Radiculopathy
Encyclopedia
Radiculopathy is not a specific condition, but rather a description of a problem in which one or more nerves are affected and do not work properly (a neuropathy). The emphasis is on the nerve root
(Radix = "root"). This can result in pain
(radicular pain
), weakness, numbness, or difficulty controlling specific muscles.
In a radiculopathy, the problem is at or near the root of the nerve, along the spine. However, the pain or other symptoms may manifest in an extremity through a process called referred pain
. For example, a nerve root impingement in the neck can produce pain and weakness in the forearm. Likewise, an impingement in the lower back or lumbar
-sacral
spine
can be manifested with symptoms in the foot. Polyradiculopathy refers to the condition where more than one spinal nerve root is affected.
test" can help to diagnose a lumbar or sacral nerve root radiculopathy.
, medication
, and relaxation. A comprehensive systematic review found moderate quality evidence that spinal manipulation
is effective for the treatment of acute lumbar radiculopathy. Only low level evidence was found to support spinal manipulation for the treatment of chronic lumbar and cervical spine-related radiculopathies, and no evidence was found to exist for treatment of thoracic radiculopathy.
Nerve root
A nerve root is the initial segment of a nerve leaving the central nervous system. Types include:* A cranial nerve root, the beginning of one of the twelve pairs leaving the central nervous system from the brain stem or the highest levels of the spinal cord;...
(Radix = "root"). This can result in pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
(radicular pain
Radicular pain
Radicular pain, or radiculitis, is pain "radiated" along the dermatome of a nerve due to inflammation or other irritation of the nerve root at its connection to the spinal column...
), weakness, numbness, or difficulty controlling specific muscles.
In a radiculopathy, the problem is at or near the root of the nerve, along the spine. However, the pain or other symptoms may manifest in an extremity through a process called referred pain
Referred pain
Referred pain is pain perceived at a location other than the site of the painful stimulus. An example is the case of ischemia brought on by a myocardial infarction , where pain is often felt in the neck, shoulders, and back rather than in the chest, the site of the injury...
. For example, a nerve root impingement in the neck can produce pain and weakness in the forearm. Likewise, an impingement in the lower back or lumbar
Lumbar
In tetrapod anatomy, lumbar is an adjective that means of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum ...
-sacral
Sacral
Sacral may refer to:*sacred*sacrum...
spine
Vertebral column
In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...
can be manifested with symptoms in the foot. Polyradiculopathy refers to the condition where more than one spinal nerve root is affected.
Causes
The nerve(s) may be inflamed, pinched (compressed), or working ineffectively due to a lack of blood flow. The nerve could be affected by a progressive disease that is destroying it in part or in whole. The "straight leg raiseStraight leg raise
The Straight leg raise, also called Lasègue's sign, Lasègue test or Lazarević's sign, is a test done during the physical examination to determine whether a patient with low back pain has an underlying herniated disk, mostly located at L5 , S1 or S2 .-Technique:With the patient...
test" can help to diagnose a lumbar or sacral nerve root radiculopathy.
Types
Forms of radiculopathy and related conditions:- Cervical radiculopathy: Radiculopathy in the cervical spine
- Cauda equina syndromeCauda equina syndromeCauda equina syndrome ' is a serious neurologic condition in which there is acute loss of function of the lumbar plexus, neurologic elements of the spinal canal below the termination of the spinal cord.-Causes:...
- ParaplegiaParaplegiaParaplegia is an impairment in motor or sensory function of the lower extremities. The word comes from Ionic Greek: παραπληγίη "half-striking". It is usually the result of spinal cord injury or a congenital condition such as spina bifida that affects the neural elements of the spinal canal...
- SciaticaSciaticaSciatica is a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, or...
- QuadriplegiaQuadriplegiaTetraplegia, also known as quadriplegia, is paralysis caused by illness or injury to a human that results in the partial or total loss of use of all their limbs and torso; paraplegia is similar but does not affect the arms...
- Piriformis syndromePiriformis syndromePiriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle causing pain, tingling and numbness in the buttocks and along the path of the sciatic nerve descending down the lower thigh and into the leg...
- Lyme DiseaseLyme diseaseLyme disease, or Lyme borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Borrelia burgdorferi sensu stricto is the main cause of Lyme disease in the United States, whereas Borrelia afzelii and Borrelia garinii cause most...
Treatment
Ideally, effective treatment aims to resolve the underlying cause and restores the nerve root to normal function. Common mainstream treatment approaches include physical therapyPhysical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...
, medication
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
, and relaxation. A comprehensive systematic review found moderate quality evidence that spinal manipulation
Spinal manipulation
Spinal manipulation is a therapeutic intervention performed on spinal articulations which are synovial joints . These articulations in the spine that are amenable to spinal manipulative therapy include the z-joints, the atlanto-occipital, atlanto-axial, lumbosacral, sacroiliac, costotransverse...
is effective for the treatment of acute lumbar radiculopathy. Only low level evidence was found to support spinal manipulation for the treatment of chronic lumbar and cervical spine-related radiculopathies, and no evidence was found to exist for treatment of thoracic radiculopathy.