Cervical and Lumbar Radiculopathy

One of the interesting elements of medicine is the use of powerful words to define medical terms. Take for instance, cervical/lumbar radiculopathy. Most people would hear those words and run to Google immediately. 

When I meet with patients in the exam room and share a diagnosis of cervical and/or lumbar radiculapathy, I usually pause and then break the discussion down into lay terms to reduce stress and confusion. Although the internet has allowed many of us to become experts outside our normal scope, hearing complicated words can still rattle and upset us quickly. 

Cervical Radiculopathy results when a nerve in the neck is irritated at the point where it leaves the spinal canal and is most commonly due to a bone spur or disc herniation. 

It is the symptom of nerve compression in the neck which may include dull or sharp pain in the neck or between the shoulder blades. This pain radiates down the arm to the hand or fingers. Some people also experience numbness or tingling in the shoulder or arm. Pain may increse with certain positions or different movements of the neck. 

When using lay terms, it has been referred to as a "pinched nerve" because a nerve in the neck has been compressed or irritated where it branches away from the spinal cord. Cervical radiculopathy is often caused by "wear and tear" changes that occur in the spine as we age, such as arthritis, but for many young people the pain is caused by a sudden injury that results in a herniated disk.

As the disks, in the spine age, they lose height and the vertebrae move closer together, begin to bulge, dry out and become stiffer. This problem causes settling or collapse of the disk spaces and loss of disk space height. 

The disk responds by forming more bone - called bone spurs - around the disk to strengthen it. Bone spurs contribute to stiffening of the spine and may narrow the foramen which are the small opening on each side of the spinal column where the nerve roots exit. The bone spurs pinch the nerve root. 

Lumbar radiculopathy refers to disease involving the lumbar spinal nerve root. This can manifest as pain, numbness, or weakness of the buttock and leg. Sciatica is the term often used to label this issue. Sciatica may feel like a harsh cramp that does not go away quickly and lasts for multiple weeks. There tends to be an onset of pain when you sit, sneeze, or cough. It is also described as a pain comparative to 'pins and needles' numbness or a burning/tingling sensation down your leg. 

It is typically caused by a compression of the spinal nerve root. The compression causes pain in the leg rather than in the lumbar spine. In healthcare, that pain is called "referred pain." Lumbar radiculopathy may occur when the spinal nerve roots are irritated or compressed by one of many conditions, including lumbar disc herniation, spinal stenosis, osteophyte formation, spondylolisthesis, forminal stenosis, or other degenerative disorders. 

If you are experiencing cervical or lumbar radiculopathy-related symptoms, it is important to reach out to a specialist to schedule a full examination to evaluate and determine the source of your pain/issues. 

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