Radiculopathy: Pinched Nerve Symptoms, Causes, and Treatment Options
Learn about radiculopathy, a condition caused by compression of spinal nerve roots. Understand symptoms, causes, and treatment options for pinched nerve conditions.
Introduction
Radiculopathy, commonly referred to as a "pinched nerve," is a condition resulting from the compression (pinching) of the spinal nerve roots as they branch off to the rest of the body. Radiculopathy frequently results from other primary degenerative diseases of the spine and is one of the more common pain syndromes resulting from degenerative diseases of the spine (1). This article discusses some of the common causes of radiculopathy, symptoms to watch out for, and treatment options to help your back feel better. For further information on related conditions and treatments, click on the relevant hyperlinks below.
Cervical Radiculopathy
Watch this educational video to learn about cervical radiculopathy, a pinched nerve condition affecting the neck and upper extremities.
Causes
Radiculopathy involves pinching of the spinal nerve at the hole where it exits the spinal canal. As such, pinched nerves typically result from diseases that cause these holes to narrow. In patients below the age of sixty, herniated discs are the most common cause of radiculopathy, however in older patients, spinal stenosis becomes more common (likely a result of differences in the demographics affected by herniated discs and spinal stenosis) (2). Other conditions that may cause radiculopathy include:
- Spondylosis (arthritis of the facet joints of the spine)
- Spondylolisthesis (forward slippage of the spinal vertebrae causing misalignment)
- Tumor/Malignancy
Symptoms
Radiculopathy is a condition defined by the presence of both pain and sensory changes in the region controlled by the pinched spinal nerve affected. Though back pain is often present, traveling/referred pain is often more severe and is more critical for the diagnosis of radiculopathy. Patients with lumbar (lower spine) radiculopathy may show the following:
- Leg pain (often highly localized)
- Altered sensation, numbness, or tingling in one leg
- Decreased strength or muscle coordination in one leg
*Patients with lumbar radiculopathy will also typically have a positive straight leg raise sign on physical examination, where pain symptoms are recreated when the patient attempts to elevate only one leg in the lying position*
Patients with cervical (upper spine) radiculopathy are more likely to exhibit:
- Arm pain (often highly localized and radiating from the upper back)
- Altered sensation, numbness, or tingling in one arm
- Decreased strength or muscle coordination in one arm
Some patients may exhibit red flag symptoms suggestive of rapidly progressive disease requiring the immediate attention of a trained medical professional. These include:
- Progressive weakness/numbness in the affected area
- Loss of bowel/bladder control
- Numbness of the anus and genitalia
- Fever, chills, or other signs of infection
- Weight loss and/or night sweats
Treatment Options
The vast majority (over 80%) of patients with radiculopathy see symptoms resolve without intervention within one month (3, 4). Patients frequently benefit from supportive care, emphasizing use of NSAIDS (eg. ibuprofen/Advil™, naproxen/Alieve™, etc), physical therapy to maintain functional mobility, and individualized occupational and postural adjustments.
Between two and six weeks from the onset of symptoms, epidural corticosteroid injections may provide significant pain relief, however, they do not address the underlying cause of pain and/or weakness. Surgery is typically only recommended for those with red flag symptoms or those with pain/weakness that remains inhibitive despite four-to-six weeks of conservative treatment.
Lumbar Radiculopathy
Learn about lumbar radiculopathy, a pinched nerve condition affecting the lower back and legs.
Sources
- https://www.neurology.org/doi/10.1212/WNL.0000000000213361?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
- https://pubmed.ncbi.nlm.nih.gov/34115979/
- https://linkinghub.elsevier.com/retrieve/pii/S1546-1440(25)00141-3
- https://pubmed.ncbi.nlm.nih.gov/34115979/
- https://www.neurology.org/doi/10.1212/WNL.0000000000213361?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Ready to Discuss Your Condition?
Contact our team to schedule a consultation and learn more about treatment options tailored to your needs.
Individual patient results vary. This information is educational and not a substitute for professional medical advice.