Orthopedic doctors generally recommend that individuals try non-invasive, non-surgical options before considering surgical treatment of radiculopathy – pain that radiates into the arms or legs. But if symptoms continue to progress over time, there are multiple surgical procedures, ranging from minimally-invasive to invasive surgery, that can offer relief.
What It Is
Radiculopathy is the name doctors give pain symptoms that spread into the upper or lower limbs. The pain doesn't really come from that part of the body, but comes instead from nerves branching out from a pinched nerve root somewhere along the spinal column. Compression or inflammation of the nerve root can cause symptoms along the nerve's pathway. Without treatment, symptoms don't always resolve on their own and can get worse.
Symptoms of Radiculopathy
The symptoms of radiculopathy can differ depending on whether nerves in the upper or lower body are affected. Disc herniation and spondylosis (spinal arthritis) often are the cause of nerve root compression. Diabetes, foraminal stenosis due to arthritis, and nerve root injuries are other causes of radiculopathy.
Symptoms of Cervical Radiculopathy:
Numbness and tingling in the arms and hands
Weakness in the neck, shoulders, arms, and hands
Difficulty performing fine motor tasks involving the fingers or hands
Symptoms worsen when turning the head from side to side
Symptoms of Lumbar (Lower Back) Radiculopathy:
Sciatica – weakness, tingling sensation or pain in the buttocks, legs, and feet
Deep pain that can be dull, sharp, or a severe burning pain that radiates down the back of the thigh and calf
Loss of certain reflexes
Symptoms affecting either the upper or lower extremities can come and go.
Treatment of Radiculopathy
Non-Invasive Treatment Options
Physical therapy, including stretching and strengthening exercises
Pain medication, which may include over-the counter non-steroidal anti-inflammatory drugs, prescription anti-inflammatory drugs, muscle relaxants, or oral or epidural steroid injections
Lifestyle changes, including avoiding activities that put added stress on the neck and spine
For more severe radiculopathy, surgery eventually may be necessary to relieve pressure causing the symptoms. Doctors don't usually recommend surgery unless conservative treatment for pain has failed or pressure on nerve roots causes weakness, or bladder or bowel dysfunction.
Minimally-Invasive Surgery Options
Endoscopic procedures, such as endo microdiscectomy or endoscopic discectomy, remove bone fragments or a spinal disc pressing against nerve roots. The surgeon needs to make only one, small incision.
Laminoforaminotomy is a procedure orthopedic surgeons, like those at Northwoods Family Orthopaedics SC, perform to relieve pain caused by a herniated disc. The surgeon makes an incision on the back of the neck to remove a herniated disc in the neck. Often, patients can go home on the same day as the surgery. Removing the disc relieves pressure on the nerves, alleviating pain and improving coordination and fine motor control.
Although it's a common back surgery, a traditional laminectomy involves the surgeon removing a part of one or more vertebrae, bone spurs, or ligaments pressing on nerves. How long recovery takes afterward depends on the extent of the surgery. Some people also require spinal fusion or an implant to stabilize the lower back.