Radiculopathy

Radiculopathy is a clinical term for symptoms that occur when a spinal nerve root becomes compressed, irritated, or inflamed. The spine is made up of a series of vertebrae stacked on top of one another, and between each vertebra, nerve roots branch off from the spinal cord and travel outward to supply sensation and motor function to different parts of the body. When one of these nerve roots is pinched or chemically irritated, it can produce symptoms that travel along the path that nerve serves.

Radiculopathy can occur anywhere in the spine but is most common in the neck (cervical radiculopathy) and the lower back (lumbar radiculopathy). The location of the affected nerve root determines where the symptoms are felt, which is why a careful clinical evaluation is so important in pinpointing exactly where the problem originates.

Cervical radiculopathy occurs when a nerve root in the cervical spine, the seven vertebrae in your neck, becomes compressed. Symptoms typically travel from the neck into one shoulder, arm, and hand. The specific pattern of pain, numbness, and weakness depends on which nerve root is affected.

Common symptoms include a sharp or burning pain in the neck and shoulder that radiates down the arm, numbness or tingling in the hand or fingers, weakness in the arm or grip, and a sensation that something is wrong with fine motor tasks like buttoning a shirt or typing. Some patients also notice that certain neck positions aggravate the symptoms while others provide temporary relief.

Lumbar radiculopathy involves compression of nerve roots in the lower back and is one of the most common causes of leg pain. The symptoms travel from the lumbar spine into the buttock, thigh, calf, and sometimes the foot. When the sciatic nerve roots are involved, this condition is often referred to as sciatica.

Symptoms can include pain that shoots or burns down one leg, weakness in the leg or foot, difficulty walking or standing for long periods, and numbness or a pins-and-needles sensation in specific areas of the leg or foot. In more severe cases, patients may notice the foot cannot be lifted properly during walking.

The most common cause of radiculopathy is a herniated or bulging spinal disc. When the soft interior of a disc pushes outward through its outer layer, it can press directly on a nearby nerve root. Degenerative disc disease, bone spurs from osteoarthritis, thickened spinal ligaments, and spinal stenosis are also frequent contributors.

Less commonly, radiculopathy can be caused by spinal tumors, infections, or traumatic injuries. In some cases, there may be more than one contributing factor at play. That is why a thorough diagnostic process is essential to identifying the exact source of nerve compression.

Dr. McCutcheon begins every evaluation with a detailed discussion of your symptoms, including when they started, what makes them better or worse, and how they are affecting your ability to function. A physical examination follows, with a focus on testing strength, reflexes, sensation, and range of motion in the affected areas.

Imaging studies are critical for confirming radiculopathy and identifying the underlying cause. MRI is the preferred imaging tool, as it provides clear views of nerve roots, discs, and soft tissues. CT scans and X-rays may also be used to evaluate bony structures and spinal alignment. In some cases, nerve conduction studies or electromyography (EMG) may be ordered to assess nerve function more precisely.

Treatment for radiculopathy depends on the severity of symptoms, the underlying cause, and how long the condition has been present. Many patients benefit from conservative treatments such as physical therapy to improve posture, flexibility, and strength, anti-inflammatory or nerve pain medications, epidural steroid injections to reduce inflammation around the affected nerve root, activity modification and ergonomic adjustments, and rest and ice or heat application for symptom management.

When conservative treatment does not provide relief, or when there is progressive weakness, loss of function, or significant nerve compression visible on imaging, surgical intervention may be recommended. Common surgical options include microdiscectomy to remove a herniated disc fragment compressing the nerve, foraminotomy to widen the opening where the nerve exits the spine, laminectomy to relieve pressure in the spinal canal, and spinal fusion when instability is present.

Dr. McCutcheon specializes in minimally invasive techniques that can allow for faster recovery, smaller incisions, and reduced tissue trauma. Every treatment plan is customized to the individual, taking into account the specific location and cause of nerve compression, your overall health, and your personal goals for recovery.