1. What is Radiculopathy?

Radiculopathy is a condition caused by irritation, compression, or inflammation of a spinal nerve root. This can result in pain, numbness, tingling, or weakness along the path of the affected nerve. It most commonly occurs in the neck (cervical radiculopathy) or lower back (lumbar radiculopathy).

2. Causes

Radiculopathy can develop from a variety of conditions that place pressure on the spinal nerves:

• Herniated or bulging discs: When the soft center of a spinal disc pushes through its outer layer.

• Spinal stenosis: Narrowing of the spaces within the spine, which can compress nerves.

• Bone spurs (osteophytes): Extra bone growth that can pinch nerves.

• Degenerative disc disease: Age-related changes in the spine that affect disc height and flexibility.

• Trauma or injury: Accidents or falls causing nerve compression.

• Tumors or infections: Rarely, growths or infections in the spine can lead to radiculopathy.

3. Symptoms

Symptoms usually follow the pathway of the affected nerve and may include:

• Sharp or burning pain radiating down the arm or leg

• Numbness or tingling in the fingers, hands, toes, or feet

• Muscle weakness in the affected limb

• Reduced reflexes in the arm or leg

• Worsening pain with certain movements, such as coughing, sneezing, or twisting

4. Diagnosis

Diagnosis of radiculopathy typically involves a combination of:

• Medical history and physical examination: Assessment of pain distribution, strength, reflexes, and sensory changes.

• Imaging studies: MRI or CT scans to visualize nerve compression or spinal abnormalities.

• Electrodiagnostic tests: Nerve conduction studies or electromyography (EMG) to evaluate nerve function.

5. Treatments

Treatment for radiculopathy depends on the severity and underlying cause and often begins with conservative approaches:

• Rest and activity modification: Avoiding movements that worsen symptoms.

• Physical therapy: Exercises to improve flexibility, strength, and posture.

• Medications: Anti-inflammatory drugs, pain relievers, or nerve-modulating medications.

• Epidural steroid injections: Targeted injections to reduce nerve inflammation and pain.

For patients who do not improve with conservative care, surgical options may be considered. Modern techniques often focus on minimally invasive spine surgery, which aims to relieve nerve compression with smaller incisions, reduced tissue disruption, and faster recovery. Examples include:

• Minimally invasive microdiscectomy: Removing herniated disc material using small instruments.

• Minimally invasive laminectomy or foraminotomy: Widening nerve passageways while preserving spinal stability.

• Endoscopic spine surgery: Using specialized cameras and instruments to treat nerve compression through tiny incisions.