Dr. Kaliq Chang explains radicular pain and some tips for coping with this common spine problem.
Radiculitis can affect any part of the spine, but is most common in the lower back or neck. The resulting pain can be chronic or can come and go, and sometimes it's severe.
Radicu-what? Perhaps the only thing more ridiculous than the name radiculitis is how much pain this spine problem can cause. But the good news about radiculitis "which is extremely common" is that most patients recover quickly, says Dr. Chang.
Exactly what is radiculitis? It's the term describing pain that radiates along a nerve path connected to the spinal column, Dr. Chang says. Radiculitis can affect any part of the spine, but is most common in the lower back or neck. The resulting pain can be chronic or can come and go, and sometimes it's severe.
"Radiculitis isn't technically a condition in itself," explains Dr. Chang, who is fellowship-trained in interventional pain management. "It's the symptoms felt when a nerve or nerve root coming from the spine is pinched, irritated, inflamed, or simply put, just not working properly."
Risk factors for radiculitis
Nerve roots at the spine can be injured in many ways falls, auto accidents, sports injuries and even aging itself are all culprits. These back injuries can damage discs between spinal vertebrae, which then emit a chemical through a crack in their outer shell that touches a nerve. It can also happen when pressure is placed on a nerve from other conditions, such as arthritis; a bone spur; a herniated disc; or spinal stenosis (which narrows the canal surrounding nerves), among other causes.
But while radiculitis can't always be prevented, certain risk factors predispose some people to it. These include:
- Participating in heavy labor or contact sports
- A family history of radiculitis or other spine disorders
- Diabetes, which can decrease normal blood flow to spinal nerves
Maintaining a reasonable weight, diligent muscle conditioning, and avoiding excessive strain on the back and neck can also help lower the odds of developing radiculitis.
"The most common symptoms of radiculitis are pain, numbness or tingling in the arms or legs," Dr. Chang says. "Some patients may have localized neck or back pain as well. When radiculitis occurs with pain radiating down the leg, it's also often called sciatica" a term with which many more people are familiar."
Tips for radiculitis treatment
Unless there are concerns about nerve death or other permanent injury, patients with radiculitis should always opt for conservative, nonsurgical treatment first, including epidural steroid injections Dr. Chang says. But treatment choices should follow a diagnostic process that may include a physical exam along with imaging scans that confirm herniated discs or other spinal conditions leading to radiculitis.
According to Dr. Chang, conservative treatments for radiculitis include:
- Rest. "Patients who can manage to completely stay off their feet for the first 24 to 48 hours after an injury may dramatically help the situation," he says.
- Pain relievers, including NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen, which relieves swelling and pressure.
- Physical therapy.
- Epidural steroid injections into the spinal area.
Surgery to treat radiculitis is only considered if all these options fail to reduce debilitating pain that prevents patients from going about their daily activities, he says. Surgical procedures can often be done endoscopically, using tiny incisions leading to less blood loss and pain and a quicker recovery.
"There's no reason not to be optimistic if you're suffering from radiculitis, since the outlook is good," Dr. Chang says. "Most patients respond well to conservative treatment choices, and those who need surgery typically also have no lingering issues. The vast majority of radiculitis cases resolve within 6 weeks to 3 months."