The spinal column is a miraculous piece of our human anatomy. It not only allows humans to stand up straight, it literally serves as the connector between some of the most vital parts of the human body. The spine also houses a significant portion of the nervous system, allowing messages from the brain to travel up and down the spine and to their intended location. You might not realize it at first, but your spine sends subtle hints when there’s a problem. If ignored, these symptoms will only be exacerbated. Some will succumb to uncomfortable numbness in their legs while lying in bed. Others will have their hand placed firmly on the steering wheel and feel nothing at all.
Needless to say, spinal health is vital to maintaining a high-quality life, so when you start to experience pain, numbness, or weakness in your arms and legs, you want to act fast to determine whether or not radiculopathy is at the root of your symptoms. Radiculopathy occurs when nerve roots in the spinal column become pinched or compressed. It most commonly occurs in the cervical, thoracic, and lumbar regions of the spine. With 33 bones in the spine, there’s plenty of places for radiculopathy to occur, which means the best treatment for radiculopathy will depend on the location of the pinched nerve, the extent of the injury, and the patient’s medical history, among several other considerations.
What Causes Radiculopathy?
Radiculopathy is caused by a pinched nerve root in the spinal column. As these nerves exit the spinal column, they can become compressed or irritated by a herniated disc, bone spur, or surrounding ligaments. These types of compressions are known as mechanical compressions. In some cases, a tumor or infection can also lead to mechanical compression in the spinal. Individuals with scoliosis, a sideways curvature of the spine, can also experience nerve compression. This typically occurs on one side of the spine.
Trauma victims may experience radiculopathy as a result of direct damage to their nerves. This is common following falls, car crashes, and other traumatic accidents, which can cause inflammation in the spinal column. Of course, radiculopathy can occur without a traumatic injury to point a finger at. Natural degeneration of the spine can lead to radiculopathy in older adults, too.
Common Symptoms of Radiculopathy
The symptoms of radiculopathy vary from person to person. Remember, the spine is composed of 33 bones spread amongst five regions (cervical, thoracic, lumbar, sacral, and coccygeal), so it makes sense that nerve compression in different regions of the spine would cause unique symptoms. To obtain a better understanding of how an individual will be affected by nerve compression along their spine, it’s important to first acknowledge the purpose of the regions where radiculopathy most often occur — the cervical, thoracic, and lumbar regions.
The cervical spine controls the neck and arms, which means radiculopathy will cause pain, numbness, or tingling in these specific regions. The same principle applies to the thoracic spine (chest and abdomen) and lumbar spine (buttocks and legs). Common symptoms of radiculopathy include:
- Pain
- Numbness
- Tingling
- Localized neck pain
- Localized back pain
- Sciatica
- Back pain that travels to the chest
- Shingles-like symptoms
- Painful hypersensitivity to touch
- Muscle weakness
Who Is at Risk for Radiculopathy?
As is the case with most injuries and illnesses, certain individuals have an increased risk of radiculopathy. Age plays a significant role as the likelihood of radiculopathy increases over time as the body undergoes natural wear and tear.
Some experts believe that the risk of radiculopathy peaks during the forties and fifties; however, younger and older individuals can also experience radiculopathy. Individuals who take part in regular, strenuous activity also have an increased risk of radiculopathy. For example, those who participate in mixed martial arts or weightlifting tend to put more weight on their spine than those who do not, increasing the risk of a pinched nerve.
Those who work in highly physical industries, such as construction, are also at a heightened risk of radiculopathy. This is because these types of workers are exposed to repetitive motion and vibration injuries that put persistent strain on the cervical, thoracic, and lumbar spine. Furthermore, any individual who has had radiculopathy in the past has an increased risk as do those who smoke.
Treatment Options for Radiculopathy
Due to the broad range of symptoms stemming from the various types of radiculopathy, treatment options must be addressed on a case-by-case basis. Most people will attempt to overcome radiculopathy with non-surgical treatment methods, like physical therapy, medication, and epidural steroid injections, before proceeding to surgery. Once these methods have been proven ineffective, an orthopedic surgeon will perform a surgical procedure to eliminate the patient’s symptoms. An orthopedic surgeon can perform an array of different surgical procedures, including:
For Cervical Radiculopathy
- Anterior Cervical Discectomy and Fusion (ACDF)
- Artificial Disk Replacement (ADR)
- Posterior Cervical Laminoforaminotomy
For Thoracic Radiculopathy
- Endoscopic Thoracic Laminoforaminoplasty
- Kyphoplasty
- Laminectomy
- Spinal Fusion
For Lumbar Radiculopathy
- Anterior Lumbar Interbody Fusion (ALIF)
- Cage Implantation
- Deformity Correction
- Transforaminal Lumbar Interbody Fusion (TLIF)
- Laminectomy
- Lumbar Laminectomy
- Lumbar Microdiscectomy
- Lumbar Spinal Fusion
- Pedicle Screw
- Percutaneous Laser Disc Decompression (Laser Spine Surgery)
- Posterior Lumbar Interbody Fusion (PLIF)
Non Surgical Treatment Options
- Physical Therapy or Chiropractic Care – This conservative approach may help reduce pain by stabilizing the spine and in some cases help promote more space your spinal nerve roots
- NSAIDs – Non-steroidal anti-inflammatory drugs reduce inflammation and pain.
- Epidural Steroid Injections or Facet Block Injections can help by reducing swelling and inflammation directly into where the pain is caused
Should You Consider Surgery?
When conservative methods fail and your symptoms hinder your lifestyle, surgery can help relieve the compression on the nerves in your spine. After reviewing your medical history, performing a physical examination, and utilizing imaging technology (i.e., x-ray, MRI) to obtain an accurate diagnosis of your condition, you can begin to think about whether or not surgery is right for you. Together, you and your orthopedic surgeon must review your diagnosis and determine the best course of treatment. Only then can you determine whether or not surgery is right for you. However, it should be noted that radiculopathy surgery is supported by high success rates and a relatively low risk of complications.
