What is radiculopathy?

In medicine, the term radiculopathy refers to the set of clinical pictures caused by peripheral nerve root problemsjust at or near its exit from the spinal cord.

Among its most frequent causes is pressure on the vertebrae of the spine, hence radiculopathy is known as "pinched nerves«.

As a consequence of radiculopathy, the affected nerves do not function properly and a neuropathy with various symptoms such as pain, weakness, numbness or difficulty controlling certain muscles and body parts.

Mechanism

The spine are made up of 33 vertebrae that protect the spinal cord against injuries and trauma.

The 33 vertebrae are held together and articulated by a system of muscles, tendons, and ligaments that make it possible for the human body to stand upright and to flex, bend, and twist.

In the spinal cord are born peripheral nervous system nerves. These nerves leave the spinal column at different heights and go to other areas of the body, such as the arms or legs.

Between each vertebra and neighboring vertebrae are the intervertebral discswhich allow the articulation between vertebrae with minimal vertebra-vertebra friction.

When an injury, trauma, or other problem occurs that causes damage to the intervertebral discsnearby nerve roots are subjected to abnormal compressionthis compression being the most common cause of radiculopathy.

This injury to the intervertebral discs can also be the result of a poor postural hygiene maintained over time or chronic (repetitive postures and movements, poor weight lifting techniques, etc.).

The spinal column is divided into several regions (cervical, thoracic, lumbar, sacral), with the regions cervical and lumbar the most frequently affected by radiculopathy.

By age, the highest frequency of radiculopathy occurs between 30 and 50 years.

Most frequent causes

The causes of radiculopathy are numerous and of very diverse origin, having in common that all of them damage or deteriorate in some way the vertebrae, the intervertebral discs or other structures of the spinal column.

Among the most frequent causes, we have:

  • disc herniation: occurs when an intervertebral disc has protrusions that press on the nerve roots. If the protrusion breaks, then a proper disc herniation occurs.
  • Sciatica
  • degenerative disc diseases
  • Bone spurs (osteophytes)
  • spinal tumors
  • spinal arthritis
  • spinal stenosisl (narrowed spinal canal, very painful disease)
  • Scoliosis (deviated spine)
  • Vertebral Compression Fractures
  • Diabetes (can cause the blood supply to the nerves to be altered)
  • Spondylolisthesis (occurs when a vertebra moves and is supported by the inner vertebra)
  • cauda equina syndrome (compression of the distal roots of the sacral, lumbar and coccygeal nerves, in the region of the cauda equina or “cauda equina”)
disc herniation
Herniated intervertebral disc presses on nerve roots and causes radiculopathy

Risk factor's

In addition to the diseases and conditions listed above, there are certain factors associated with an increased risk of radiculopathy.

The deterioration of bone tissues that occurs with the age it also affects the spine, so with age there is a greater risk of developing radiculopathy due to mechanical causes (spinal deviation, herniated discs, spurs, etc.).

Being overweight and poor postural hygiene are also risk factors for mechanical types of radiculopathy.

Among poor postural hygiene, movements and daily activities carried out in the work environment stand out, since they involve movements and loads on the spine that are repeated daily for long periods of time. The magnitude of this problem is such that postural hygiene in the work environment is a field that falls within the work safety plans.

Other causes may have their origin in genetic predisposition, hence the family history of bone degenerative diseases are another important risk factor.

Symptoms

The pain it is the main symptom and it frequently radiates towards the areas of the body innervated by the affected nerves. For example, a radiculopathy in the neck can cause pain and weakness in the arm (radiated pain should not be confused with reflex pain, whose cause and pathophysiological mechanism are very different).

  • cervical radiculopathy: occurs when nerves in the neck and upper back are pinched. Symptoms include pain, numbness, and tingling in the neck, shoulders, arms, and/or upper back.
  • Thoracic radiculopathy: Pinched or irritated nerves are located in the mid-back area. It produces pain in the chest and torso, numbness and tingling, stabbing pain in the ribs and abdomen. It is uncommon and is sometimes confused with symptoms of shingles or problems with the heart, bladder, and other abdominal organs.
  • lumbar radiculopathy: also called sciatica, produces pain in the lower back, legs and hip area. The pain can be localized or radiate from the lower back to the foot. It may be accompanied by numbness of the buttocks, feet or legs. Nerves that innervate the intestine and bladder can also be affected and cause fecal and urinary incontinence.

Diagnosis, treatment and prevention

The diagnosis of a radiculopathy is usually based on a Physical exam and in the symptomatologyand is usually confirmed by X-ray, MRI, computed tomography, and other imaging techniques. diagnostic imaging.

The main treatment of radiculopathy consists of physiotherapymuscle strengthening exercises and, if necessary, analgesic and anti-inflammatory medication.

Depending on the severity and specific conditions of the patient, the drugs used can be NSAIDs (ibuprofen, naproxen, etc.), corticosteroids or, in the most serious cases, opiate pain relievers.

In some cases, doctors may recommend surgery to repair a herniated intervertebral disc, bone spur, or other mechanical cause of the radiculopathy.

To prevent the appearance of radiculopathies it is very important to maintain good postural hygiene in daily life. This includes good posture in the work environment, using correct lifting techniques, engaging in regular physical exercise, and maintaining a proper body weight.

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