When the root of a nerve near the spinal column is inflamed or irritated, the symptoms can radiate out from it source; this is called radiculopathy or radiculitis. There are two main types of radiculopathy: cervical radiculopathy that originates in the neck and causes arm pain, and lumbar radiculopathy that originates in the lower back and causes leg pain.

Contact Us

Call to Schedule an Evaluation:

414-488-1111

What is Cervical Radiculopathy?

Cervical radiculopathy is characterized by pain that radiates from the neck to the arms. The important factors that suggest the need for more specific evaluation or treatment are the severity of the pain, the duration of the symptoms, and/or weakness in the neck or limbs.

Some patients have both neck and arm pain related to their pinched nerves, but some only have neck pain. For more information, please visit our Neck and Arm Pain page.

What are the Causes of Cervical Radiculopathy?

Muscle strain is a common cause of cervical radiculopathy, but it is usually temporary in nature.

Cervical radiculopathy can also be caused by degenerative changes that occur as a result of aging, genetics, and wearing out of the discs. Degenerative changes can cause changes in the vertebrae, as well, which often appear as bony spurs.

How is Cervical Radiculopathy Diagnosed?

Testing can include simple tests such as X-rays, computed tomography (CT or CAT) scans and MRIs to evaluate the source of problems.

Further, more invasive testing can include:

  • Nerve conduction studies, which measure nerve and muscle function.
  • Myelograms, a test where contrast dye is injected into the sack around the spinal cord followed by imaging studies to see what areas might be causing pressure on the spinal cord or nerve roots.
  • Discograms, in which a contrast dye is injected into the disc itself to determine whether it is herniated and to what extent the disc might be contributing to whatever symptoms are present.

How is Cervical Radiculopathy Treated?

Simple, conservative interventions for cervical radiculopathy can be as basic as instruction on posture and range of motion exercises aimed at minimizing further irritation to the nerve roots and strengthening the neck.

Another conservative treatment is cervical traction where the head is pulled up or pushed away from the shoulders for short periods of time each day. Additional treatments include physical therapy, activity modification, use of medications such as anti-inflammatories, pain medication, and/or muscle relaxants.

More invasive treatments include epidural steroid injections (ESIs) and surgery. Surgical options include, but are not limited to, discectomy to remove a portion of a disc, or fusion, which removes a disc and replaces it with bone chips and/or metal instruments to keep the area from bending.

What is Lumbar Radiculopathy?

When pain radiates from the back down the legs, the condition is called lumbar radiculopathy. The pain may radiate down one or occasionally both legs. It my travel down the front, back or side of the leg. It may involve the foot and toes, or it may stop anywhere in the leg.

It can be quite disabling and is responsible for over 100 million lost days of work per year. Somewhere between 75-80% of adults will experience low back pain at some point in their lives, usually from muscle strain, and it is a common cause of disability.

What are the Causes of Lumbar Radiculopathy?

Risk factors for back pain include smoking, obesity, particularly excess weight around the abdomen, and repetitive motion, such as that found in some occupations. Some other common causes of low back pain include disc injury, degeneration (aging or drying) of the disc or lumbar stenosis. Additional causes include compression fractures and spinal tumors.

How is it Diagnosed?

To diagnose low back pain, a neurosurgeon will use a combination of a complete medical history, a physical examination, and appropriate radiological imaging.

In many cases a magnetic resonance imaging scan (MRI) is indicated. Other tests may be necessary, including computed tomography (CT or CAT scan), electromyelogram (EMG), myelogram or discogram. An EMG involves inserting needles into nerves on the arms or legs, a myelogram involves contrast dye injected into the spinal column prior to X-ray, and a discogram involves inserting a needle and injecting dye into the disc.

What are the Treatment Options for Lower Back Pain?

The good news is that the majority of back pain patients will recover with conservative treatment, and surgery is not necessary. All patients will need to make routine exercise and proper body mechanics part of their everyday lifestyle to reduce the risk of injury.

Initial treatments for lower back pain is focused on pain relief and return to work and daily activities. Medications such as non-steroidal anti-inflammatories may reduce swelling and thereby discomfort. Physical therapy and exercises to stretch and strengthen the lower back and abdomen may be beneficial. In many cases, epidural steroid injections (ESIs) may provide relief of discomfort. The treatments are individualized based upon the patient’s symptoms.

If symptoms persist despite conservative therapy, surgical intervention may be considered. The specific type of surgery will vary depending upon the structural defect.

Possible surgeries include a lumbar microdiscectomy, lumbar laminectomy or spinal fusion with or without instrumentation. Microdiscectomy involves removing a disc with the aid of a surgical microscope. Laminectomy is removal of vertebral bone. Spinal fusion uses bone chips, with or without screws, rods or metal cages, to fuse together two vertebrae after the disc in between has been removed.

What is Recovery from Surgery Like?

When surgery is indicated, the majority of patients will recover in one to three months. Most patients will require medications for the immediate post-operative period, and some will require mild analgesia for longer periods. Most patients find that they have a significant return of function and are able to live healthy, productive lives. Using good body mechanics and following the physician’s instructions regarding bracing and lifting restrictions enhances the chances of successful recovery.