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Radicular pain is pain associated with damage to one of the nerve roots, the connections between the spinal cord and peripheral nervous system. Injury to a nerve root is known as radiculopathy and is classified by where it is located. People who experience radicular pain may experience other symptoms as well. A neurologist is usually involved in diagnosis and treatment of radiculopathy.
The nerve roots consist of bundles of motor and sensory nerves that emerge from underneath the vertebrae. Each nerve root feeds a section of the peripheral nervous system, covering an area known as a dermatome. Radicular pain can cover an entire dermatome, or show up in just one section. Pinpointing the area where the pain is occurring is an important step in diagnosis and treatment, as a neurologist can figure out which nerve root is involved on the basis of the location of the pain.
Some reasons for radicular pain to develop include compression or inflammation of a nerve root, degenerative diseases involving the nervous system, and decreased bloodflow to the nerves, as seen in some patients with diabetes. In addition to pain, other symptoms can include tingling, numbness, and partial weakness. The patient may also have difficulty controlling muscle movements in the area where the pain is located.
Cervical radiculopathy originates in the nerve roots that emerge from the upper area of the spine, known as the cervical spine. It is also possible to experience thoracic or lumbar radiculopathies. Radicular pain that is caused by damage to the nerve roots in the lumbar spine is known as sciatica. People who experience sciatica often report that they have shooting pains that travel down the leg, and the pain is usually centered on one side of the body, corresponding to the involved nerve root.
When a patient seeks treatment for radicular pain, the first step is usually a full physical examination and medical imaging studies to look at the spine. Identifying the location, nature, and cause of the damage is an important step in treatment. If the radiculopathy can be treated, as for example with surgery to relieve compression, this will resolve the radicular pain. If the cause cannot be treated, options for the patient can include analgesic drugs to manage pain, electrical stimulation of the nerve to control pain signals, or a neurotomy to sever the nerve if the pain is unbearable and the patient appears to be a good candidate for this procedure.