Patient education: Radiculopathy of the neck and back (including sciatica) (The Basics)

What is radiculopathy? — 

This is weakness, numbness, or tingling that happens when nerves coming from the spinal cord get pinched or damaged. Radiculopathy can affect different parts of the body, depending on which nerve or group of nerves is affected. People sometimes refer to radiculopathy as having a "pinched nerve."

Here are 2 common examples of radiculopathy:

●Cervical radiculopathy – People with this type have pain, weakness, numbness, or tingling down 1 arm. It happens when 1 or more of the nerves that go from the spine to the arm get pinched or damaged.

●Lumbosacral radiculopathy – People with this type have pain, weakness, numbness, or tingling in the buttocks or down the leg. It happens when 1 or more of the nerves that go from the spine to the foot and leg get pinched or damaged. This is often called "sciatica."

What causes radiculopathy? — 

It is usually caused by a problem with the back. To understand radiculopathy, it's helpful to first learn a little about the back and spine.

The neck and back are made up of (figure 1):

●Vertebrae – These are the bones of the spine. Each has a hole in the center. The vertebrae are stacked on top of each other, and the holes form a hollow tube called the "spinal canal." The spinal cord passes through this tube and is protected by the vertebrae.

●Discs – Rubbery discs sit in between each of the vertebrae. These add cushion and allow movement.

●Spinal cord and nerves – The spinal cord is the bundle of nerves that connects the brain to the rest of the body. It runs through the vertebrae. Nerves branch from the spinal cord and pass in between the vertebrae. From there, they connect to the arms, legs, and organs.

●Muscles, tendons, and ligaments – These support the vertebrae. They are used to move the head and neck, stand upright, and bend and flex the body. They are also called the "soft tissues" of the neck and back.

Radiculopathy can happen when changes in the back cause a nerve to get pinched or damaged. This can happen if:

●The vertebrae form bumps called bone spurs, which press on nearby nerves. People with a condition called "spinal stenosis" often have this problem (figure 2).

●The discs between the vertebrae break open and bulge out (called "herniated discs"), causing them to press on or irritate nearby nerves.

●Other medical conditions, such as diabetes, infection, inflammation, or a tumor, injure the nerves near the spinal cord.

Should I see a doctor or nurse? — 

Yes. If you have new pain, weakness, numbness, or tingling in your arms or legs, see your doctor or nurse.

Will I need tests? — 

Maybe. Doctors can tell a lot about a person's radiculopathy based on which parts of the body are affected and how. So you might not need any tests, especially if you have had symptoms only for a short time.

But if your doctor is concerned about nerve damage, they might order 1 or more of these:

●Imaging tests, such as X-rays, MRIs, or CT scans – These create pictures of the inside of the body. They can show problems with the back.

●Electromyography ("EMG"), also called a "nerve conduction study" – This is a way to check how well electrical pulses travel across nerves to the part of the body that has symptoms. The test helps show whether the nerves controlling that body part are working right.

How is radiculopathy treated? — 

Many people do not need formal treatment. Sometimes, the radiculopathy goes away as the back and nerves heal. In other cases, people find ways to cope with their symptoms.

When people do get treatment, the treatments can include:

●Over-the-counter pain medicines (if these do not work, your doctor might prescribe a stronger pain medicine)

●Medicines to relax the muscles (called "muscle relaxants")

●Avoiding activities or positions that worsen pain

●Injections of medicines that numb the nerves in the back or reduce swelling

●Physical therapy to learn special exercises and stretches

●Surgery to repair the problem causing symptoms

More on this topic

Patient education: Radiculopathy of the neck and back (including sciatica) – Discharge instructions (The Basics)
Patient education: Exercises for sciatic pain (The Basics)
Patient education: Neck pain (The Basics)
Patient education: Whiplash (The Basics)
Patient education: Low back pain in adults (The Basics)
Patient education: Upper back pain (The Basics)
Patient education: Herniated disc (The Basics)
Patient education: Lumbar spinal stenosis (The Basics)

Patient education: Neck pain (Beyond the Basics)
Patient education: Low back pain in adults (Beyond the Basics)