, patients can develop weakness in the muscles controlled by the affected nerves. This can indicate nerve damage.

The diagnosis of radiculopathy begins with a medical history and physical examination by the physician. During the medical history, the doctor will ask questions about the type and location of the symptoms, how long they have been present, what makes them better or worse, and what other medical problems present. By knowing the exact location of the patient’s symptoms, the doctor can help localize the nerve that is responsible. The physical examination will focus on the extremity involved. The doctor will check the patients muscle strength, sensation, and reflexes to see if there are any abnormalities.

The patient may then be asked to obtain imaging studies to determine the source of the radiculopathy. Plain X-rays are often obtained first. These can often identify the presence of trauma or osteoarthritis and early signs of tumor or infection. A MRI scan may then be obtained. This study provides the best look at the soft tissues around the spine including the nerves, the disc, and the ligaments. If the patient is unable to obtain an MRI, they may obtain a CT scan instead to explore possible compression of the nerves. In some cases the doctor may order a nerve conduction study or electromyogram (EMG). These studies look at the electrical activity along the nerve and show if there is damage to the nerve.

Fortunately, most people can obtain relief of their symptoms of radiculopathy with conservative treatment. This may include anti-inflammatory medication, physical therapy, chiropractic treatment, and avoiding activities that strain the neck or back. The majority of radiculopathy patients respond well to this conservative treatment, and symptoms often improve within 6 weeks to 3 months. If patients do not improve, they may benefit from an epidural steroid injection. A physician will inject steroid medication (with the help of an X-ray machine) between the bones of the spine adjacent to the involved nerves. This can help to reduce the inflammation and irritation of the nerve and help reduce the symptoms of radiculopathy. If all the above options are not successful and the symptoms of radiculopathy are severe, surgery may be an option. The goal of the surgery is to remove the compression from the compressed nerve. A laminectomy removes a small portion of the bone covering the nerve to allow it to have additional space. A discectomy removes the portion of the disc that has herniated out and is compressing a nerve.

Dr. Jeff J. Mollins has been treating patients injured in accidents for over 25 years. Many of these injured patients suffer from radiculopathy. Dr. Mollins and his team of referred medical specialists will accurately diagnose, document, and treat this condition and get you back to health as expeditiously as possible. Remember, Dr. Mollins and his referred specialists are certified to treat workers compensation patients. If you are injured on the job, you may receive treatment at no cost and paid for your lost wages until you return to work. Even after you return to work you can be treated for free. So remember, if you have any of the symptoms of a radiculopathy, don’t wait. Get in touch with Dr. Mollins as soon as possible.

Posted in: Back Pain Treatment, Blog