In previous posts, we’ve discussed chronic pain, including how chronic conditions can affect dentists. Dentists and surgeons have strenuous jobs that require them to hold unnatural and static positions for extended periods of time, putting stress on their musculoskeletal systems. Consequently, it is not uncommon for dentists and surgeons to experience spinal issues, including radiculopathy. In this post we will examine the causes, diagnosis, symptoms, and treatment of radiculopathy.
Radiculopathy is a condition caused by a compressed nerve in the spinal column. This pinched nerve can occur at any spot in the spine, but is typically found in the cervical or lumbar portions of the back and, less frequently, in the thoracic spine. Symptoms vary based on where the nerve roots are compressed; however, the roots typically become inflamed and cause numbness, weakness, and pain. Those suffering from radiculopathy can find it difficult or impossible to function with the same level of dexterity they used to have.
Generalized symptoms of radiculopathy include:
- Sharp or shooting pains in the back, arms, legs, or shoulders that may worsen during certain activities
- Weakness or loss of reflexes in the arms or legs
- Numbness of the skin or “pins and needles” sensations in the arms or legs
- Some individuals develop a hypersensitivity to light touch at the affected areas
The location of and specific symptoms will vary based on where the compressed nerve occurs:
- Cervical Radiculopathy: Pressure on a nerve root in the neck. Symptoms include weakness, burning or tingling sensations, or loss of feeling in the shoulder, arm, hand, or fingers.
- Lumbar Radiculopathy: Pressure on a nerve root in the lower back. Symptoms include pain, weakness, or numbness that starts in the lower back and radiates through the buttocks down the back of the leg.
- Thoracic Radiculopathy: A pinched nerve in the upper/mid back. Symptoms include pain in the chest or torso, which can be mistaken for shingles.
Radiculopathy is caused by the irritation or compression of the nerves where they exit the spine. This compression can occur in several ways:
- Disc herniation, osteophytes (bone spurs), osteoarthritis, or the thickening of the surrounding ligaments
- Inflammation due to trauma or degeneration
- Conditions such as diabetes, rheumatoid arthritis, and obesity
- Poor posture and/or repetitive movements
- Genetic pre-disposition
In order to diagnose radiculopathy, a physician will perform a medical history review and physical examination. The examination will include an evaluation of muscle strength, sensation, and reflexes to detect any abnormalities. Additional imaging may be required, including:
- X-rays: to identify trauma, osteoarthritis, or early signs of a tumor or infection
- MRI or CT scan: to look at the soft tissues around the spine (nerves, discs, ligaments, etc.)
- Electromyogram (EMG) and nerve conduction studies: to look at electrical activity along the nerve to identify any damage
The course of treatment for radiculopathy will usually start out conservative, but more aggressive treatment may be needed when pain persists.
- Weight loss (if necessary) to reduce pressure on problem areas
- Physical therapy
- Avoiding activity that causes strain on the neck or back
- Chiropractic treatment
- Epidural steroid injection
- Surgery to remove the compression on the spine
These posts are for informative purposes only and should not be used as a substitute for consultation with and diagnosis by a medical professional. If you are experiencing any of the symptoms described below and have yet to consult with a doctor, do not use this resource to self-diagnose. Please contact your doctor immediately and schedule an appointment to be evaluated for your symptoms.
John Hopkins Medicine, https://www.hopkinsmedicine.org/healthlibrary/conditions/nervous_system_disorders/acute_radiculopathies_134,11
Columbia Spine, http://columbiaspine.org/condition/radiculopathy/
Medical News Today, https://www.medicalnewstoday.com/articles/318465.php