Treating Radiculopathy: Know Your Options
Numerous conditions can narrow nerve space within the spine, leading to painful pinching or compression of the involved nerve root. This nerve pinching is known as radiculopathy in the medical world.
Depending on which nerves are affected, radiculopathy can interfere with your mobility and spread pain into your head, shoulders, arms, chest, or legs.
Dr. John S. Michels is an award-winning pain management physician with a thriving practice in the Dallas-Fort Worth area of Texas. As a previous Super Bowl champion who suffered a career-ending injury, Dr. Michels also has a unique perspective on the many benefits of solving pain by targeting its source.
Check these facts from Dr. Michels about radiculopathy and the nonsurgical treatments he offers to get you moving and living pain-free again.
How do you know it’s radiculopathy?
The type of symptoms you’re experiencing and their location often suggest radiculopathy. Along with pain at the site of nerve root compression, radiculopathy can cause symptoms anywhere along the irritated nerve’s distribution.
For instance, sciatica is a common condition caused by sciatic nerve compression (lumbar radiculopathy). The sciatic nerve splits and exits the spinal column in the lower back, traveling down the backs of both thighs and calves to the feet.
The nerve branches out at several points along its journey, bringing sensation and movement to the hips, pelvic region, buttocks, and lower extremities.
Thus, sciatica can cause symptoms in any of those areas and may occur on one or both sides. At its worst, it can also affect bowel and bladder function.
Otherwise, your symptoms vary depending on which area of the spine is affected. For example, cervical (neck) radiculopathy symptoms tend to radiate into the shoulders and arms.
On the other hand, thoracic (mid to upper back) radiculopathy can cause symptoms that wrap around your sides to the chest.
Symptoms related to radiculopathy include:
- Moderate to severe pain at the site of the compressed nerve
- Sharp, shock-like pain that can travel along the nerve
- Tingling and numbness in the affected regions
- Muscle weakness in the arms or legs
- Altered reflexes in the affected extremities
- Difficulty walking
- Loss of bowel or bladder control (requires urgent medical attention)
During your initial evaluation, Dr. Michels carefully reviews your symptoms, performs a physical exam, and obtains imaging studies to identify underlying conditions causing the nerve root compression.
What is causing my radiculopathy?
Injury sustained during a car accident, fall, or other trauma can lead to radiculopathy. But it’s most often related to chronic (long-term) conditions such as:
Facet joint arthritis
Osteoarthritis can affect the tiny facet joints that hinge vertebrae together in the spine.
Arthritis-related joint swelling and stiffness can narrow the small openings (foramen) between the joints through which nerves exit the spinal column. The narrowed opening can pinch and irritate nerve roots.
Degenerative disc disease
Discs are round, rubbery structures that sit between the vertically stacked bones (vertebrae) in the spine. They act as cushions between the vertebrae and help maintain proper spacing between structures in the spinal column.
Degenerative changes related to aging or overuse cause the intervertebral discs to flatten and dry out or sometimes slip out of place. These changes can cause misalignment of the spine and impinge on nearby nerves.
Herniated disc
A herniated disc occurs when the inner jelly-like core pushes through the disc’s more rigid outer layer. The resulting bulge can crowd and compress nerves. Discs can also slip out of place (spondylolisthesis) and pinch nearby nerves.
Spinal stenosis
Stenosis or narrowing of the spinal canal may result from disc disease, facet joint arthritis, or other conditions affecting the spine.
For instance, bone spurs often form because of bone rubbing against bone in the case of arthritis or moderate to severe disc disease. When the spurs grow toward the spinal canal, they can narrow it and cause radiculopathy.
Treating radiculopathy
For radiculopathy that doesn’t respond to home care measures such as ice, heat, and over-the-counter pain relievers, Dr. Michels may recommend one or more of the following treatments:
- Oral corticosteroids to reduce inflammation
- Epidural steroid injections to relieve inflammation and pain
- Neuromodulation (spinal cord stimulation) to block pain signals to the brain
- Facet joint injections
- Radiofrequency nerve ablation
- Regenerative medicine therapies
- Nerve blocks
Once these treatments relieve your pain, Dr. Michels may also recommend a guided physical therapy and rehab program to restore strength and flexibility and help prevent future problems.
Schedule an evaluation with Dr. Michels today by calling our office or requesting an appointment online.