How painful is radiculopathy and is it a spinal condition that always requires surgery?

Radiculopathy, while a fairly common condition, may not be a term with which most people are familiar. Using the less technical “pinched nerve” or “sciatica” terms are far more likely to ring a bell. Other times the diagnosis might otherwise be labeled “piriformis syndrome” or “Sacroiliac (SI) joint pain.” The image produced by the thought of a nerve being pinched is also a pretty good way of thinking about radiculopathy. 

The spinal cord, which is made up of nerve tissue, is what connects the brain with the rest of the body. It runs through the spinal column and is, at the same time, extremely important and extremely fragile. To protect the spinal cord, there are a series of bones surrounding it. These are the vertebrae, which are designed to allow nerve roots to split off from the spinal cord and travel out to all of the other areas of the body. 

The definition of radiculopathy is based on the range of symptoms that are experienced when something causes a nerve in, or as it exits,  the spinal column to be compressed (pinched), inflamed or irritated. These symptoms will be different, depending upon what area of the spinal column is affected. 

Symptoms of Radiculopathy Based on Spinal Column Location      

Lumbar or Lumbosacral Radiculopathy — the lumbar region of the spine is in the lower back and this is where radiculopathy is most often found. This is also the region where the sciatic nerve is located and lumbar radiculopathy is commonly referred to as sciatica. Symptoms consist of pain and numbness and are generally felt anywhere from the lower back all the way down to the foot.

Thoracic Radiculopathy — the thoracic region of the spine is located in the upper back. Nerve compression is uncommon in this area. If it does happen, the symptoms are usually described as a band of pain that circles around the chest.  Statistically, this is a much less common presentation. The thoracic spine is a common location for the infectious origin of nerve root pain known as “shingles.”

Cervical Radiculopathy — the part of the spine that passes through the neck is referred to as the cervical spine and when a nerve in this area becomes compressed or pinched, it is diagnosed as cervical radiculopathy. Symptoms of cervical radiculopathy can be felt in the neck, chest, shoulders and down into the arms and hands. In addition to pain, these symptoms may include muscle weakness, numbness, tingling and loss of fine motor coordination.   

Radiculopathy can be quite painful and limit your ability to move and function normally. The good news is that it will usually go away on its own. Over-the-counter medications to reduce the pain and discomfort, plus anti-inflammatory drugs for the inflammation can help. Modifying activities to keep from aggravating the area and using ice or heat is also recommended. Your healthcare professional may also prescribe muscle relaxers, fluoroscopically guided steroid injections, acupuncture, and physical therapy.  

Surgery may be required in those cases where more conservative methods were not successful. If the condition is severely affecting the quality of life or if neurological decline is evident, your spine surgeon may recommend the removal of tissue or bone that is compressing the nerve. In such scenarios, our physiatric team would help in planning the appropriate surgery, communicating with your surgical specialist, and guiding post-operative rehabilitation.

While most of the time a pinched nerve will heal on its own, it is important to seek medical help right away if you experience any of the following more emergent  symptoms:

  • Sudden and ongoing weakness or numbness in the arm or leg
  • Paralysis in the arm or leg (or anywhere)
  • Incontinence or loss of bowel control
  • Loss of feeling in the genital or anal regions

At Long Island Spine Rehabilitation Medicine, our physicians are committed to more than just treating your symptoms. We strongly believe that each individual is best served through an integrative treatment plan. We focus on finding the underlying cause and providing non-surgical, evidenced-based solutions tailored to your specific condition and needs. If you are experiencing back pain or have questions about any condition or service, we invite you to schedule a consultation by using our convenient online form by clicking here.