Radiculopathy, or a pinched nerve in the spine, can lead to a variety of uncomfortable symptoms, including pain, weakness, and numbness.
In this article, we look at how this condition can occur, along with its symptoms, diagnosis, and treatment.
The spine is a stacked structure made up of 33 bones or vertebrae, which protect the spinal cord from injury or trauma.
The bones of the spine allow a person to stay upright, bend, and twist. They are held in place by a network of muscles, tendons, and ligaments. Nerves extend from the spine to other areas of the body, such as the arms and legs.
The spine curves in an S-shape, which is vital for spinal health. These curves are responsible for shock absorption, balance, and a range of movements.
Each region of the spine has a specific name and function. They are the:
- cervical spine or neck
- thoracic spine or mid back
- lumbar spine or lower back
- sacrum, connecting the spine to the hips
- coccyx or tail bone
Each vertebra is cushioned from its neighbor by an intervertebral disc. This protects the vertebrae from rubbing on top of each other.
When injuries occur, these intervertebral discs can become damaged and cause compression or irritation of a nearby nerve root. Depending on which nerve is compressed, a person can experience pain in a variety of locations throughout the body.
People can develop radiculopathy as the result of an injury, or it may occur for no apparent reason. Those individuals aged 30 to 50 years old are most likely to experience radiculopathy, in the cervical and lumbar spine areas.
Radiculopathy can be caused by a variety of conditions or injuries, including:
- a herniated disc, when a disc protrudes, compressing the nerve root
- degenerative disc disease
- bone spurs
- tumors of the spine
- osteoarthritis or spinal arthritis
- spinal stenosis, a painful condition when the spinal canal narrows
- compression fractures
- spondylolisthesis, when a vertebra moves and rests on the vertebra below
- scoliosis caused by an abnormal curve in the spine
- diabetes, caused by altered nerve blood flow
- cauda equine syndrome, an uncommon but serious condition when nerve root compression affects the pelvic organs and lower extremities
Additional risk factors for developing radiculopathy include:
- being overweight
- poor posture
- improper lifting techniques
- repetitive motions
- a family history of degenerative bone conditions
Because the nerves extending from the spinal cord travel to different parts of the body, people will experience different symptoms, depending on where in the spine the nerve compression occurs.
Cervical radiculopathy occurs when a nerve in the neck or upper back is compressed. The symptoms associated with cervical radiculopathy include:
- pain in the neck, shoulder, upper back, or arm
- weakness or numbness typically experienced on one side
A person may experience pain in the chest and torso when the nerve compression or irritation occurs in the mid back region.
Thoracic radiculopathy is an uncommon condition that may be misdiagnosed as shingles, heart, abdominal, or gallbladder complications.
Symptoms associated with thoracic radiculopathy include:
- burning or shooting pain in the rib, side, or abdomen
- numbness and tingling
A person may experience pain in the low back, legs, and hip region when the nerve compression or irritation occurs in the lower part of the back.
Lumbar radiculopathy is also known as sciatica, and symptoms include pain and numbness in the low back, hips, buttock, leg, or foot. Symptoms are typically made worse with long periods of sitting or walking.
In some cases, nerves affecting the bowel and bladder can become compressed, leading to bowel or bladder incontinence or loss of control.
Other generalized symptoms of radiculopathy may include:
- sharp pain starting in the back, extending to the foot
- sharp pain with sitting or coughing
- numbness or weakness in the leg and foot
- numbness or tingling in the back or leg
- sensation or reflex changes, hypersensitivity
- pain in the arm or shoulder
- worsening pain with movement of the neck or head
In addition to a physical exam and symptom review, doctors may diagnose radiculopathy using:
- radiologic imaging with X-ray, MRI, and CT scans
- electrical impulse testing called electromyography or EMG, to test nerve function
Typically, radiculopathy is treatable without surgery. Depending on the severity of the radiculopathy and other health conditions, doctors may recommend certain medications, including:
- non-steroidal drugs, such as ibuprofen, aspirin or naproxen
- oral corticosteroids or injectable steroids
- narcotic pain medications
- physical therapy
- a soft cervical collar
- ice and heat application
In some cases, doctors may recommend surgery to treat the cause of the nerve compression.
Some surgical procedures include repair of a herniated disc, widening of the spinal canal space, removing a bone spur, or fusing the bones.
Each case is unique, and surgical recommendations will be discussed in detail. The choices will depend on the cause of the radiculopathy, the overall health of the person, and other individual factors.
Some strategies may prevent nerve compression pain. These include:
- maintaining good posture, even when driving
- proper lifting techniques
- taking regular physical activity, including weight bearing exercises
- developing core strength
- maintaining a healthy weight
- taking frequent breaks and incorporating stretching into routines
- avoiding tilting the head to hold the phone to the shoulder