radiculopathy

Introduction

Dysfunction of a nerve root often caused by compression of the root. Pain, sensory impairment, weakness or depression of deep tendon reflexes may be noticed in the distribution of nerves derived from the involved nerve root.

Etiology

• compressive lesions
  • osteophyte
  • ruptured disk
  • neoplasm
• non-compressive lesions
  • post-infectious
  • inflammatory radiculopathy
  • metabolic - diabetes mellitus

Clinical manifestations

• sharp, lancinating pain in a dermatomal pattern
• pain is increased by coughing or sneezing
• pain often has a myotomal rather than dermatomal pattern
• manifestations in the root distribution
  • weakness
  • sensory impairment
  • decreased muscle stretch reflexes

Radiology

• magnetic resonance imaging
  • indications:
    • rule out malignancy or infection
    • assessment of whether surgery is necessary
  • generally does not change initial management

Management

• avoid activities that induce pain
• physical therapy
• non-steroidal anti-inflammatory agents (NSAIDs)
• epidural glucocorticoid injections may provide short-term benefit
• limited bedrest
• surgery for refractory cases

More general terms

• sign/symptom
• spine disease; vertebral disorder
• peripheral nerve disease; peripheral neuropathy

More specific terms

• cervical radiculopathy
• L1 radiculopathy
• L4 radiculopathy
• L5 radiculopathy
• S1 radiculopathy
• sciatica; lumbosacral radiculopathy; sciatic neuropathy
• T1 radiculopathy

Additional terms

• entrapment neuropathy; nerve entrapment syndrome; pinched nerve
• nerve root