Patients tend to complain of severe neck and arm pain in the case of cervical radiculopathy; there are also symptoms of burning and tingling. The distribution of these symptoms however, follows a myotomal pattern rather than a dermatomal pattern [7]. There is concomitant loss of motor function and altered reflexes in the nerves affected [5]. The pain felt in cervical radiculopathy manifests through the shoulder girdle, arm and forearm, the paresthesias and numbness is mostly felt in the central portion of the hand and muscular weakness is felt in the arm and forearm [9]. In one study, symptoms were preceded by some sort of physical exertion or trauma in 15% cases [8]. Although there are no criteria for the confirmed diagnosis of cervical radiculopathy, the history and examination of the patient usually give evidence enough to make the diagnosis [17] [18]. On examination, certain maneuvers further confirm the diagnosis of cervical radiculopathy, these include holding up the affected arm on top of the head [19] or moving the head to look down and away from the side of pain tends to improve the pain; whereas rotation of or bending of the head towards the side of symptoms tends to increase the pain [20].

Thoracic radiculopathy is characterized by sharp, burning pain felt in chest, arm or abdomen. The symptoms worsen with coughing, straining or sneezing. Lumbar radiculopathy, commonly known as sciatica, presents as numbness, tingling and muscle weakness in the lower back radiating all the way down to one or both the legs and feet.

• Disability

  Is cervical radiculopathy a disability? Not necessarily. If a person’s condition is serious and debilitating enough, it may be considered a disability. However, not all people with radiculopathy experience significant disabilities. [medicalnewstoday.com]

  The reliability and construct validity of the neck disability index and patient specific functionale scale in patients with cervical radiculopathy. [physio-pedia.com]

  At least 50 % of patients following lumbar surgery (LS) for radiculopathy are referred for PT to address postoperative pain and disability. [ncbi.nlm.nih.gov]

  The purpose of this paper is to present the effect of manual therapy on pain, ROM, disability in a patient… CONTINUE READING Create an AI-powered research feed to stay up to date with new papers like this posted to ArXiv [semanticscholar.org]

• Collapse

  The body, believing that these collapsed disks are in trouble, responds by constructing sharp bone spurs around the disks for strength. [thespinehealthinstitute.com]

  Degenerative disc disease can cause radiculopathy as one or more spinal discs thin and the space between the vertebrae collapses, putting pressure on the surrounding nerves. [spine-health.com]

  This problem causes settling, or collapse, of the disk spaces and loss of disk space height. As the disks lose height, the vertebrae move closer together. [orthoinfo.aaos.org]

• Burning Pain

  Signs and symptoms (may include one or more): Stabbing pain in the buttock (sciatica) Dull non-localized ache Back pain going down one leg Leg cramping Numbness in the leg to the foot Burning pain down the back of the leg Symptoms worsening with sitting [spineoptions.com]

  Symptoms here include burning pain, often in the arm or shoulder, weakness, numbness, and tingling. Thoracic Radiculopathy The thoracic spine is the middle and upper parts of your back. [dignityhealth.org]

  So the location of the pain or numbness in the arm varies depending on which nerve is compressed in the neck. Some patients feel frank pain in the arm, others feel numbness or tingling or burning pain. [cincinnatispinesurgeon.com]

• Lymphadenopathy

  There were no petechiae, lymphadenopathy, bone pains or rash. The chest, cardiovascular and abdominal examinations were normal. Nervous system examination revealed normal higher mental functions and no cranial nerve involvement. [pmj.bmj.com]

  Lymphadenopathy was evident in bilateral hila and mediastina with marked FDG and Gallium accumulation in FDG-PET-CT and Gallium scintigraphy, respectively. The number of lymphocytes and the CD４／CD８ratio were increased in the BALF. [repo.lib.tokushima-u.ac.jp]

  On examination the presence of lymphadenopathy or exquisite localised tenderness over a vertebral body should raise suspicion that there could be a serious underlying cause for the pain. [bjgp.org]

• Camping

  Simpson-Camp L, Richardson EJ, Alaish SM. Streptococcus viridans tubo-ovarian abscess in an adolescent virgin. Pediatr Int. 2012; 54 (5):706-9. doi: 10.1111/j.1442-200X.2012.03569.x. [PubMed: 23005903 ]. 25. Singh-Ranger D, Sanusi A, Hamo I. [ircmj.com]

• Abdominal Pain

  This clinical syndrome is characterized by its immediate postoperative development, band-like thoracic or abdominal pain pattern, severe pain that both overwhelms the incisional pain and is refractory to medications, and absence of motor deficit. [ncbi.nlm.nih.gov]

  Pyosalpinx is a complication of PID and a cause of acute abdominal pain misdiagnosed due to similar abdominal emergencies. [ircmj.com]

  When symptoms are present, you may experience: foul-smelling vaginal discharge yellow vaginal discharge pain during ovulation, menstruation, or sex spotting between periods dull lower back pain abdominal pain nausea vomiting fever frequent urination This [healthline.com]

  Regardless of sexual history, PID should be considered in all women with abdominal pain. [bmcwomenshealth.biomedcentral.com]

• Fecal Incontinence

  Therefore, urinary tract infection, poor hygiene, fecal incontinence, anogenital malformations, and pooling of urine in the posterior vagina secondary to any reason seem to be the principally described risk factors [ 1 ]. [bmcwomenshealth.biomedcentral.com]

  In some cases of PID among virgin female patients, there was a history of abdominopelvic surgery such as for congenital bowel abnormality, fecal incontinence, or appendectomy owing to a perforated appendix. [ircmj.com]

• Blister

  Atypical or bullous pyoderma gangrenosum is characterized by superficial blisters (bullae). [rarediseases.org]

  The skin under the collar needs to be checked every day to prevent blisters or sores. Cervical Pillow A special pillow may help your pain at night and allow you to sleep better. [umms.org]

  Symptoms of pyoderma gangrenosum Pyoderma gangrenosum usually appears suddenly as either a small pimple, red bump or blood blister. The skin then breaks down into a painful ulcer with a purple or blue edge that may ooze fluid. [nhs.uk]

• Leg Pain

  OUTCOME MEASURES: Primary outcomes were activity limitation (Oswestry Disability Index) and separate 0-10 numerical pain rating scales for leg pain and back pain. Measures were taken at baseline and at 5, 10, 26, and 52 weeks. [ncbi.nlm.nih.gov]

  This type of surgery typically provides relief of radicular pain/leg pain for 85% to 90% of patients. [spine-health.com]

  Leg pain and low back pain were measured using the VAS 0–100 (where 0 = no pain). [bmcmusculoskeletdisord.biomedcentral.com]

• Peripheral Neuropathy

  Peripheral neuropathy is the damage of the peripheral nervous system, such as carpal tunnel syndrome that involves trapped nerves in the wrist. [hopkinsmedicine.org]

  Although multiple studies have reported characteristics reminiscent of peripheral neuropathy in MS, there have been limited reports in NMOSD. [ncbi.nlm.nih.gov]

  Radiculopathy versus neuropathy. Radiculopathy symptoms may be similar or the same as those of peripheral neuropathy, making a correct diagnosis harder to find. Peripheral neuropathy occurs when the peripheral nervous system is damaged. [edisonspinecenter.com]

  Related Content Arachnoiditis How Muscles Recover from Nerve Injuries Nerve Damage & Healing Parsonage Turner Syndrome Peripheral Neuropathy Spinal Cord and Peripheral Nerve Stimulation Symptoms of Lumbar Nerve Injuries Arthritis of the Neck and Back [neckandback.com]

• Dysesthesia

  […] associated with unpleasant leg sensations, Rest induces symptoms, Getting active brings relief, Evening and night deteriorate symptoms); given the fact that Restless Legs Syndrome presents with a great variety and heterogeneity of symptoms (mostly pain, dysesthesia [ncbi.nlm.nih.gov]

  Frequent signs and symptoms include varying degrees of sensory, motor and reflex changes as well as dysesthesias and paresthesias related to nerve root(s) without evidence of spinal cord dysfunction (myelopathy). [eorif.com]

  […] areas Weakness of biceps Decreased biceps brachii and brachioradialis reflexes C7 Pain, paresthesias, and numbness in the shoulder blade and axilla, radiating to the middle finger Weakness of triceps Decreased triceps brachii reflex T (any) Bandlike dysesthesias [merckmanuals.com]

  Choong Sik Chae, Geun Young Park, Yong-Min Choi, Sangeun Jung, Sungjun Kim, Donggyun Sohn and Sun Im, Rapid, Objective and Non-invasive Diagnosis of Sudomotor Dysfunction in Patients With Lower Extremity Dysesthesia: A Cross-Sectional Study, Annals of [dx.doi.org]

• Burning Sensation

  Radiculopathy symptoms include pain that feels like a burning sensation, numbness, and tingling in the arms or legs. [atlanticspinecenter.com]

  The intensity of pain varies dramatically, from a dull non-localized ache to a precise sharp and burning sensation. Sciatica is a type of lumbar radiculopathy that affects the large sciatic nerve, where nerve roots come together in the buttock. [spineoptions.com]

  It can vary widely, from a mild ache to a sharp, burning sensation or excruciating pain. Sometimes it can feel like a jolt or electric shock. It can be worse when you cough or sneeze, and prolonged sitting can aggravate symptoms. [mayoclinichealthsystem.org]

  Pain and Numbness –An early sign of nerve damage (neuropathy) is a tingling or burning sensation in the arms and/or legs. It may begin in your toes and feet, with the pain progressively getting more severe. [dolmanlaw.com]

  Thoracic Radiculopathy Symptoms: A burning sensation Radiating pain Tingling Numbness These symptoms can occur in the ribs, side, and abdomen. [miamineurosciencecenter.com]

• Hyperalgesia

  Signs of peripheral (heat hyperalgesia) and central sensitization (dynamic mechanical allodynia and hyperalgesia) at the affected L5 or S1 dermatome were assessed with quantitative sensory testing. [ncbi.nlm.nih.gov]

  Hypersensitivity of the skin (hyperalgesia or allodynia) can occur. A simple brushing of bed sheets on exposed skin can cause intense pain. This is referred to as peripheral neuropathy. A good example of this phenomenon is “phantom pain syndrome”. [neckandback.com]

  The neurologic examination has moderately strong intraobserver reliability with a kappa value between 0.4 and 0.64 The sensory examination can distinguish between a C8 radiculopathy and ulnar neuropathy, as there will be splitting of the hyperalgesia [physio-pedia.com]

Laboratory studies are often not necessary to diagnose radiculopathy. Although the erythrocyte sedimentation rate and C-reactive protein levels may be increased in many patients with spinal infection or cancer, these tests are not specific [9].

Radiographs of the affected region of the spine are usually obtained; lateral, anteroposterior, and oblique views are helpful [21]. However, radiographs have a low sensitivity for the detection of tumors or infections; they are also insufficient to detect disk herniation and the intervertebral narrowing [22]. Magnetic resonance imaging (MRI) is the modality of choice when a detailed workup is required in patients with radiculopathy [23]. MRI is indicated if substantial pain is still present four to six weeks after the initiation of treatment or if there are progressive neurologic deficits [9]. Computed tomography (CT) is of limited value in assessing radiculopathy, due to the lack of soft tissue visualization, but it is useful in assessing the extent of bony spurs, narrowing of foramina, or the extent of ossification of the posterior longitudinal ligament [9] [24].

The main objectives of treatment are to provide symptomatic relief from pain and improve function [25]. Analgesics, including opioids and non-steroidal antiinflammatory drugs (NSAIDs), are usually used as first-line therapy [9]. Patients suffering from acute pain have been given a short course of prednisone, starting with a dose of 70 mg per day and decreasing by 10 mg every day [25]. Some studies have reported favorable results with epidural injections of corticosteroids. These show that up to 60 % of patients were relieved of their symptoms and were able to return to their routine activities [9]. Epidural injections, however, come with several rare and serious complications including neurologic sequelae from infarction of the spinal cord or brainstem [26]. 

Short-term immobilization (less than two weeks) with a hard or a soft collar (either continuously or every at night) also aids in pain control in cervical radiculopathy, according to some researches [25]. Rarely, surgery is recommended in cases where there is compression of the spinal cord and substantial evidence of moderate to severe myelopathy [9]. It is also recommended for those who have persistent and debilitating pain after a minimum of 6 to 12 weeks of nonsurgical management [9]. It is recommended to join a progressive exercise program once the pain is under control [9].

Most cases of radiculopathy improve with a few days or weeks of treatment and rest. Radiculopathy caused by a herniated disc usually improves without surgery. However, recurrence of radiculopathy is possible. It can happen whether or not surgery was used for treatment.

Cervical radiculopathy is due to the narrowing of the foramina in the vertebrae in 70% of the cases [9]. This occurs because of changes taking place in these bones due to old age and osteoporosis. In many cases, there is no actual pathology and the symptoms are due to excessive tension and stretching in neck and shoulder muscles due to prolonged periods of poor posture and muscle use [4].

Lumbar radiculopathy, on the other hand, is mostly caused by degenerative conditions such as lumbar spinal stenosis or herniated disc. Studies have identified extradural masses such as synovial cysts and gas-containing ganglion cysts as less common causes [2]. Other occasional causes of lumbar radicular syndromes include obstruction of venous outflow, venous congestion and lumbar epidural varix [1].

Certain symptoms, when present, signal toward a more serious, albeit unusual [10] etiology like cancer or infection. These symptoms include history of cancer itself, fever, chills, unremitting night time pain and unexplained weight loss [9]. An important differential diagnosis to keep in mind when a patient complains of radiculopathy is signs and symptoms of myelopathy. These may be mild such as diffuse numbness and clumsiness, urinary urgency and frequency, or advanced like urinary retention and incontinence [9].

The most common causes of radiculopathy include compression of nerve roots, osteoarthrosis of joints, disk degeneration and prolapsed intervertebral disks [9]. Prolapsed lumbar disk is seen mostly in the age group of 20-39 years of age and is mostly due to sitting for prolonged periods of time such as when driving motor vehicles or in sedentary occupations; pregnant women at full term are also at risk for prolapsed disk [9].

The likelihood of osteoarthrosis of the cervical and lumbar spine increases with age [9]. Disk degeneration is also related to age where the initial stages occur from the ages of 20 to 29 years and osteophyte formation occurs from the age of 50 years onwards [3]. According to research conducted in Rochester, Minnesota of the United States of America, the annual incidence of cervical radiculopathy for men is 107.3 per 100,000 and for women are 63.5 per 100,000 [6]. Lumbosacral radiculopathy is estimated to affect around 3 to 5% of the population in the US.

The pathophysiology behind radiculopathy is still undetermined. However, studies have shown that symptoms tend to arise when the dorsal-root ganglion is also involved [11] [12]. Once there is superimposed hypoxia, the symptoms are further aggravated [13]. It has been documented through several studies that a number of inflammatory mediators are released by herniated intervertebral disks including prostaglandin E2, matrix metalloproteinases, interleukin-6 and nitric oxide causing the symptoms of radiculopathy [14] [15] [16].

While some causes of radiculopathy are not avoidable, there are certain ways to reduce the risk of developing a radiculopathy. These include maintaining good posture and a healthy weight. In order to avoid complications, one must use safe techniques when lifting heavy objects and take frequent breaks when performing repetitive tasks. A regular exercise regime not only helps with physical fitness but also improves strength and flexibility of muscles, this hinders the chances of developing a radiculopathy.

Radiculopathy is the discomfort or pain which is perceived when there is nerve root damage due to pathology in the surrounding tissues such as muscles, tendons, cartilage or bone [5]. When the nerve roots are compressed, there is inflammation [5] resulting in numbness, weakness, and pain. Cervical radiculopathy most commonly occurs due to disc herniation or degenerative changes, or as in most cases, both [5]. Thoracic radiculopathy is a less common condition. Lumbar radiculopathy occurs mostly due to a structural problem like a herniated disc. Treatment varies according to the type of pathology and the severity of the disease.

Radiculopathy is usually due to nerve root compression which may occur due to a number of reasons. While mostly the reasons are disc compression and herniation, certain morbid conditions may also be the cause of discomfort. Hence a follow up with your physician is advised. Radiculopathy most often results in pain, weakness and numbness. The modes of treatment usually involve pain medication and physiotherapy. Surgery is indicated only in advanced cases when the spinal cord itself is being compressed. The best way to prevent any sort of radiculopathy is to exercise regularly and maintain the strength of ones muscles and bones by taking a balanced diet.

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