Radiculopathy and Sciatica

What is Radiculopathy?

The spine consists of 33 bones, best known as vertebrae, which shield the spinal cord from experiencing injury or trauma. The bones of the spine permit an individual to remain upright, bend, and twist. The vertebrae are held in place by a collection of muscles, tendons, and ligaments. Nerves also extend from the spine to the upper and lower extremities, such as the arms and legs. The spine curves in an S-shape, which is essential for spinal health. These curves are accountable for equilibrium, shock absorption, and a range of movements. Each section of the backbone has a specific name and function. They are the: 

• Cervical spine or neck
• Thoracic spine or middle back
• Lumbar spine or lower back
• Sacrum, which links the backbone to the hips
• Coccyx or tail bone

Each vertebra is cushioned from each other with an intervertebral disk. This shields the vertebrae from rubbing over each other. When trauma or injuries occur, these intervertebral discs can become damaged and cause the compression or impingement of a nerve. Depending on which nerve is compressed, an individual can experience a variety of painful symptoms, including sciatica or sciatic nerve pain. Individuals can develop radiculopathy as a result of an injury, or it may occur seemingly without a cause. People within 30 to 50 years old are most likely to experience radiculopathy. 

Causes and Risk Factors

 Radiculopathy can ultimately develop due to a variety of injuries and/or aggravated conditions, including:

• Herniated discs, or when a disc protrudes, irritating the nerve root
• Sciatica
• Degenerative disc disease
• Bone spurs
• Tumors in the spine
• Osteoarthritis or spinal arthritis
• Spinal stenosis, or the narrowing of the spinal canal
• Compression fractures
• Spondylolisthesis, or when a vertebra slides over the vertebra beneath it
• Scoliosis brought on by an abnormal curve in the backbone
• Diabetes, caused by altered nerve blood flow
• Cauda equine syndrome, or a condition where nerve root compression affects the pelvic organs and lower extremities

 Additional risk factors for developing radiculopathy include: 

• Aging
• Being overweight or obese
• Poor posture
• Improper lifting methods and techniques
• Repetitive movements
• A family history of degenerative bone health issues

Signs and Symptoms

Since the nerve roots extending from the spinal cord travel throughout various areas of the human body, many individuals will experience different symptoms depending on the location where the nerve compression or impingement occurs. We will discuss the different symptoms an individual may experience depending on where the irritation occurs along the spine.

Cervical Radiculopathy

Cervical radiculopathy develops when a nerve in the neck, or cervical spine, becomes compressed or impinged due to an injury and/or aggravated underlying condition. The symptoms associated with cervical radiculopathy include: 

• Pain in the neck, shoulder, upper back, or arm
• Weakness or numbness is generally experienced on a single side of the human body

Thoracic Radiculopathy

Individuals may commonly experience painful symptoms in their chest and torso when nerve compression or impingement occurs in the thoracic spine or middle back region of the spine. Thoracic radiculopathy may be frequently misdiagnosed as shingles, heart, abdominal, or gallbladder problems. The symptoms associated with thoracic radiculopathy include: 

• Burning or shooting pain in the ribs, side, or abdomen
• Tingling sensations and numbness

Lumbar Radiculopathy

Individuals may experience painful symptoms in the low back, hips, and legs when nerve compression or impingement occurs in the lumbar spine or low back region of the spine. Lumbar radiculopathy is also commonly referred to as sciatica or sciatic nerve pain. Sciatica symptoms include pain, tingling sensations, and numbness along the length of the sciatic nerve. Occasionally, the nerve roots in charge of controlling the bowel and bladder may become irritated, resulting in bowel or bladder incontinence as well as loss of control. Other generalized symptoms associated with lumbar radiculopathy include: 

• Sharp pain extending from the low back to the foot
• Sharp pain with sitting or coughing
• Weakness or numbness in the lower extremities
• Tingling sensations and numbness in the lower extremities
• Hypersensitivity, or sensitivity and reflex alterations
• Sharp pain radiating into the upper extremities
• Intense pain and discomfort with movements of the head and/or neck

Diagnosis

Together with a physical evaluation and review of symptoms, healthcare professionals may diagnose radiculopathy utilizing: 

• Radiologic imaging with X-ray, MRI, and CT scans
• Electrical impulse testing, referred to as electromyography or EMG, to examine and test nerve function

Treatment

Normally, any type of radiculopathy can ultimately be treated without the need for surgical interventions or surgery. Based on the severity of the radiculopathy, healthcare professionals may recommend a variety of treatment approaches, including: 

• Non-steroidal drugs and/or medications, such as ibuprofen, aspirin, or naproxen
• Oral corticosteroids or injectable steroids
• Narcotic pain medicines
• Physical therapy and chiropractic care
• A soft cervical collar
• Ice and heat therapy applications

In a variety of instances, healthcare professionals may recommend surgery to help treat the source of the nerve root compression or impingement. Several surgical interventions include repair of a herniated disc, widening of the spinal canal, eliminating a bone spur, or fusing the bones. Because each patient's case is unique, healthcare professionals will discuss surgical recommendations in detail before following-up with the procedures. The options for surgery will depend on the cause of the radiculopathy and the overall health of the individual as well as other essential factors. 

Prevention

Several strategies may ultimately help prevent and protect against nerve compression or impingement. These include:

• Maintaining good posture, even if driving
• Proper lifting methods and techniques
• Participating in exercises or physical activities like weight-bearing exercises
• Developing core strength
• Maintaining a healthy weight
• Taking frequent breaks and incorporating stretching
• Avoiding tilting the head to hold the phone to the shoulder

Differential Diagnosis of Hip Pain and Discomfort

Radiculopathy is characterized as the compression or impingement of a nerve root in the spine. The irritation of this well-known health issue can cause a wide variety of uncomfortable and painful symptoms, including pain and discomfort, tingling sensations, weakness, and numbness. Lumbar radiculopathy can also sometimes be referred to as sciatica. Sciatica is characterized as a collection of symptoms, similar to those previously described, due to the compression or impingement of the sciatic nerve in the low back. Proper diagnosis is essential for treatment. - Dr. Alex Jimenez D.C., C.C.S.T. Insight

The purpose of the article was to discuss radiculopathy and sciatica. Radiculopathy is often associated with common symptoms, including pain, tingling sensations, and numbness, similar to sciatica. The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues as well as functional medicine articles, topics, and discussions.

Curated by Dr. Alex Jimenez