Radicular pain: Difference between revisions
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| name = Radiculitis |
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{{wikt | radicular}} |
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'''Radicular pain''', or '''radiculitis''', is [[pain]] "radiated" along the [[ |
'''Radicular pain''', or '''radiculitis''' (from the {{Langx|la|radicula|lit=small root}}), is [[pain]] "radiated" along the [[Dermatome (anatomy)|dermatome]] (sensory distribution) of a [[nerve]] due to inflammation or other irritation of the [[nerve root]] ([[radiculopathy]]) at its connection to the [[spinal column]].<ref>{{cite journal| pmid= 15253601 | volume= 33 | title= Lumbar radicular pain | year= 2004 | author= Govind J | journal= Aust Fam Physician | issue= 6 | pages= 409–12}}</ref> A common form of radiculitis is [[sciatica]] – radicular pain that radiates along the [[sciatic nerve]] from the lower spine to the lower back, gluteal muscles, back of the upper thigh, calf, and foot as often secondary to nerve root irritation from a [[spinal disc herniation]] or from [[osteophytes]] in the [[lumbar]] region of the spine.{{cn|date=February 2023}} Radiculitis indicates inflammation of the spinal nerve root, which may lead to pain in that nerve's distribution without weakness – as opposed to [[radiculopathy]]. When the radiating pain is associated with numbness or weakness, the diagnosis is radiculopathy if the lesion is at the nerve root, or [[myelopathy]] if at the spinal cord itself. |
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== Treatment options == |
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Seeking treatment for radiculitis should not be delayed. Depending on the severity, certain muscles (i.e.: in the toes, feet and calf) may start to atrophy over time, which in turn requires physical therapy for recovery. Also, radiculitis is known to cause patients to "favor" certain muscles (or a certain side of their body) which can result in the over-development of those muscles relative to the ones that don't get used as much. |
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Initial treatment for the pain may involve one or a combination of the following interventions: |
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* One or two days of rest, if the pain is severe |
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* Application of ice (to reduce the inflammation) and/or heat (to encourage blood flow to help the irritated area to heal) |
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* [[Non-steroidal anti-inflammatory drugs]] (NSAIDs), such as [[ibuprofen]] or [[Relafen]] |
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* [[Acetaminophen]] (paracetamol), e.g. Tylenol, which helps reduce the pain signals in the brain |
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* [[Spinal manipulation]] or mobilization when [[lumbar spine]] related<ref name="leininger">{{cite journal |author= Leininger B, Bronfort G, Evans R, Reiter T |year=2011 |title= Spinal manipulation or mobilization for radiculopathy: a systematic review |journal= Phys Med Rehabil Clin N Am |volume=22 |issue=1 |pages=105–125 |pmid=21292148 |doi=10.1016/j.pmr.2010.11.002}}</ref> |
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* [[Gabapentin]] or the newer prescription medicine [[pregabalin]] |
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* [[Analgesics]] or pain killers, such as [[Vicodin]], [[Percocet]], or, in severe cases, a low dosage of [[Methadone]] |
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* Muscle relaxers, such as [[cyclobenzaprine]] or [[methocarbamol]] |
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* [[Epidural]] steroidal injections, which involves injecting a steroid (and sometimes a pain killer) directly into the problem area in the low back to treat the inflammation that is irritating the nerve root |
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Once the initial period of severe pain is under control, a variety of treatments may be employed to address the underlying cause of the pain, such as a disc herniation, [[lumbar spinal stenosis]], or [[degenerative disc disease]]: |
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* [[Chiropractic]]<ref name="leininger">{{cite journal |pages=105–125 |doi=10.1016/j.pmr.2010.11.002 |title=Spinal Manipulation or Mobilization for Radiculopathy: A Systematic Review |year=2011 |last1=Leininger |first1=Brent |last2=Bronfort |first2=Gert |last3=Evans |first3=Roni |last4=Reiter |first4=Todd |journal=Physical Medicine and Rehabilitation Clinics of North America |volume=22 |pmid=21292148 |issue=1}}</ref> and/or [[Physical therapy]]: stretching and [[physical exercise]]; often recommended after a period of one to two days of rest and treatment to get the pain under control. |
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* Massage Therapy can be a useful adjunct in relieving pain; [[myofascial release]] may be helpful. |
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* Yoga Therapy by a skilled Yoga Therapist is another excellent adjunct treatment {{Citation needed|date=May 2011}}. |
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Modifying personal habits and lifestyle to prevent future exacerbation of the underlying cause of the pain is also important. For example, maintaining an appropriate body weight that's known not to aggravate the discs (this varies from patient to patient) as well as changing the way one goes about bending over for objects on the ground (heavy or light, it doesn't matter...all one has to do is bend in the wrong direction to invoke an episode). Another important lifestyle change that is usually recommended is to maintain a regular stretching and exercise program. |
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There are also a variety of surgeries that can be employed to treat severe cases of radicular pain, depending on the underlying condition that the surgery addresses. To treat a disc herniation, which may cause persistent radiating pain, a microdiscectomy surgery is usually performed. This is a minimally invasive approach that removes the portion of the disc that presses against the nerve root. The surgery has a high success rate, minimal healing time (typically the patient will go home on the same day as the surgery), and usually provides immediate relief of the sciatica and other symptoms caused by a herniated disc. This surgery may be recommended after several weeks of non-surgical treatment, or even earlier if the pain and other sciatica symptoms are severe. However, even in discal herniations, the long term outcomes do not differ between those who undergo surgery and those who do not. The decision to undergo surgery is not trivial, and is preferably made in consultation with two or more physicians. |
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== See also == |
== See also == |
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* [[Intervertebral disc]] |
* [[Intervertebral disc]] |
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* [[Sciatica]] |
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* [[Spinal disc herniation]] |
* [[Spinal disc herniation]] |
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* [[Arachnoiditis]] |
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== References == |
== References == |
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{{reflist}} |
{{reflist}} |
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== External links == |
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{{Medical resources |
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| DiseasesDB = 29521 |
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| ICD10 = {{ICD10|M|54|1|m|50}} |
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| ICD9 = {{ICD9|729.2}} |
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| ICDO = |
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| MedlinePlus = |
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| eMedicineSubj = |
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| MeshID = D011843 |
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}} |
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{{Dorsopathies}} |
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{{Soft tissue disorders}} |
{{Soft tissue disorders}} |
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{{Use dmy dates|date= |
{{Use dmy dates|date=February 2021}} |
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[[Category:Musculoskeletal disorders]] |
[[Category:Musculoskeletal disorders]] |
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[[it:Radicolite]] |
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[[ru:Радикулит]] |
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[[sv:Radikulit]] |
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[[uk:Радикуліт]] |
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Latest revision as of 16:20, 31 October 2024
 | This article needs additional citations for verification. (December 2010) |
| Radiculitis | |
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| Specialty | Neurology  |
Look up radicular in Wiktionary, the free dictionary.
Radicular pain, or radiculitis (from the Latin: radicula, lit. 'small root'), is pain "radiated" along the dermatome (sensory distribution) of a nerve due to inflammation or other irritation of the nerve root (radiculopathy) at its connection to the spinal column.[1] A common form of radiculitis is sciatica – radicular pain that radiates along the sciatic nerve from the lower spine to the lower back, gluteal muscles, back of the upper thigh, calf, and foot as often secondary to nerve root irritation from a spinal disc herniation or from osteophytes in the lumbar region of the spine.[citation needed] Radiculitis indicates inflammation of the spinal nerve root, which may lead to pain in that nerve's distribution without weakness – as opposed to radiculopathy. When the radiating pain is associated with numbness or weakness, the diagnosis is radiculopathy if the lesion is at the nerve root, or myelopathy if at the spinal cord itself.
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