Spinal Nerve Pain (Radiculopathy)

Spinal nerve pain, known medically as radiculopathy, occurs when a nerve root is squeezed or inflamed as it leaves the spine. Often called a "pinched nerve", it most commonly affects the neck, causing pain in the shoulder and arm, or the lower back, causing pain in the leg. Less often it affects the mid-back, causing a band of pain around the chest or tummy.

Symptoms

• Neck (cervical): pain spreading from the neck to the shoulder blade, arm and hand
• Lower back (lumbar): pain spreading to the buttock, thigh, leg or foot
• Electric-shock, burning or pins-and-needles feeling along a particular strip of skin
• Numbness in certain fingers or toes
• Weakness of grip, difficulty lifting the arm, or weakness of the ankle or foot
• Pain that increases with certain neck movements, looking up, sitting, bending or coughing

Causes

• Disc bulge or herniation pressing on a nerve root
• Age-related wear and tear (spondylosis) with bony spurs narrowing the nerve opening
• Arthritis of the small facet joints and thickening of spinal ligaments
• Slipping or instability of a vertebra (spondylolisthesis)
• Injury to the spine
• Less commonly, cysts, infections or tumours

Diagnosis

A careful examination of muscle strength, sensation and reflexes helps identify which nerve root is involved. An MRI of the neck or lower back shows the discs, nerves and spinal canal clearly. X-rays, sometimes taken while bending forwards and backwards, assess alignment and stability, and a CT scan may be used for bone detail. Nerve conduction studies help separate radiculopathy from conditions that can look similar, such as carpal tunnel syndrome, diabetic nerve damage or shoulder problems.

Treatment

Most people with a pinched nerve improve with non-surgical treatment. This includes medicines for pain and nerve irritation as prescribed by your doctor, physiotherapy with stretching and strengthening exercises, and correction of posture, especially for those who spend long hours on a computer or mobile phone. Avoiding heavy lifting and awkward positions during the painful phase helps the nerve settle. When pain persists, an image-guided nerve root block may give relief.

Surgery is considered when pain continues despite adequate treatment, when weakness is significant or getting worse, or when the spinal cord is also under pressure. In the neck, options include removing the disc from the front and fusing the segment (ACDF), artificial disc replacement in suitable patients, or widening the nerve opening from the back (foraminotomy). In the lower back, microscopic or endoscopic removal of the disc or bone pressing on the nerve is commonly performed, with fixation added only if the spine is unstable. The right option depends on your examination and scan findings.

When to Seek Urgent Care

Go to the nearest emergency immediately if you notice:

• Rapidly increasing weakness in an arm or leg
• Clumsy hands, unsteady walking or difficulty with buttons, which can mean spinal cord pressure
• Loss of bladder or bowel control, or numbness around the private parts
• Pain with fever, or nerve pain following a fall or accident
• Left arm or shoulder pain with chest discomfort, sweating or breathlessness, as this may be a heart problem

If arm or leg pain from a pinched nerve is troubling you, please consult Dr. Prashant Sharma at Keshav Super Speciality Hospital, Meerut, to understand the cause and your treatment options.

Related Conditions

• Spinal Paralysis
• Spine Tumour
• Spine Fracture
• Spinal Tuberculosis (Pott's Spine)
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