radiculopathy

Generality

Radiculopathy is a pathological condition that affects the roots of the spinal nerves and their extensions, with consequent involvement of the motor and sensory functions of the organism.

Radiculopathy can affect both a single nerve root and several nerve roots simultaneously.

There are different forms of radiculopathy, but the most widespread appear to be those that occur at the cervical level (so we speak of cervical radiculopathies ) and at the lumbar and sacral level (in this case, we speak of lumbo-sacral radiculopathies ).

Causes

In most cases, radiculopathy is caused by a compression of the spinal nerve roots. In turn, these compressions can be caused by various diseases and disorders, such as:

Rheumatoid arthritis;
Disc hernias;
Meningitis that can extend to the spinal nerve roots;
Presence of osteophytes;
Scoliosis;
Thickening of the surrounding ligaments;
Spinal column neoplasms (however, it is a rather rare event that this type of neoplasias gives rise to radiculopathy).

Furthermore, infections caused by Herpes zoster, Lyme disease, syphilis and histoplasmosis can also be the cause of the onset of radiculopathy. In other cases, this disorder may represent one of the complications of diabetes.

Finally, radiculopathy can also be caused by trauma to the spine (as happens, for example, in the case of a fracture of the vertebrae); not surprisingly, patients who practice certain types of sports or perform heavy jobs that involve frequent and excessive loads on the spine, are exposed to a greater risk of developing this pathological condition.

Symptoms

Depending on the nerve root involved, and depending on the extent of nerve damage, the symptoms triggered by radiculopathy can be different and affect various parts of the body.

In fact, the spinal nerves control different parts of the body and this is why cervical radiculopathy produces typical symptoms at the level of the neck, while the lumbar one causes a characteristic symptomatology at the level of the lower limbs.

However, among the main symptoms that can appear in case of radiculopathy, we remember:

Asthenia;
Hyperalgesia;
Pain in various areas of the body (color, feet, lower and upper limbs, back, shoulders, joints) which can be exacerbated by the execution of various types of movements;
hyperreflexia;
Hypoaesthesia;
paresthesia;
Muscle stiffness and weakness;
Spastic tetraparesis.

Furthermore, lumbosacral radiculopathy, when it involves more nerve roots at the same time, can give rise to serious complications such as sphincter alterations and sexual dysfunctions.

In any case, for more detailed information on this subject, please refer to the article on this site "Symptoms Radiculopathy".

Diagnosis

The diagnosis of radiculopathy must be made by the doctor, who will evaluate all the symptoms presented by the patient. In addition to this, the doctor can resort to performing specific tests, such as, for example, CT, MRI, X-rays, electromyography and blood tests, so as to be able to definitively confirm his diagnosis.

Naturally, once the presence of radiculopathy has been ascertained, it is necessary to identify the triggering cause in order to establish the most appropriate treatment for each individual case.

Treatment

As mentioned, for the treatment of radiculopathy it is, first of all, fundamental to identify the triggering cause and intervene on the latter.

However, since radiculopathy is a painful disorder, whose symptoms can greatly affect the quality of life of patients suffering from it, the doctor may decide to prescribe the administration of pain control drugs and other symptoms associated with this particular pathological condition.

Among the different drugs that can be used to control the symptoms of radiculopathy, we recall:

Non- steroidal anti-inflammatory drugs (NSAIDs), such as, for example, ibuprofen, ketoprofen or naproxen . These active ingredients, thanks to their particular mechanism of action, are able to exert an analgesic and anti-inflammatory action. Thanks to the use of NSAIDs, therefore, not only can pain control be achieved, but the inflammation of the nerve affected by radiculopathy can also be counteracted.
Among the main side effects caused by this large category of drugs, we recall those that occur at the gastrointestinal level (gastrolesivity).
Antidepressants belonging to the tricyclic class (such as clomipramine ) and to the class of selective serotonin and noradrenaline reuptake inhibitors (such as duloxetine ). These active ingredients are normally used in the treatment of depression; however, they have also proved to be particularly effective in combating neuropathic pain, which can occur in the event of nerve damage, therefore also in the case of radiculopathy.
The side effects induced by these drugs can vary greatly depending on the active ingredient used.
Anticonvulsants, such as gabapentin and pregabalin . These active ingredients - normally used in the treatment of epilepsy - have also proved effective in treating neuropathic pain.
Among the main side effects that may occur following the use of the aforementioned anticonvulsant drugs, we recall dizziness and drowsiness.
Muscle relaxants, such as tizanidine and baclofen . These active ingredients are used for the treatment of spasticity which can be one of the symptoms of radiculopathy.
Among the adverse effects that can occur after taking these drugs, we find: sedation, marked muscle weakness and dizziness.