Radiculopathy Treatment

Medically reviewed by Joshua L. Hare, DO, Founder & Medical Director

Radiculopathy is a pinched nerve root in the spine

Radiculopathy occurs when a spinal nerve root is compressed, irritated, or inflamed as it exits the spinal column. This compression can be caused by herniated discs,[1] bone spurs, spinal stenosis, or degenerative changes, and results in pain, numbness, tingling, or weakness that radiates along the path of the affected nerve. Cervical radiculopathy affects the arms and hands, while lumbar radiculopathy (the most common form, often called sciatica) affects the legs and feet. At IPC, we use fluoroscopic-guided diagnostic and therapeutic injections to precisely identify and treat the affected nerve root. Treatment options include transforaminal epidural steroid injections, selective nerve root blocks, and for patients who need decompression, minimally invasive procedures like percutaneous disc decompression or ELID.

The terms overlap, but they describe different parts of the problem. Back pain describes where pain is felt; radiculopathy identifies spinal nerve-root involvement. Lumbar radiculopathy can produce sciatica,[2] the radiating leg-pain pattern covered in our sciatica guide. Cervical radiculopathy instead affects nerves traveling toward the arm and hand.

Symptoms of radiculopathy

Radiculopathy is what happens when a spinal nerve root is compressed or irritated where it exits the spine. The distinguishing feature is that symptoms follow the territory of that specific nerve rather than spreading diffusely.

• Pain radiating along a defined path — from the neck into the shoulder, arm and specific fingers, or from the low back into the buttock, leg and specific toes
• Numbness or tingling in that same band of skin
• Weakness in the particular muscles that nerve supplies — difficulty lifting the front of the foot, rising onto tiptoes, or gripping and holding objects
• Pain that is often sharp, burning or electric rather than a dull ache
• Symptoms provoked by particular positions, and by coughing, sneezing or straining

Which fingers or toes are involved is genuinely useful diagnostic information, because it indicates which nerve root is affected. It is worth noting before an appointment.

When to see a pain specialist about radiculopathy

Arrange an evaluation if radiating symptoms have persisted beyond a few weeks, if pain is severe enough to disturb sleep, or if numbness or weakness is present at all.

The value of a specialist assessment is confirming which nerve root is responsible, since imaging commonly shows changes at several levels and not all of them are causing symptoms. A diagnostic transforaminal injection under live X-ray guidance can identify the level precisely, and the same route is used therapeutically to reduce inflammation around the nerve.

Weakness that is getting worse, rather than staying stable, needs prompt assessment — a foot that is starting to drop or a grip that is measurably weakening should not wait. New loss of bladder or bowel control, numbness in the saddle area, or weakness in both legs needs same-day emergency assessment.

Treatment options for radiculopathy

Radiculopathy means a specific nerve root is involved, so the first task is working out which one. Several of the options below are diagnostic as well as therapeutic, and what they show guides the decisions after them.

References

Clinical sources for this page.

1. National Library of Medicine, MedlinePlus Medical Encyclopedia. Herniated disk. Back to first citation ↑
2. Johns Hopkins Medicine. Radiculopathy. Back to first citation ↑