Radiculopathy - Pain Caused by Nerve Roots

Radiculopathy

Doctors use the term radiculopathy to specifically describe pain, and other symptoms like numbness, tingling, and weakness in your arms or legs that are caused by a problem with your nerve roots. The nerve roots are branches of the spinal cord that carry signals to the rest of the body at each level along the spine. This term comes from a combination of the Latin word "radix," which means the roots of a tree, and the Latin word "pathos," which means a disease.
This disease is often caused by direct pressure from a herniated disc or degenerative changes in the lumbar spine that cause irritation and inflammation of the nerve roots.

Radiculopathy usually creates a pattern of pain and numbness that is felt in your arms or your legs in the area of skin supplied the by sensory fibers of the nerve root, and weakness in the muscles that are also supplied by the same nerve root. The number of roots that are involved can vary, from one to several, and it can also affect both sides of the body at the same time.

Illustration of the dermatomal distribution of the nerve roots. On sensory and motor neurological examination, the offending nerve root can often be identified by the distribution of symptoms and signs.

Symptoms

The most common symptom of true sciatica is posterior thigh, lower leg or foot pain that can be much worse than the accompanying lower back pain. Usually a patient will experience moderate to severe pain, which begins in the buttocks and runs down through the leg or foot. It is important to know that true sciatica will produce pain that radiates beyond the knee. Often a patient will have a previous history of lower back pain beginning a few days or weeks before the leg pain occurs, then the leg pain becomes worse than the back pain, and in some cases the back pain will completely disappear.

However, in the case of longstanding history of sciatica, the pain may gradually become localized to the buttocks and back of the leg. In this situation, the patient may have a vague aching pain that does not reach all the way to the lower leg or foot, though it may have done so earlier in the course of the disease.

Often there is not a specific traumatic event or motion associated with the onset of sciatica. Standing, sitting, heavy lifting, sneezing, or having a bowel movement may aggravate the pain. Lying down is usually the most comfortable position. Occasionally paresthesias, weakness and diminished bowel or bladder function will accompany sciatica, but these are rare symptoms.

Diagnosis and Treatment

A thorough history and physical examination is an important part of the diagnosis of sciatica. Nerve root tension tests can be used to confirm the presence of sciatica by attempting to reproduce the discomfort with certain motions and body positions. These tests are performed by a doctor and involve moving the legs in certain ways that slightly stretch the sciatic nerve. If the patient experiences pain during these tests, an irritated sciatic nerve is likely to be a source of the pain.