Radiculopathy

A nerve root is a nerve that leaves the spinal cord to branch out to other areas of the body. Radiculopathy is a condition in which a nerve root is pinched or irritated.

The pain of radiculopathy, called radicular pain, radiates from the point of injury to the areas served by that nerve.

• Cervical radiculopathy (in the neck) can cause pain, weakness or numbness in the shoulder and/or arm.
• Thoracic radiculopathy (in the upper and mid-back) can cause pain that may start in the middle back and may travel around to the chest. Thoracic radiculopathy is rare.
• Lumbar radiculopathy (in the lower back) can cause pain, weakness or numbness that starts in the lower back and radiates through the buttock and down the back of the leg. This particular type of radiculopathy is known as sciatica.

Radiculopathy is most often caused by a herniated disc or spinal stenosis. Both are degenerative conditions, that result from everyday wear-and-tear on the spine.

In most cases, radiculopathy can be diagnosed with a thorough medical examination. However, further testing may be necessary to determine the cause of the radiculopathy. Possible tests include:

• X-ray (also known as plain films)– test that uses invisible electromagnetic energy beams (X-rays) to produce images of bones. Soft tissue structures such as the spinal cord, spinal nerves, the disc and ligaments are usually not seen on X-rays, nor on most tumors, vascular malformations, or cysts. X-rays provide an overall assessment of the bone anatomy as well as the curvature and alignment of the vertebral column. Spinal dislocation or slippage (also known as spondylolisthesis), kyphosis, scoliosis, as well as local and overall spine balance can be assessed with X-rays. Specific bony abnormalities such as bone spurs, disc space narrowing, vertebral body fracture, collapse or erosion can also be identified on plain film X-rays. Dynamic, or flexion/extension X-rays (X-rays that show the spine in motion) may be obtained to see if there is any abnormal or excessive movement or instability in the spine at the affected levels.
• Magnetic resonance (MR) scans- these scans clearly show soft tissues like discs and nerve roots.
• Computed tomography (CT) scans- these scans use X-rays and a computer to create detailed images of the spine and nearby structures.
• CT plus myelogram (myelo-CT)- this type of scan uses an injectable dye and CT scan to measure nerve function.

Many forms of radiculopathy will respond best to non-operative measures like medication and physical therapy.

When surgery is the best option, it is tailored to the cause of the radiculopathy.

Herniated discs, for example, may be treated with a cervical or lumbar microdiscectomy.

Spinal stenosis may be treated with a decompression surgery like a laminectomy.

Dr. McCormick or someone on his team can discuss the surgical and nonsurgical options, and which might be best in a particular case.

Dr. Paul C. McCormick is an expert in treating radiculopathy. Each doctor can also offer you a second opinion.