Radiculopathy / Pinched Nerve

Radiculopathy / Pinched Nerve

What is a pinched nerve?

A pinched (compressed) nerve occurs when pressure is applied to a nerve by items surrounding the nerve, typically disc tissue or bone spurs. But other structures such as ligaments and cysts can apply pressure disrupting the nerve and causing pain, tingling, numbness or weakness.

Radiculopathy is the condition that refers to a pinched nerve root within the spine that causes pain to travel into your arms or legs.  This can occur in any of the five regions of the spine:

  • Tailbone
  • Sacrum, which is around the hips
  • Lower back or lumbar area
  • Mid-back or thoracic area
  • Neck or cervical spine

While injuries are a common cause of a pinched nerve, it is important to know that a nerve can become pinched for a number of reasons.

Symptoms of a pinched nerve

Signs and symptoms of a pinched nerve or radiculopathy include:

  • Numbness or decreased sensation in the area supplied by the nerve
  • Sharp, burning or radiating pain that worsens when you sit or move your neck or head
  • Numbness or tingling
  • Muscle weakness

It is not always possible to pinpoint a cause for a pinched nerve. However, there are many known conditions and injuries that can cause radiculopathy in the spine:

  • Degenerative disc disease
  • Herniated discs
  • Spinal stenosis
  • Bone spurs
  • Compression fractures
  • Osteoarthritis

The following factors can increase the chance of a nerve becoming pinched:

  • Underlying congenital stenosis
  • Degenerative arthritis causing mild to moderate stenosis
  • Prior fusion causing adjacent segment degeneration

The following factors may increase the likelihood of developing radiculopathy:

  • Trauma
  • Work-related injury
  • Poor posture
  • Obesity
  • Repetitive motions (overuse)
  • Pregnancy
  • Aging

Treatments for radiculopathy

Conservative options

Conservative treatment options include epidural steroid injections and nerve root blocks, medications, and exercises. Steroid injections may significantly help depending on the level of compression and may be performed 1-2 times.  If pain and disability persist, then surgery may be necessary.

Physical/chiropractic therapy and exercises can also adjust, stretch and strengthen muscles in the affected area to relieve pressure on the nerve. Modifications to normal activities that aggravate the nerve can also help decrease pain. 

Surgery

Studies have shown that a pinched nerve due to a disc herniation can resolve up to 90% of the time within 3 months.  The problem is the level of pain, numbness, and weakness that develops can either improve or be permanent. Also, the loss of wages and benefits need to be considered.  Depending on the severity of symptoms and failure of some conservative measures then surgery is indicated to decompress the nerve and attempt to restore functionality. Depending on where the problem is located and whether prior surgery has been performed some symptoms may continue such as numbness, weakness, and pain.  The type of surgery depends on the location of the pinched nerve and may involve removing bone spurs, a herniated disc, or severing a ligament to create room for the nerve to pass.

Pinched Nerves can be treated with the following procedures:

Endoscopic Spine Surgery
Cervical Disk Replacement
Laminotomy
Laminectomy
Foraminotomy
Discectomy

It is always best to work with a spine surgeon familiar with your problem and the various solutions to find the best approach for treating your symptoms.