Radiculopathy (Radiculitis, from Latin radicula — root) is a condition of the peripheral nervous system that occurs as a result of damage, inflammation, or compression of the spinal nerve roots. Radiculopathies most commonly develop as a complication of osteochondrosis (such as disc protrusions and intervertebral hernias) and are characterized by severe pain that arises in the area of nerve root compression and typically has a paroxysmal nature.

Radiculitis is a widely spread condition, affecting more than 10% of the population over the age of 40-50. In recent decades, with the low activity levels of modern city dwellers, this disease has “become younger” and is now also seen in individuals aged 25 to 35. People involved in professional sports, as well as those who spend long hours sitting at a computer or driving a car, are especially prone to it.

TYPES OF RADICULOPATHY:

Radiculopathy is mainly classified according to its location. There are three main types:

  1. Lumbar-sacral radiculitis is the most common form. It has several subtypes, including: lumbago (also known as “low back pain”), sciatica and lumbosciatica. The first manifests as acute pain, the second as pain in the legs and buttocks, and the third is a combination of the previous two.
  2. Cervical radiculitis is the second most common and is localized directly in the neck area.
  3. Cervico-thoracic radiculitis is very rare, as the sternum is a fixed part of the body, unlike the spine.

Types of lumbar-sacral radiculopathy:

  • Lumbago (lumbargia) – this is an acute onset of pain in the lower back triggered by sudden physical exertion, overheating, or chilling of the body. The painful episode can last anywhere from a few minutes to several hours or even days. The primary cause of this type of radiculopathy is muscle strain in the lower back, intervertebral hernias, or vertebral displacement.
  • Sciatica (sciatica) – in this form of radiculitis, the pain is localized in the buttock, the back of the thigh, calf, and may extend down to the foot. In some cases, muscle weakness is also observed. This is due to irritation or damage to the sciatic nerve, the largest nerve in the body. The pain in sciatica is described as shooting, like an electric shock, and may also involve sensations of burning, tingling, “pins and needles,” and numbness simultaneously. Pain intensity can vary from mild to severe, to the point where the patient cannot sleep, sit, stand, walk, bend, or turn.
  • Lumbosciatica – this is pain in the lower back radiating to one or both legs. The pain in this type of radiculitis usually spreads along the buttock and the back-lateral surface of the leg but does not reach the toes. Typically, the pain is aching, burning, and progressively increasing.

CAUSES OF RADICULITIS DEVELOPMENT:

The causes of radiculitis are pathological processes that occur in the spine, specifically:

  • Degenerative-dystrophic processes – osteochondrosis and its complications: protrusions and intervertebral disc hernias.
  • Congenital defects of the musculoskeletal system, leading to changes in muscle tone.
  • Postural disorders, spinal deformities – scoliosis.
  • Improper distribution of physical loads on the spine during professional activities (such as driving, office workers, and loaders – prolonged staying in one position, heavy lifting).
  • Sedentary lifestyle, which gradually leads to impaired blood circulation in the muscles of the lumbar region.
  • Improper hydration throughout the day and over several months.
  • Vitamin and mineral deficiencies, which can lead to osteoporosis and trophic damage to nerve fibers.
  • Infectious spinal cord damage, including tuberculosis, osteomyelitis, chronic syphilis, and other infections.
  • Regular spinal trauma and injury to surrounding soft tissues (blows, sharp twisting motions, compression during jumps, ligament strains).
  • Obesity (Grade 1–2) and the presence of harmful habits such as smoking, excessive consumption of tea, coffee, and alcohol.

SYMPTOMS OF THE DISEASE:

Cervical Region:

  • Pain in the neck area (often affecting the occipital region).
  • Frequent dizziness.
  • Discomfort radiating to the shoulder, elbow joints, hands, and fingers. In these areas, pain and numbness, as well as reduced motor activity, are common.
  • Paresthesia (loss of sensitivity, a sensation of cold).
  • Metabolic disturbances manifesting as peeling skin and cold skin on contact.

The appearance of the above symptoms leads to oxygen deprivation of the brain. Home therapy will provide only temporary relief, but the condition will continue to progress, which is dangerous for health and life.

Thoracic Region:

  • Pain is typically of a band-like nature, occurring between the shoulder blades and across the chest.
  • Discomfort radiates to the armpit and shoulder joint.
  • Pain may extend to the middle finger of the hand and affect the triceps.
  • During examination, doctors may note a decrease in the triceps reflex.

Note that radiculopathy in the thoracic region can lead to problems with breathing and the heart. Dealing with the consequences can be extremely difficult. Remember this when delaying a visit to the doctor.

Lumbar Radiculopathy:

  • Intense pain in the thigh, buttocks, and legs.
  • Acute discomfort localized in the lower back, radiating to both legs.
  • Decreased mobility with sudden bends or movements.
  • Numbness in the lower limbs, with a loss of movement. In some cases, full paralysis below the waist can occur.

In advanced stages, problems with the intestines and urinary system may develop, and sexual dysfunction may occur.

DIAGNOSIS:

When radiculopathy is suspected, the patient is prescribed a specific set of examinations to confirm or rule out the preliminary diagnosis:

  • During the initial examination, a vertebrologist performs a neurological assessment to determine the severity and exact location of the spinal nerve root damage.
  • The doctor considers the intensity of the pain and the sensitivity of the affected area.
  • If necessary (to confirm inflammatory or degenerative processes, vertebral instability), instrumental studies are prescribed: MRI, CT scan, X-ray, electromyography.

Based on the information obtained, the doctor makes a diagnosis, confirms radiculopathy, and selects the necessary therapeutic course. The choice of specific medications or procedures depends on the severity of symptoms, the nature of the disease, and the presence of comorbidities.

TREATMENT

Conservative treatment methods for spinal radiculopathy:

  • Use of nonsteroidal anti-inflammatory drugs (NSAIDs). These help reduce inflammation and relieve pain.
  • Vitamin B, which has a beneficial effect on nerve fibers. Muscle relaxants help relieve muscle spasms.
  • For severe pain, applications with Dimexide and Novocaine are used.
  • Local treatments include warming ointments with irritant effects and combined preparations that provide pronounced pain relief and anti-inflammatory effects.
  • Physiotherapy during remission is an essential part of radiculopathy treatment. Effective methods for radiculitis include acupuncture, magnetotherapy, and electrophoresis.
  • Excellent results are shown by therapeutic exercises (LFC) and manual therapy. These procedures relieve pain, stretch the spine, and relax muscles.

The combination of these therapeutic measures positively affects the patient’s condition.

Minimally invasive procedures and surgery

If there is no improvement after conservative therapy or if the patient’s condition worsens, doctors resort to other treatment methods. Minimally invasive procedures such as intradiscal microtherapy and discectomy, as well as surgical intervention, are used.

To prevent the development of radiculopathy or to prolong remission, the following recommendations help:

  • Engage in sports (suitable activities include gymnastics, therapeutic exercise, swimming, yoga, Pilates).
  • If you have prolonged static loads on the spine (sedentary work, driving), take a break every hour and do light exercises.
  • Sleep on an orthopedic mattress and choose a low pillow.
  • Comfortable footwear is important (heels no higher than 4 cm).

Following these simple rules positively influences the patient’s condition and helps prevent many pathologies, including radiculopathy of all spinal regions. Take care of your health, and if specific symptoms appear, consult a doctor and start the necessary treatment.