Share your insights

Help us by sharing what content you've recieved in your exams


Background knowledge ๐Ÿง 


  • Radiculopathy refers to a condition where one or more nerves are affected and do not work properly (a neuropathy).
  • This can result in pain, weakness, numbness, or difficulty controlling specific muscles.
  • It is often due to compression of the nerve root where it exits the spine.


  • Commonly affects individuals between 30-50 years of age.
  • Cervical radiculopathy affects about 85 in 100,000 people annually.
  • Lumbar radiculopathy is more common than cervical radiculopathy.
  • Higher prevalence in males compared to females.
  • Risk increases with age due to degenerative changes.


  • Nerve root compression often due to herniated disc, bone spur, or spinal stenosis.
  • Inflammation around the nerve root contributes to symptoms.
  • Impairment of blood flow to the nerve can also play a role.
  • Compression leads to demyelination and potential axonal loss.
  • Results in altered signal transmission and subsequent pain and sensory/motor deficits.

Aetiology/Causes/Risk factors

  • Herniated intervertebral disc – most common cause.
  • Degenerative disc disease.
  • Spinal stenosis – narrowing of the spinal canal.
  • Spondylolisthesis – vertebra slips over the one below it.
  • Trauma or injury to the spine.
  • Infections or tumors affecting the spine.
  • Risk factors include age, heavy physical work, smoking, and obesity.


  • Cervical radiculopathy – affects nerves in the neck.
  • Thoracic radiculopathy – less common, affects nerves in the mid-back.
  • Lumbar radiculopathy (sciatica) – affects nerves in the lower back.
  • Each type can be identified based on the specific nerve roots involved and corresponding clinical features.

Clinical Features ๐ŸŒก๏ธ


  • Pain radiating along the affected nerve root distribution (dermatome).
  • Numbness and tingling in the area supplied by the nerve.
  • Muscle weakness in the muscles innervated by the affected nerve.
  • Loss of reflexes in the involved region.
  • Pain typically worsens with movements that compress the nerve (e.g., neck or back movements).
  • Symptoms may be aggravated by coughing or sneezing.
  • In severe cases, bladder and bowel dysfunction can occur (emergency).


  • Decreased muscle strength in the distribution of the affected nerve root.
  • Reduced or absent deep tendon reflexes.
  • Sensory loss corresponding to the dermatome.
  • Positive Spurling’s test in cervical radiculopathy (pain with neck extension and rotation).
  • Positive straight leg raise test in lumbar radiculopathy (pain with leg raising).
  • Gait abnormalities if lower limb involvement is significant.
  • Muscle atrophy in chronic cases.

Investigations ๐Ÿงช

Initial tests

  • Clinical history and physical examination to identify signs and symptoms.
  • X-rays to assess for bony abnormalities and alignment.
  • MRI is the gold standard for visualizing soft tissue structures, including disc herniation and nerve compression.
  • CT myelography if MRI is contraindicated.
  • Electromyography (EMG) and nerve conduction studies to assess nerve function.
  • Blood tests if an infectious or inflammatory cause is suspected.
  • Ultrasound can be used to visualize peripheral nerve involvement.

Diagnostic tests

  • MRI to identify disc herniations, nerve root compression, and other soft tissue abnormalities.
  • CT scan for detailed bone assessment.
  • Electromyography (EMG) to evaluate electrical activity of muscles and confirm radiculopathy.
  • Nerve conduction studies to assess the speed and strength of signals in the nerves.
  • Myelography to evaluate the spinal canal and nerve roots using contrast dye and X-rays.
  • Blood tests to rule out other causes like infection or systemic diseases.

Management ๐Ÿฅผ


  • Conservative treatment includes physical therapy, NSAIDs, and activity modification.
  • Epidural steroid injections for inflammation and pain relief.
  • Surgical options if conservative measures fail or neurological deficits progress.
  • Discectomy or laminectomy to relieve nerve compression.
  • Rehabilitation post-surgery to restore function and strength.
  • Education on ergonomics and posture to prevent recurrence.
  • Pain management with medications or physical modalities.
  • Lifestyle modifications such as weight management and smoking cessation.


  • Chronic pain and disability.
  • Permanent nerve damage if untreated.
  • Muscle atrophy and weakness.
  • Bladder and bowel dysfunction in severe cases.
  • Reduced quality of life due to persistent symptoms.
  • Psychological effects such as depression and anxiety.
  • Dependence on pain medications.


  • Most patients improve with conservative management.
  • Surgical outcomes are generally good for those with refractory symptoms.
  • Prognosis depends on the cause and severity of nerve compression.
  • Early intervention leads to better outcomes.
  • Regular follow-up is essential to monitor progress and prevent complications.
  • Education on prevention is crucial for long-term success.

Key points

  • Radiculopathy is a common condition caused by nerve root compression.
  • Early diagnosis and treatment are crucial for preventing chronic symptoms.
  • MRI is the preferred diagnostic tool for visualizing nerve compression.
  • Conservative management is effective for most patients.
  • Surgical intervention may be necessary for severe or refractory cases.
  • Patient education and lifestyle modifications are essential for long-term management.
  • Regular follow-up and rehabilitation improve outcomes.

No comments yet ๐Ÿ˜‰

Leave a Reply