Radiculopathy is a condition caused by a compressed nerve in the spine. The most common forms are cervical radiculopathy, which involves the neck, and lumbar radiculopathy, which involves the lower back. Thoracic radiculopathy, which affects the mid-back, is less common.
In radiculopathy, the pinched nerve can be caused by a bone spur, a ruptured disc or abnormal thickening of the ligaments. Less common causes include tumors or infections that reduce the amount of space in the spinal canal. Abnormal curvatures of the spine like scoliosis can also cause compressed nerves.
Diabetes can cause radiculopathy by decreasing blood flow to the spinal nerves. Injury to the spine, like that caused by an accident, can also cause radiculopathy, as can some degenerative conditions.
A susceptibility to radiculopathy can run in some families. Radiculopathy is most common in people who frequently put excessive loads on the spine. It is thus more common in people that perform heavy labor and in some athletes.
In thoracic radiculopathy, the affected nerves control the thoracic and abdominal muscles, and they also control feeling in that area. The most common symptoms of radiculopathy are numbness and pain. In thoracic radiculopathy, the pain often starts in the mid-back and circles around to the chest. Many people mistake it for shingles.
Some patients also become abnormally sensitive to light touches in the affected area. To these people, a gentle touch feels painful. A less common symptom is weakness in the muscles controlled by the affected nerves. As this can indicate actual nerve damage, this symptom is particularly serious.
Treating the radiculopathy will depend on its cause. If the radiculopathy is caused by a disease or injury, the doctor will start by treating those.
Therefore, the doctor will have to determine the cause of the radiculopathy in order to decide on a treatment. They will typically start with a medical history and physical exam. The doctor will often ask for X-rays, which can be used to identify conditions like osteoarthritis or a tumor. A discography is a type of X-ray used to locate ruptured discs. The doctor may also order an MRI, which will give them a view of the nerves, discs and other soft tissues around the spine.
Most patients respond well to conservative and non-invasive treatments like anti-inflammatory medications, chiropractic, physical therapy and simply avoiding activities that strain the back.Many patients improve between six weeks and three months.
If the patient has not improved within that time, the doctor will typically administer an epidural steroid injection. The doctor injects the steroid medication between the vertebrae next to the affected nerves. The injection can quickly ease the symptoms by reducing the inflammation.
In severe cases, the doctor may perform surgery to give the pinched nerve more room. The procedure used will depend on the causes of the radiculopathy. If the patient has a herniated disc, for example, the surgeon will perform a discectomy and remove the part of the ruptured disc pressing on the nerve. In a laminectomy, the surgeon will remove part of the bone covering the nerve to give it more space.