SPINAL CONDITIONS
Radiculopathy
Radiculopathy happens when a spinal nerve is irritated or compressed. Patients commonly report pain, tingling, numbness or weakness that can travel into the arm or leg, impacting their ability to perform everyday activities like work, driving, exercise and quality of sleep.
At Melbourne Spine Studio, Dr Alvin Pun reviews radiculopathy in the neck, mid-back, and lower back. He considers where your symptoms are felt, possible causes of nerve irritation and how the condition influences your day-to-day to guide treatment.
What is radiculopathy?
Nerves branch from the spinal cord and travel to different areas of the body. Radiculopathy develops when one of these nerve roots becomes compressed or irritated, causing symptoms along the path of that nerve.
The location of the affected nerve determines where symptoms are felt and is why a problem in the neck can cause symptoms in the arm or hand, or a nerve problem in the lower back can cause pain, tingling or weakness in the leg or foot.
Types of complex spinal conditions
CERVICAL RADICULOPATHY
Cervical radiculopathy affects a nerve in the neck and can cause pain, tingling, numbness or weakness that travels into the shoulder, arm, hand or fingers. It is sometimes described as a pinched nerve in the neck.
THORACIC RADICULOPATHY
Thoracic radiculopathy affects nerves in the mid-back. This is less common and can cause pain, tingling or altered sensation that travels around the ribs, chest or abdomen.
LUMBAR RADICULOPATHY AND SCIATICA
Lumbar radiculopathy affects nerves in the lower back and can cause symptoms through the buttock, hip, leg, foot or toes. When pain follows the sciatic nerve pathway into the leg, it is commonly referred to as sciatica.
What causes radiculopathy?
Radiculopathy can develop when there is less space around a spinal nerve or when a nerve becomes irritated by pressure or inflammation, from a number of causes.
|
Herniated or bulging discs |
Spinal or foraminal stenosis |
Bone spurs and spinal arthritis |
Degenerative disc disease |
|
Spondylolisthesis |
Spinal injury |
Changes from previous surgery |
Infection or tumour (less common) |
Symptoms of radiculopathy
Radiculopathy follows the pathway of an affected nerve, so symptoms may be felt some distance from the spine, unlike general neck or back pain. Depending on the nerve affected, symptoms can include:
- Pain that travels from the neck or back into an arm or leg
- Sharp, burning, shooting or electric-like pain
- Numbness, tingling or pins and needles
- Muscle weakness
- Reduced grip strength
- Weakness in the leg, ankle or foot
- Reduced reflexes
- Pain that changes with certain neck or back movements, sitting or walking
Please call 000 or visit an emergency department for loss of bladder or bowel control, numbness around the groin or saddle area, rapidly worsening weakness or sudden difficulty walking.
How is radiculopathy diagnosed?
X-RAY
Shows spinal alignment, arthritis, disc space narrowing and bony changes that may contribute to nerve compression.
MRI
Captures detailed images of the discs, nerves, spinal cord and surrounding tissues to identify where a nerve may be compressed or irritated.
CT SCAN
Provides a detailed view of the bones of the spine and can assess bone spurs, arthritis, fractures, previous surgery or assist with surgical planning.
NERVE CONDUCTION STUDIES
Measure how electrical signals travel through the nerves and can help assess numbness, tingling, weakness or radiating pain.
ELECTROMYOGRAPHY (EMG)
Examines the electrical activity of muscles and can help determine if symptoms are related to nerve irritation or damage.
Treatments for radiculopathy
Treatment begins with one or more non-operative options in most cases. Based on the cause and your symptoms, these can include physiotherapy, activity changes, medications and targeted spinal injections.
Spinal injections, including nerve root or epidural injections, may be used in selected cases to reduce inflammation around an irritated nerve or help determine which nerve is contributing to symptoms.
Surgery may be discussed when symptoms are persistent or worsening, weakness is progressing or imaging shows significant nerve compression. Depending on the cause and location, surgical treatment can include microdiscectomy, spinal decompression, foraminotomy, anterior cervical discectomy and fusion, artificial cervical disc replacement or spinal fusion.
Radiculopathy Treatment at Melbourne Spine Studio
Dr Alvin Pun is an Australian and internationally trained orthopaedic spine surgeon with subspecialty expertise in complex spinal disorders, including nerve-related conditions and a special interest in the surgical and non-surgical management of spinal nerve compression.
Consultations are available across Victoria at Toorak, East Melbourne, Box Hill, Wantirna and Mildura.