Dr Colum Nolan
Senior Consultant Spine & Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
If you’ve ever felt sharp, shooting pain that travels from your neck or lower back into your arms or legs, you may be experiencing radiculopathy. This condition occurs when a spinal nerve becomes compressed or irritated, often due to a herniated disc, bone spur, or spinal degeneration. In this article, find out what radiculopathy is, its types, symptoms and treatments available.
Understanding Radiculopathy
Radiculopathy, commonly known as a “pinched nerve,” is a condition that occurs when a nerve root in the spine is compressed or irritated. This compression causes a variety of symptoms, including pain, numbness, tingling or weakness that radiate along the nerve’s path.
Types and Symptoms of Radiculopathy
While radiculopathy can occur anywhere along the spinal column, the location of the pain and other symptoms depends on which region is affected.
- Cervical Radiculopathy (Neck): Cervical radiculopathy affects the neck and causes symptoms that travel into the shoulders, arms and hands. Common symptoms include pain, numbness, tingling in your fingers, and muscle weakness or reduced reflexes in your upper body.
- Thoracic Radiculopathy (Mid-Back): This is the least common type. It affects the upper or mid-back, leading to pain or numbness that wraps around the chest or abdomen and potential muscle weakness in the upper back.
- Lumbar Radiculopathy (Lower Back): This affects the lower back. Symptoms typically include pain radiating from the lower back down to one or both legs, often accompanied by numbness, tingling and muscle weakness. A common form of lumbar radiculopathy is sciatica.
Causes and Risk Factors
Radiculopathy is most often caused by a compressed nerve root in the spine. This compression can be the result of a few different conditions:
- Herniated or Bulging Discs: This is the most common cause. When a spinal disc bulges or ruptures, its soft centre can press directly on a nearby nerve root.
- Degenerative Disc Disease: As we age, our spinal discs naturally lose water and elasticity, which can make them more prone to herniation and lead to nerve compression.
- Bone Spurs (Osteophytes): These bony growths can form on the vertebrae as a result of arthritis and can narrow the space available for nerve roots, causing irritation.
- Spinal Stenosis: This condition is the narrowing of the spinal canal, which puts pressure on both the spinal cord and the nerve roots.
- Other Factors: Less common causes include spinal tumours, scoliosis or traumatic injuries that directly impact the spine and nerves.
What Are the Non-Surgical Treatments for Radiculopathy?
For radiculopathy, conservative treatments are usually considered first. They aim to reduce inflammation, relieve pain and improve overall function in eligible patients.
- Medications: Over-the-counter NSAIDs can reduce swelling and pain. For severe cases, a doctor may prescribe muscle relaxants, corticosteroids or certain nerve pain medications.
- Physiotherapy: Tailored exercises gradually strengthen core muscles, improve posture and increase flexibility to relieve nerve pressure.
- Steroid Injections: Epidural or peri-root injections deliver corticosteroids directly to the inflamed area, providing temporary relief by reducing inflammation around the nerve root. These are often guided by imaging and can be repeated if needed.
- Lifestyle Modifications: Resting and avoiding activities that aggravate the condition can help the irritated nerve heal. Additionally, maintaining a healthy weight helps reduce stress on the spine, and practising proper ergonomics can prevent further strain.
What Are the Surgical Treatment Options for Radiculopathy?
When conservative methods do not suffice or symptoms are severe, surgical intervention may be necessary. The primary goal of surgery is to decompress the irritated nerve root and restore a patient’s quality of life.
- Microdiscectomy: A minimally invasive procedure commonly used for lumbar radiculopathy. The surgeon makes a small incision to remove the portion of a herniated disc that is pressing on the nerve. This procedure is known for its quick recovery time.
- Laminectomy: This surgery involves removing the back part of a vertebra (lamina) to create more space within the spinal canal. It is often performed to relieve pressure on the spinal cord and nerves caused by spinal stenosis.
- Foraminotomy: This procedure enlarges the opening through which the nerve root exits the spinal canal (foramen). By removing bone or other tissue, the surgeon frees the pinched nerve, a technique often used in cases of cervical radiculopathy.
- Spinal Fusion: This is a more extensive procedure typically performed when the spine is unstable. After a damaged disc is removed, the vertebrae are fused together with a bone graft and surgical hardware to create stability and prevent further nerve compression.
Conservative vs Surgical: Which is Right for You?
Deciding between conservative and surgical treatment for radiculopathy depends on a few key factors: the severity of your symptoms, your response to initial therapies and your overall health.
Conservative treatment is often suitable if you have:
- Mild to moderate symptoms that are not getting progressively worse
- Stable neurological function, meaning you are not experiencing significant muscle weakness or loss of reflexes
Surgery is considered when non-surgical treatments have not provided sufficient improvement. It may be recommended if you have:
- Severe or persistent symptoms that do not improve after 6 to 8 weeks of non-surgical care
- Progressive neurological deficits, such as worsening muscle weakness or numbness
- A clear source of nerve compression that can be addressed surgically
Your doctor will assess your condition to determine the most appropriate treatment option for you.
Recovery From Radiculopathy Treatment
Recovery from radiculopathy is a gradual process that can take anywhere from a few weeks to several months. Most people experience significant symptom relief within the first weeks and many achieve a full recovery over time by consistently following the following advice:
- Continue physiotherapy and home exercises to maintain mobility and prevent recurrence
- Engage in functional training to support a safe return to daily activities and work
- Maintain good posture and proper ergonomics in your daily activities
- Short-term use of supportive devices during the early stages of recovery
Don’t let nerve pain affect your quality of life. Contact us at Oxford Spine & Neurosurgery Centre to learn more about your treatment options and how Dr Colum Nolan can help you recover safely.
Our Spine Specialist in Singapore
Dr Colum Nolan
Senior Consultant Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)
Dr Colum Nolan is a Senior Consultant Neurosurgeon and the Medical Director of Oxford Spine & Neurosurgery Centre. He undertook specialist neurosurgery training in Ireland and Australia, and later on completed a complex spine surgery fellowship at Addenbrooke’s Hospital in Cambridge, UK.
Dr Column held key leadership roles including Director of the Spine and Spinal Disorders Programme at the National Neuroscience Institute (NNI), as well as the Head of Neurosurgery Service at Sengkang General Hospital.
With his depth of experience, Dr Colum is committed to guiding each patient towards the safest and most effective treatment for their needs.
