Radiculopathy (cont.)

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What are the symptoms of radiculopathy?

The symptoms of radiculopathy depend on which nerves are affected. The nerves exiting from the neck (cervical spine) control the muscles of the neck and arms and supply sensation there. The nerves from the middle portion of the back (thoracic spine) control the muscles of the chest and abdomen and supply sensation there. The nerves from the lower back (lumbar spine) control the muscles of the buttocks and legs and supply sensation there.

The most common symptoms of radiculopathy are pain, numbness, and tingling in the arms or legs. It is common for patients to also have localized neck or back pain as well. Lumbar radiculopathy that causes pain that radiates down a lower extremity is commonly referred to as sciatica. Thoracic radiculopathy causes pain from the middle back that travels around to the chest. It is often mistaken for shingles.

Some patients develop a hypersensitivity to light touch that feels painful in the area involved. Less commonly, patients can develop weakness in the muscles controlled by the affected nerves. This can indicate nerve damage.

How is radiculopathy diagnosed?

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The diagnosis of radiculopathy begins with a medical history and physical examination by the physician. During the medical history, the doctor will ask questions about the type and location of symptoms, how long they have been present, what makes them better and worse, and what other medical problems present. By knowing the exact location of the patient's symptoms, the doctor can help localize the nerve that is responsible. The physical examination will focus on the extremity involved. The doctor will check the patient's muscle strength, sensation, and reflexes to see if there are any abnormalities.

The patient may then be asked to obtain imaging studies to look for a source of the radiculopathy. Plain X-rays are often obtained first. These can often identify the presence of trauma or osteoarthritis and early signs of tumor or infection. An MRI scan may then be obtained. This study provides the best look at the soft tissues around the spine including the nerves, the disc and the ligaments. If the patient is unable to obtain an MRI, they may obtain a CT scan instead to explore possible compression of the nerves.

In some cases the doctor may order a nerve conduction study or electromyogram (EMG). These studies look at the electrical activity along the nerve and can show if there is damage to the nerve.

Medically Reviewed by a Doctor on 11/8/2013

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