Radiculitis (radiculopathy) is a general term used by healthcare professionals to describe symptoms associated with a compressed or inflamed spinal cord root. Symptoms may include pain in the neck or back, radiating along the innervation of the nerves from the root, as well as muscle weakness, numbness, and tingling in the innervated area of the limbs. The most common cause of radiculitis (radiculopathy) is intervertebral disc herniation. The disc located between the vertebrae, having an elastic structure, performs shock-absorbing functions in the spine. Discs give the spine mobility, flexibility and the ability to bear loads. Over the course of life, discs wear down, degenerate, and sometimes disc herniations occur. As a result of this, the disc substance may come into contact with nearby spinal cord roots. In this case, compression and irritation of the root occurs. In other cases, the root may be affected by osteophytes, stenosis of the spinal canal or foraminal canal. Compression and inflammation of the nerve roots can result in chronic pain, both in the neck or lower back, and distally in the area of innervation. Therefore, radicular pain means not only localization in the spine, but also at a significant distance along the nerve fibers. In addition, when the root is compressed, the conduction of nerve fibers can be disrupted, which leads to sensory disturbances (numbness, tingling or burning) and muscle weakness in the extremities. Treatment of such symptoms depends on the causes of radiculitis (radiculopathy). It is necessary to find out what exactly is affecting the root - disc herniation, osteophyte, arthritis or foraminal stenosis.
Causes and types of radiculitis (radiculopathy)
The anatomical causes of radiculitis (radiculopathy) are dysfunction of one of the roots. When compression of the root occurs, symptoms appear on the affected side and in the innervation zone. Typically, when symptoms appear, such as pain in the neck or lower back, radiating to the arm or leg, numbness or muscle weakness in the extremities, one should suspect that there is compression and irritation of the root exiting the spinal cord. Most often, the spine is affected by the discs and sometimes the vertebrae themselves. For example, when a disc ruptures, it bulges into the spinal canal and impacts the root. Bone structures can also affect the root through degeneration or bone growths (osteophytes). Patients with radiculitis (radiculopathy) face various symptoms: wandering pain from the neck to the arms and from the lower back to the legs, various disturbances or changes in sensitivity (numbness, tingling, burning in the limbs), decreased muscle strength in certain muscles. Main causes of radiculitis (radiculopathy)
- Disc herniation in the lumbar, cervical or thoracic spine.
- Spinal canal stenosis
- Foraminal stenosis (narrowing of the canal through which the root passes)
- Disc degeneration
- Injury
- Presence of osteophytes, tumors
Depending on the location of radiculitis (radiculopathies), cervical, thoracic or lumbar radiculitis is distinguished.
Animal wool belt
A dog belt helps a lot
How to cure radiculitis at home? Simultaneously with external and internal means, you need to use a special belt. It is made from camel or dog hair.
It is untreated wool that provides the healing effect. Ordinary wool fabric does not have such healing powers.
The belt has a powerful water-repellent effect. Also, both camel and dog hair contain wax and lanolin. They have an anti-inflammatory effect.
Cervical radiculitis (radiculopathy)
Cervical radiculitis by its name indicates localization in the neck, namely in the cervical spine. Symptoms (pain, sensory disturbance or muscle weakness) can be on both the right and left, depending on the location of the root concerned. The causes of cervical radiculitis can be different: disc herniation, disc protrusion, disc degeneration, osteoarthritis, foraminal stenosis, etc. Symptoms can appear both in the area of localization of the irritated root and radiate to the arms, shoulders, fingers. Between the 7 cervical vertebrae (C1-C7) there are 8 pairs of spinal cord roots that conduct electrical impulses from the central nervous system and spinal cord. The area of innervation has a clear topic and depends on the specific root. The roots in the cervical spine are C1-C8. Each pair is responsible for a specific area:
- C1-C2 – head
- C3-C4 – diaphragm
- C5- upper torso
- C6 – wrist and biceps
- C7- triceps
- C8 – brush
Thoracic radiculitis (radiculopathy)
Thoracic radiculitis means localization in the middle of the back (in the thoracic spine, consisting of 12 vertebrae). Symptoms are typical for radiculitis: radiating pain, tingling, numbness, muscle weakness. Compared to cervical or lumbar radiculitis, thoracic radiculitis is rare. This is explained by the relative rigidity of the thoracic spine, which serves as the attachment point for the ribs and provides support for the upper and lower torso. The slight flexibility of this department prevents the vertebrae and discs in this department from age-related changes too. But, nevertheless, if symptoms are present, the possibility of this type of radiculitis cannot be completely excluded. Potential causes of the development of thoracic radiculitis may be the following factors: degenerative changes in the discs, disc protrusion, disc herniation, osteoarthritis, osteophyte, spinal trauma (especially when twisting), spinal canal stenosis, foraminal stenosis.
Prevention
An excellent prevention of radiculitis is therapeutic exercises, which are recommended to be performed daily, except during periods of exacerbation. Avoid hypothermia and stress, watch your weight, engage in swimming or other sports, try not to stand in a bent position for a long time and watch your posture. Throughout your life, adhere to the principles of a healthy diet, stop drinking alcoholic beverages and smoking tobacco. These simple measures can protect you from developing dangerous diseases and radicular syndrome.
Lumbar sciatica
Lumbar radiculitis means localization in the lower back (in the lumbar spine, consisting of 5 large and fairly mobile vertebrae), where the center of gravity of the human body is located. The signs of radiculitis are similar to other parts (pain, loss of sensitivity and muscle weakness) and the affected area corresponds to the zone of innervation (that is, pain and other symptoms accompany the nerve fiber along its course in the body). Lumbar radiculitis (radiculopathy) is often called sciatica. This term refers to irritation of the large sciatic nerve, which begins at the exit from L1-L5, passes through the pelvis into the legs and reaches the feet. The most striking symptom of sciatica is intense pain in the buttocks, hip and foot (usually unilateral). The main causes of lumbar radiculitis (radiculopathy) are: arthritis, degenerative changes in the vertebrae, spinal canal stenosis, foraminal stenosis, compression fracture, disc herniation, disc protrusion, spondylolisthesis.
Symptoms of radiculopathy
Doctors use the term radiculitis (radiculopathy) to describe a set of symptoms that appear when there is pressure on the roots of the spinal cord (which is a bundle of nerve fibers emanating from the spinal cord). However, radiculitis (radiculopathy) is not an independent disease, but only a complex of symptoms including pain, muscle weakness and sensory disturbances, which originate in the spine and go to the limbs. The human spine is divided into five sections and sciatica (radiculopathy) most often occurs in the cervical thoracic and lumbar spine. 31 pairs of roots arise from a long spinal cord in the rather narrow spinal canal of the spine. Various reasons can reduce the space where the roots are located and put compression on them - this is a disc herniation or protrusion, stenosis, tumor, infectious process, osteophyte. Despite all the variability of symptoms, the most common symptoms are the following:
- Pain (discomfort) from dull and intermittent to constant and debilitating with irradiation. Pain (as a protective factor in the body) indicates that there is a damaging effect on nerve fibers.
- Impaired sensitivity. It should be noted that the spine is a rather complex structure. We unconsciously carry out a huge number of movements, and this happens automatically. But in order for the movements to be harmonious, it is necessary that there is feedback from the brain to the muscles and sensory receptors. When the roots are compressed, the conduction of impulses in both directions is disrupted. Accordingly, both sensitivity (numbness, burning, tingling) and impulse transmission to the muscles are impaired.
- Muscle weakness. Sometimes muscle weakness occurs in isolation (with isolated compression of motor neurons). For normal muscle functioning, two-way communication is necessary, both with the spinal cord and the brain. When the root is compressed (by a disc herniation, osteophyte or something else), the supply of impulses is interrupted and the muscle stops working normally. With prolonged disruption of the normal conduction of impulses, muscle atrophy or even flaccid paresis occurs.
Forecast
The painful symptom of radiculitis can be successfully treated with physiotherapy and medications, but this is not enough. It is important to cure the disease that led to the development of radicular syndrome. This will guarantee that the attack will not happen again.
When the disease becomes chronic, it is important to maintain a period of rest for as long as possible, following the recommendations of the attending physician and adhering to preventive measures. The chronic form is characterized by less acute, rather aching pains that do not greatly limit movement and affect the performance of everyday tasks. In this case, the occurrence of “lumbago” is also possible if the inflammation of the pinched roots intensifies under the influence of pathological processes.
Diagnosis of radiculitis
Radiculitis is not a disease, but only a set of symptoms indicating the presence of an impact on one of the 31 pairs of spinal cord roots. The complex of symptoms includes: pain, loss of sensitivity, weakness in the muscles along the innervation of the nerves involved. The causes of radiculitis (radiculopathy) can be: disc herniation, disc protrusion, stenosis, etc. In order for the doctor to accurately make a diagnosis, a number of measures are necessary:
- clarification of symptoms (nature of pain, intensity, duration, presence of sensory disturbances)
- examination (allowing you to determine muscle strength, range of motion)
Neurological examination - checking reflex activity and sensitivity. X-ray is a routine method that allows us to visualize the extent of degenerative changes in the spine. MRI allows you to clearly visualize the presence of root compression. EMG is a method that allows you to determine the degree of damage to nerve fibers.
Treatment
Treatment depends on the severity of symptoms (pain, sensory disturbances and motor disturbances). In any case, all conservative treatment options must first be exhausted.
Drug treatment
The goal of drug treatment is to relieve inflammation, reduce swelling of the underlying tissues and reduce pain. Physiotherapy. There are many physiotherapeutic techniques that can improve blood circulation in the tissues adjacent to the root, reduce pain, and improve the conduction of impulses along nerve fibers. Manual therapy and massage. Help relieve muscle blocks and muscle spasms. IRT. Acupuncture by influencing biologically active points helps restore the process of conducting impulses along nerve fibers. Exercise therapy. Dosed physical activity helps restore normal biomechanics of the spine and a normal pattern of movements. With the help of exercises, it is often possible to relieve root compression by redistributing load vectors. In addition, exercises stop degenerative processes in the spine, increase the elasticity of ligaments and muscles and, thus, increase range of motion. Exercises are used both with weights (on simulators) and various gymnastics (including such as Qi-gong). Systematic exercises are, in addition, the prevention of relapses of various conditions in the spine. Currently, the most demonstrative effect is the effect of training on simulators. In case of persistent pain syndrome and in the presence of a pronounced clinical picture (muscle paresis and sensory disturbance), surgical decompression of the root is performed.
First aid
An acute attack of radiculitis limits the patient's ability to move, so the person needs outside help. The algorithm of actions is as follows:
1. Give the patient a painkiller in the form of a tablet or give an analgesic injection. Neuropathic pain cannot be tolerated.
2. Additionally, give a sedative to drink. Preference should be given to natural remedies (valerian, peony, motherwort). This will partially relieve the pain.
3. Place the patient on a chair in a position comfortable for him if it is impossible to ensure bed rest, otherwise, put him to bed.
4. Immobilize the painful part of your back with a tight belt (you can use a sheet, bath towel or corset).
5. Apply ointment or gel from the NSAID group to the sore area to relieve inflammation.
6. Hold the patient if necessary.
After the ambulance arrives, provide the patient with peace, and then help him visit a neurologist for further treatment.