Back pain is a common occurrence. Most people experience such pain at least once in a lifetime. For half of working citizens they arise annually and last, at least, one day. They cause injuries, various pathologies, including radiculopathy (radiculitis).
What is radiculopathy?
Having heard the diagnosis made by the doctor, patients involuntarily ask themselves the question: "Radiculopathy - what is it, what are its causes and consequences?" The general term "radiculopathy" in neurology refers to symptoms associated with damage, damage or pinching of the roots of the spinal nerves. During the examination, one damaged root can be revealed, as well as several.
Symptoms are expressed by pain in the back of a shooting or piercing character, combined with lethargy of muscles, tingling, numbness in the innervated areas of the limbs. Radicular radiculopathy syndrome is manifested by soreness in all kinds of areas.
Pain syndrome permeates the neck, lower back, limbs and individual organs. It is found, for example, in the area where the heart or stomach is located. Only a doctor can correctly diagnose sciatica.
Radiculopathy and its causes
Varieties of osteochondrosis are the main cause of all radiculitis. The disease can be the result of chronic injuries, pathologies that have developed in the internal organs, inflammation that affects the spine, tumors. His provocateurs are stress, metabolic imbalance, infectious diseases, hypothermia, weight lifting.
Often the impetus for the development of the disease is the intervertebral hernia. The intervertebral disc, endowed with elasticity, plays the role of a shock absorber. Developing osteochondrosis leads to degenerative processes that result in protrusion (localized protrusion of the disc). As a result, protrusion flows into the intervertebral hernia, leading to compression and irritation of the nearby roots.
Osteophytes and stenoses are considered to be the cause of irritated roots — narrowing of the gaps in the spinal “tunnel” or foraminal canals (where the nerves come from). Foraminal stenosis usually affects the lumbar region, where the roots connecting to the sciatic nerve suffer from compression.
Chronic radiculopathy - what is it, what are its symptoms? The roots undergo continuous compression, they are irritated and inflamed. This translates into chronic pain, causing discomfort in the neck and lower back, and projected along the nerve fibers to a significant removal. Root compression ends in impaired impulse conduction, loss of function, and muscle dystrophy.
Symptoms of radiculitis
To deal with the symptoms of the disease, we ask ourselves again the question: "Radiculopathy - what is it?" Sciatica is not an independent disease. It is just a complex of symptoms that combines soreness, decreased sensitivity, muscle dystrophy, starting in the spine and descending to the limbs.
Patients are concerned about wandering pains projecting from the neck to the arms or from the lower back to the legs, which has undergone changes in sensitivity (limbs are numb, tingling and burning), loss of muscle strength in specific areas of the body. Quite a variety of signs of radiculopathy were combined into groups:
- Soreness. Pain sensations are manifested in various variations from dull, periodically arising, to constant debilitating with the presence of irradiation.
- Altered sensitivity. The spine is a complex structural unit of the human body. Thanks to him, people make a great many unconscious automatic movements. The harmony of movements is provided by the reflection of the brain, muscles and sensitive recipes. Radiculopathy, the symptoms of which are manifested, causes compression of the roots. This leads to the fact that the transmission of pulses in both directions proceeds with violations, and the sensitivity undergoes changes.
- Muscle dystrophy. Damaged nerves are incapable of continuous bilateral transmission of impulses (from muscles to the brain and spinal cord and vice versa). Therefore, the muscles stop working in normal mode. Long-term impairment of impulse transmission leads to weakness, atrophy, and even a weak cut of the muscles.
Types of Radiculopathy
Clinicians identified several varieties of radiculitis. Depending on the location of the affected nerves, radiculopathy, the symptoms of which are obvious, can be cervical, thoracic, lumbosacral, or mixed.
Relative to the lesion, sciatica (spondylogenic), vertebrogenic and mixed type are distinguished. This classification of the disease provides a clear differentiation of the main features of radiculitis in a particular patient.
Discogenic sciatica
Patients are more often diagnosed with primary discogenic radiculopathy, caused by deformation of the cartilage tissue growing on the intervertebral discs. In this case, the roots are impaired, the course of the inflammatory process is observed, which is accompanied by swelling and a powerful pain syndrome.
There is a loss of some functions associated with the innervation of nerves subjected to infringement. Banal sciatica is accompanied by pain, motor and autonomic disorders provoked by affected roots.
Vertebrogenic radiculitis
Note that vertebrogenic radiculopathy is always secondary. It proceeds against the background of developed stenosis, which struck the foraminal openings, where the path of the nerve roots lies.
Spinal roots passing through the “tunnel”, the walls of which form various structures (intervertebral hernias, yellow ligaments, osteophytes, etc.), are compressed and irritated. The “tunnel” narrows under the influence of age-related and degenerative transformations. As a result, in the place of clamping of the root there is a violation of blood circulation with subsequent swelling.
The pain is distally distributed, penetrating from the spine into the hands or feet. Symptoms of root dysfunction, expressed by cuts, loss of sensitivity and decreased reflexes, are not always immediately apparent. However, characteristic soreness is obvious evidence of radicular syndrome.
This type of sciatica is accompanied by severe muscle spasm, significantly limiting motor activity. Typically, vertebrogenic radiculopathy lasts a long time (at least 2-4 months) and requires urgent medical attention.
Cervical sciatica
Cervical radiculopathy is provoked by a hernia, protrusion or degeneration of the disc, osteoarthritis, foraminal stenosis and other pathologies. Typically, cervical radiculopathy occurs unexpectedly, expressed by shooting pains. Checking sensitivity, muscle strength, reflexes, make sure that the ailment is neurological in nature.
The disease is characterized by the occurrence of pain in the neck, giving away in the muscles of the hands and fingers. The localization of pain is caused by a suffering root. They are always sudden and very sharp, provoked by flexion of the neck. Soreness is mitigated by careful turning or tilting the head in one direction or another. Unsuccessful movements become the reason for its strengthening.
Patients have difficulty finding comfortable sleeping positions. Their sleep is interrupted by stitching pain in the neck and arms. Patients complain of a loss of sensation in the hand, a tingling sensation and numbness, while a significant decrease in muscle strength.
Thoracic Radiculopathy
This type of radiculitis appears in the middle of the back, at the location of the thoracic spine. Localization of pain is observed in the area of the intercostal nerves. An increase in soreness occurs with movement and deep breaths.
Thoracic radiculopathy is less common than lumbosacral or cervical. For the thoracic region, relative stiffness is characteristic. The department’s flexibility is negligible, so the disks in it undergo minimal changes.
However, when characteristic symptoms are found, they abstain from the absolute exclusion of the fact that the patient is burdened with chest radiculitis. Often, an anamnesis with injuries recorded in it prompts one to lean toward such a diagnosis.
Potential causes of thoracic radiculopathy include factors associated with degenerative transformations, protrusions and herniated discs, osteoarthritis, osteophytes, stenosis. Infectious diseases, usual hypothermia, osteochondrosis, physical injuries, awkward movements cause it.
Lumbosacral radiculitis
The most common is lumbosacral radiculopathy. It has symptoms that are similar to related diseases. Lumbar sciatica is chronic. It is often aggravated by acute relapses. Bending the body or starting walking, patients experience increased pain.
The localization of lesions is due to the area of innervation. The concentration of pain depends on the focus of inflammation. Patients feel it in the lumbar region and the gluteal region, in the thigh, its posterolateral and anterior zone, and the anterior outer part of the lower leg. The pain penetrates the rear of the foot, passes along the heel, thumb, touches the calf muscles and is found in the outer ankle.
Soreness is very pronounced when the roots are compressed by bone outgrowths, discs, various dense tissues, for example, formed by an intervertebral hernia. The pain caused by soft tissues (muscles, ligaments) that have pinched nerves is not so powerful. It is characterized by a mild dynamics of growth.
Radiculopathy of the lumbosacral spine is provoked, usually by destructive processes in the ligaments, articular lesions of the spine. It is caused by disorders of the intervertebral discs resulting from osteochondrosis, hernias, and other diseases.
Types of Lumbar Radiculopathy
Three types of lumbar radiculitis usually manifest themselves. These include:
- Lumbago. Pain is concentrated in the lumbar region. Soreness provokes inadequate physical activity, causing overstrain in the lumbar muscles, a sharp hypothermia. In addition, attacks are caused by lumbar hernias and displaced vertebrae.
- Lyuboishelgia is another lumbar radiculopathy, accompanied by pain that occurs in the lumbar region, extending to one or both legs. Soreness spreads over the gluteal region and the posterior part of the legs, without descending into the fingers. Pain syndrome is described as aching, burning and growing.
- Sciatica The pains are concentrated in the area of the buttocks, grab the thigh and lower leg from the back, go down to the feet. In addition to painful sensations, muscle weakness caused by damage or irritation of the sciatic nerve is noted. Soreness with sciatica is a shooting character, resembling an electric shock. Sometimes there is a simultaneous manifestation of tingling, numbness and "goose bumps". Pain syndrome varies in degree and intensity. Soreness ranges from mild to incredibly powerful. The patient loses sleep, pain disturbs him when standing, sitting, walking, and does not allow him to bend or turn.
Lumbar radiculopathy is provoked, the treatment of which is initially limited to conservative therapy, arthritis, degenerative modifications of the vertebrae, stenosis, compression fractures, hernia and protrusion of the discs, spondylolisthesis.
Conservative treatment of radiculopathy
If the diagnosis is "radiculopathy", treatment is prescribed taking into account the symptoms (pain, loss of sensation, motor impairment). First, patients are treated with conservative therapy:
- With the help of medications they relieve inflammation, swelling that occurs in the underlying tissues, soreness.
- Physiotherapeutic methods normalize blood circulation in the tissues surrounding the root, reduce pain, and facilitate impulses.
- Muscle blocks and cramps are eliminated by performing massage and manual therapy.
- Acupuncture techniques can restore nerve impulses.
- Exercise therapy with dosed volumes provides restoration of the biomechanics of the spine. Exercises that redistribute load vectors often relieve root compression. Thanks to gymnastics and exercises on the simulator, they stop the degenerative processes in the spine, increase the elasticity of ligaments and muscles. As a result, movements increase in volume. In addition, regular training is an excellent prevention that prevents relapses of varying degrees of intensity due to malfunctioning of the spine.
The listed methods perfectly treat chronic discogenic radiculopathy. The applied efforts relieve patients from the disease forever, returning them to a full life.
Surgical treatment of radiculitis
Surgical intervention requires complicated radiculopathy. What is radiculitis surgery? The type of upcoming surgery is affected by the condition of the spine, age and human health. Indications for it are persistent pain, a negative clinical picture.
The procedures consist in performing surgical decompression of the root, removing a protruded disc or bone adjacent to the nervous tissue, and performing disk-dissolving manipulations (chemonucleolysis) and other surgical operations.
Treatment Methods for Vertebrogenic Radiculitis
Vertebrogenic radiculopathy must be treated immediately . Therapy is chosen, given the etiology of radicular syndrome. First of all, they eliminate the main syndrome - pain. It is removed with anti-inflammatory drugs from the group of non-steroidal drugs. The choice of medicines is prudent, because they can lead to severe side effects.
If a patient is burdened with an intervertebral hernia, a compression fracture, an oncological pathology, he cannot avoid surgical intervention. In the postoperative period, thorough medical supervision is organized.
Patients who have had radicular syndrome are provided with comprehensive rehabilitation. They are restored in sanatoriums, receive therapeutic massage sessions, exercise therapy.