Get Treatment For Radiculopathy

The term radiculopathy describes a cluster of symptoms that result from compression or inflammation of spinal nerve roots. These symptoms usually appear along the pathway of the nerves, and not at the point where the compression has occurred. The symptoms of radiculopathy include a long-term back or neck pain, which travels along a nerve to other parts of your body, numbness, a "pins and needles" or burning or tingling sensation in your arms and legs, muscle weakness, and loss of reflex.

Pinched nerves or nerve root compression in the spinal column most commonly occurs because of direct pressure from a herniated disc (slipped disc), bone spur formation or soft tissue swelling. This disrupts the signals between the brain and the nerve endings. Radiculopathy is most likely to happen in your lower back, but may also occur in the neck region. A pinched nerve in the cervical spine can cause numbness in your fingers and hands. The treatment of radiculopathy depends on the underlying causes.

Radiculopathy - Surgical Procedures Performed at Cedars-Sinai Marina del Rey Hospital

Spinal surgery is recommended when all the conservative treatment options prove to be ineffective in providing relief from radiculopathy symptoms or if there are signs of nerve damage. Surgery can relieve your symptoms as well as remove the source that exerts pressure on the nerve roots.

At Cedars-Sinai Marina del Rey Hospital, spinal surgeons make use of advanced techniques to perform spinal decompression. In a majority of radiculopathy patients, a spinal decompression is advised during which a small portion of the damaged spine is removed to avoid the pinching of the nerve roots. In some patients, a stabilization surgery will be necessary to improve the stability of the spine and relieve pressure exerted on the pinched nerve.

Minimally invasive spinal surgery is preferred over traditional open surgery because of its benefits such as short recovery period, safety and effectiveness, and lesser risk of complications. During minimally invasive spinal decompression procedures, the muscles and tissues are spared from being damaged as it requires only a 1-inch incision to create an approach to your spine. Then, the bone, ligament, or any other tissue that compresses on the nerve roots is removed. The procedures involved in minimally invasive decompression include the following:

• Foraminotomy
• Laminotomy
• Discectomy

During the minimally invasive stabilization procedures, after removing the affected portion of the disc, an implant is inserted in order to provide immediate stability and pain relief.

Drugs and Other Treatment Needed for Radiculopathy

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Symptoms of Radiculopathy

The common symptoms of radiculopathy or pinched nerve include:

• Pain that may be described as dull, throbbing or sharp in intensity
• Radiating kind of pain
• Feeling of numbness or tingling often described as “pins and needles” sensation in the arms and legs
• Weakness in the arms and legs

Diagnosis of Radiculopathy

Your doctor will find the cause of the pinched nerves with the help of certain tests and a complete physical examination.

Physical examination: Your doctor will ask you questions about your past medical history, present symptoms, and general health condition. Then, an examination of your neck, shoulder, arms, and hands is done to check for any loss of sensation, weakness or change in the reflexes. You may be asked to move your neck or arm in a certain way to elicit your symptoms.

Diagnostic Tests

• X-rays: X-rays may reveal if there is a misalignment of the bones, damage to the discs or narrowing of the foramen.
• Computed tomography (CT) scan: This scan provides more details than plain radiographs, and helps to distinguish spurs surrounding the neuroforamen.
• Magnetic resonance imaging (MRI) scan: This scan creates detailed images of soft tissues, such as nerves and discs. An MRI scan can reveal whether the pinched nerve is because of soft tissue damage (bulging discs or herniated discs) or damage to the nerve roots or the spinal cord itself.
• Electromyography (EMG): This test measures the electric impulses of your muscles at rest and at contractions. Nerve conduction studies performed along with EMG helps your doctor check whether your symptoms are due to pressure on spinal nerves or by any other condition that has damaged the nerves, for instance, diabetes.

Risk Factors for Radiculopathy

The factors involved in increasing your risk of developing radiculopathy include:

• Abnormalities in the anatomy of your spine: Spinal disc herniation, bulging discs, bone spur formation, and a condition called spondylolisthesis.
• Aging: A common cause of spinal degenerative diseases is advancing age.
• Genetic factors
• Poor body posture
• Overuse injuries

Causes of Radiculopathy

The anatomical cause of radiculopathy is abnormal pressure over one of the spinal nerve roots. The specific causes of radiculopathy may vary, but arise from spinal disorders such as:

• Herniated disc in the lumbar, cervical, and thoracic spinal segments: A herniated disc usually occurs with pulling, lifting, bending, and twisting type of movements.
• Degenerative disc diseases: These include arthritis or spondylosis. These result in worn-out discs and pinched nerves that occur with increasing age.
• Traumatic injury to the spine
• Spinal stenosis: This involves the narrowing of the spinal column, which further increases the chances of exerting excessive pressure on the nerve roots.
• Foraminal stenosis: In this condition, the opening through which the nerves come out of the spinal canal becomes narrow causing pressure on the nerve root.
• The presence of tumors or bone spurs in the spinal canal.

Alternative treatments for radiculopathy should be used along with conventional treatments and under your doctor’s supervision. The common alternative therapies used for radiculopathy are:

• Acupuncture: This ancient form of Chinese medicine has been useful in managing radiculopathy pain. In this method, the acupuncturist will insert a fine needle into specifically identified points on your body. This method is usually considered when pain control is ineffective with medications, physical therapy or a combination of these. On the other hand, acupuncture can be used in place of cervical epidural steroid injections in patients who are unable to take these injections. The Council of Acupuncture and Oriental Medicine Associations have proposed evidence-based guidelines in which acupuncture has been recommended in the treatment of cervical radiculopathy.
• Chiropractic treatment: Chiropractic treatments include spinal manipulation to improve spinal functions and reduce pain. This type of treatment can help relieve the pressure on the nerve roots and provide a marked reduction in pain caused by pinched nerves.

The only way to prevent radiculopathy is to avoid the compression of the nerve roots in the spine. Compression of nerve or pinched nerve commonly occurs due to a degenerative condition of the spine, which develops as your spine becomes weak with advancing age. While spinal degeneration cannot be prevented, there are certain measures you can take to improve the strength and flexibility of your neck and back region. This, in turn, can avoid nerve compression.

Pinched nerve prevention can also be achieved by avoiding unreasonable stress on your spine. Poor posture, being obese, and stretching in an incorrect way can increase the stress on your back and neck. There are few lifestyle changes that can be made to improve your spine health. The preventive methods include the following:

• Maintain a healthy body weight
• Diet: Eat a well-balanced diet and drink a lot of water every day.
• Stay physically active: Take part in low-impact and stretching exercises daily.
• Maintain good posture at your workplace: If you sit for a long time at your job, take timely breaks and walk around, and maintain an ergonomic posture.
• Avoid lifting heavy weights or use proper techniques of lifting weights
• Quit smoking and limit alcohol consumption.

If you need to know more about radiculopathy or pinched nerves, feel free to contact our specialty-trained, orthopedic spine surgeons at Cedars-Sinai Marina del Rey Hospital.