Sciatica or Radicular Syndrome
Radicular syndrome results in pain and other symptoms such as numbness, tingling and weakness in the arms or legs. The quality and type of pain can vary, from dull, aching and difficult to localize, to sharp and burning.
Radicular syndrome is caused by compressed or irritated nerve roots. The nerve roots are branches of the spinal cord that carry signals out to the rest of the body at each level along the spine.[/tab] [tab title=”Treatments”]Physical therapy, chiropractic manipulation, patient education and anti-inflammatory medication are the most common non-operative treatments for radicular pain. If these fail to provide relief, epidural steroid injections may also be considered as well as surgery.
Description of Radicular Syndrome
Radicular syndrome results in pain and other symptoms such as numbness, tingling and weakness in the arms or legs. It is caused by compressed or irritated nerve roots. The nerve roots are branches of the spinal cord that carry signals out to the rest of the body at each level along the spine. Radicular syndrome is often caused by direct pressure from a herniated disc or degenerative changes in the spine that cause irritation and inflammation of the nerve roots. Sensory symptoms are more common than motor symptoms, and muscle weakness is usually a sign that the nerve compression is more severe. The quality and type of pain resulting from radicular syndrome can vary, from dull, aching and difficult to localize, to sharp and burning.
Screening and Diagnosis of Radicular Syndrome
The correct diagnosis for radicular syndrome begins with a complete physical examination of the neck, back, arms and lower extremities. Your doctor will look for any problems with flexibility, muscle strength, sensation and reflexes. X-rays may be indicated to show the bony anatomy of the spine. An MRI scan or a CT scan may also be ordered. An MRI scan is useful in showing compression of nerve roots by giving a detailed picture of soft tissue structures. A CT scan is often used to evaluate the bony anatomy in the spine, which can show how much space is available for the nerve roots and spinal cord within the spinal canal. Early on, in mild situations, imaging studies may not be required.
Treatments for Radicular Syndrome
Physical therapy, chiropractic manipulation, patient education and non-steroidal anti-inflammatory medication are the most common non-invasive treatment options for most patients with no evidence of significant muscle weakness caused by radicular syndrome. Epidural steroid injections may also be considered for severe cases. As discussed earlier, muscle weakness is a concerning sign of nerve root compression or radicular syndrome. Nerve testing (electromyograpthy or EMG) may be indicated to objectively test the condition of the nerve-muscle connection, particularly if strength testing is limited by pain. If a patient suffers from actual nerve injury, surgery may be indicated to relieve the pressure on the nerves. In other situations, surgery may be offered if the non-surgical treatment options have failed to improve the symptoms of radicular syndrome. It is important to discuss treatment options with your doctor in deciding which treatment, if any, may be best for you.