by Raj N. Sureja, MD
Better known as a spinal pinched nerve, radiculopathy occurs when the bones, muscle or tendons surrounding a nerve are damaged, causing them to change position and exert more pressure on the spinal cord nerves. The nerves can become swollen, causing pain and numbness. Radiculopathy can cause pain in the legs when it occurs in the lumbar (lower) section of the spine. When there is pressure on the nerve root in the lower back, it can cause a shooting pain down the legs, called sciatica.
What causes radiculopathy?
There are various causes of a radiculopathy. A herniated spinal disc occurs when the outer edge of the disc tears and the inner nucleus breaks through the weakened layer and into the spinal canal. This will put direct pressure on the nerve root, which can cause pain, numbness and weakness along the nerve pathway down into the lower leg. After a disc weakens or completely collapses, bone spurs can form that stiffen the spine and cause nerves to be compressed. This can have the same effect as a herniated disc. When repetitively doing a physical activity, stress can be put on the spine and tighten up the nerves. Depending on what nerves in the lumbar region are affected will determine where the pain is located in the lower leg.
What are the symptoms?
• Sharp pain that travels from the lower back down to the foot
How is it diagnosed?
X-rays can show bone positioning and any disc damage, while MRI (Magnetic Resonance Imaging) scans can get a closer look at the soft tissues of the body. We can also perform a nerve conduction study that will evaluate the ability of the nerves to send signals throughout the body.
How can it be treated?
Nonsurgical treatment is usually recommended for a radiculopathy. Physical therapy, spinal injections, such as cortisone shots or epidurals, and pain medications can be used to manage the pain. After several weeks of conservative treatment, without the pain subsiding, surgery can be considered. The most common procedure for a radiculopathy is a discectomy. This will basically remove whatever is causing the nerve compression, whether that is a bone spur or part of a herniated disc from the spine.
How can it be prevented?
Radiculopathy can’t always be avoided, but there are a few steps to take to reduce the chances for this condition. Maintaining a healthy weight, a regular exercise regimen, and always using caution when lifting heavy objects, is a great starting place. Increasing your flexibility, when exercising, can strengthen the spine and protect it from future damage.