Spinal Radiculopathy – Lumbar and Cervical
Description
The spine is designed to be strong, especially because it gets support from surrounding structures, like ligaments, tendons, and muscles. It works to be stable – to keep you upright, like when you’re standing in a long line, but it also allows for flexibility to help you move freely, like when you have to reach far in front of you or when you need to quickly check your blind spot while driving.
The spine houses your spinal cord, which is a main line of communication between your brain and your body. Nerves branch off of the spinal cord, and they can go anywhere from your hands
to your feet, and many places in between.
When one of those nerves, often coming from the neck or the lower back, gets irritated or compressed, that can lead to pain and other symptoms. In the event that this happens along a nerve root, it’s often called “radiculopathy”. You may also hear it referred to as a “pinched nerve” – a pinched nerve can happen at the nerve root or somewhere else along a nerve.
Causes & Triggers
Causes of radicular pain can vary, but two common places it can happen are along the cervical spine (your neck) or the lumbar spine (your low back). Sometimes, a quick, hard movement can cause irritation. Other times, it can be caused by repetitive movements or prolonged postures; it may also happen following a trauma, like a car accident or fall. Other causes can include a disc herniation or other conditions, such as spondylolisthesis, degenerative conditions like arthritis, infection, or tumors.
Signs & Symptoms
The symptoms you may experience can vary depending on the location of the nerve irritation. With cervical radiculopathy, you may experience:
- Pain
○ Commonly in the arm – it may move down the arm into the wrist or hand
○ May have neck pain
○ May be described as sharp, shooting, or burning - Numbness or tingling along the arm or into the hand
- Muscle weakness in the neck, shoulder, or arms
- Restricted range of motion in the neck
With lumbar radiculopathy, you may experience:
- Pain
○ Pain down the leg – it may move from the back, down the leg, into the ankle or foot
○ May have low back pain
○ May be described as sharp, shooting, or burning - Numbness or tingling along the leg or into the foot
- Muscle weakness in the lower body
- Restricted range of motion in the low back
It’s important to remember that the amount of pain experienced does not always equal the amount of injury taking place. Nerve irritation can cause significant pain, but it does not necessarily mean that your back is weak or seriously injured. If you’re experiencing these types of symptoms, it’s important to see a healthcare provider, like a physician or physical therapist, who can help you determine the possible cause of your pain and the extent of the injury. They will also work to help you find the best treatment options for your specific situation.
Tips & Treatment
Generally, neck or back pain can be assessed by a healthcare professional, like your primary care physician or a physical therapist. In many situations, a diagnosis can be made during your
evaluation; a healthcare provider may request imaging to help rule in the diagnosis, but it may not always be required in order to begin treatment.
Often, the first line of treatment is conservative. Many people experiencing radiculopathy can find relief or improvement with a non-operative approach to treatment. With conservative care, a physical therapist will work with you, often to improve strength, range of motion, and/or decrease your pain through exercises, movements, and other recommendations. As you progress, the physical therapist may begin to work with you on specific tasks or activities that you’re looking to get back to or improve upon. A physician may also prescribe medications or injections as a part of a treatment plan.
In other cases, you may be referred to a specialist, like an orthopedic surgeon, to discuss surgical options. If conservative treatment does not improve your condition, or if your injury is more severe, a physician may recommend surgery, such as a “decompression surgery”, as a treatment option.
Depending on the cause of your pain and other factors, the types of procedures or treatments that will work best for you can vary. Some of the treatment options you may discuss with your
healthcare provider include:
- Physical therapy
- Medications
- Spinal injections
- Decompression surgery
Because there are different options for treatment, it’s important to discuss the options available to you with your healthcare professional, so you can decide together what will work best for you.
