Radiculopathy

By Ehren Allen, Certified Manual Therapist/Physical Therapist

Radiculopathy

Radiculopathy is symptoms that originate in the spine but radiate to the extremities.  The symptoms are usually in just 1 of the extremities.  You man have symptoms in both legs or both arms can happen if both sides of the spine are involved.

Symptoms of Radiculopathy

Symptoms of radiculopathy include:

• Pain that radiates
• Loss of sensation
• Decreased muscle strength
• Loss of Reflexes

The symptoms of radiculopathy usually follow the specific pattern related to the spine level involved. Areas of the skin in the arms and legs have nerve sensations from specific spine levels. These skin areas are known as dermatomes.

Causes of Radiculopathy

Muscle groups in the legs are linked to specific spine levels as well.  There is crossover from other spine levels but certain muscle groups receive most of their nerve supply from one spinal nerve level. This may lead to weakness in the muscles related to the spinal levels. The muscles that relate to specific spine levels are known as Myotomes.

Issues that can cause radiculopathy from the spine include:

• Arthritis
• Bone Spurs
• Herniated Disk
• Degenerative Disk Disease

Some other common causes include bone spurs on the spine, tumors, scoliosis diabetes, or trauma.

Chronic Pain from Radiculopathy

In more long term or severe cases, chronic pain can result. The definition of chronic, is pain that lasts longer than the normal healing time for an injury, or more than 3 to 6 months. Symptoms include those of radiculopathy, but can also include dull muscle aches and burning sensations.

Diagnosis of Radiculopathy

Diagnosis of the cause and origin of the leg pain requires a detailed patient history and examination. Prior to consulting with your doctor, it is best to keep a journal of the severity of symptoms.  Write down how long the symptoms last and what makes them better or worse. Also, what other medical problems are present. The more specific information you can give the doctor, the better they will be able to localize the exact nerve that may be causing your symptoms.

To learn more about Robotic Spine Surgery, please read this article.

Treatment of Radiculopathy

Treatment of Radiculopathy may include:

• Physical Therapy
• Medication
• Guided Injections
• Surgical intervention

Physical therapy is typically the first line of defense. PT is a conservative treatment that can reduce symptoms and improve mobility and function. Physical therapists perform thorough evaluations to determine the source of the symptoms. They use manual therapy, exercises, education, and modalities to help reduce symptoms.

Your physician may give you oral pain medications or anti-inflammatory medications.  This is often helpful early in the recovery process in conjunction with physical therapy. Your MD may wean you off of pain medications as early as possible due to risk of dependency.

Guided injections are another treatment option. The MD will place a steroid medication at the site of the injury or involved spine level. Doctors use image guidance to place the needle in the precise location of the spine.

By: Ehren Allen, PT 

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