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What Is Radiculopathy? Cervical, Lumbar, and Thoracic Types

radiculopathy

The spine is an essential component of human anatomy for many reasons; it gives the body structure, allows us to stand upright and practice good posture, enables flexible movement, and the nerves within facilitate brain-body communication. The spine is involved in virtually every working system within the body. Keep reading to learn about radiculopathy and its effects on the body.

As the brain and spine work in tandem to form the body’s central nervous system (CNS), the 31 pairs of spinal nerves are the body’s major nerves; they are located at all levels of the spine, and when a spinal nerve is pinched, this is called radiculopathy and can cause a number of symptoms.

Before discussing the specifics of radiculopathy, let’s start by exploring some basic spinal anatomy and the role of the spinal nerves within.

Spinal Anatomy

The spine consists of 33 vertebrae (bones) stacked on top of one another in a straight and natural alignment.

The vertebrae form a canal in the center of the spine, in which the spinal nerves are housed, called the spinal cord, and the vertebrae that surround it protect it from injury and/or trauma.

The vertebrae are separated by intervertebral discs that perform many integral roles in how the spine functions: facilitating flexible movement, giving the spine structure (adjacent vertebral bodies attach to each end of a disc), and act as the spine’s shock absorbers.

The discs also help the spine to maintain its natural curvatures and alignment; in a healthy and properly-aligned spine, the spinal nerves have enough space to function optimally without facing irritation and/or inflammation.

If an intervertebral disc faces injury, trauma, or degenerative changes, it can change shape and intrude upon the space housing a nearby nerve, causing nerve compression and a variety of symptoms that can be felt anywhere along the affected nerve’s pathway.

The spine’s optimal health and function depend on its ability to maintain its natural curvatures, which give healthy spines a soft ‘S’ shape when viewed from the sides and appear straight from the front and back.

The spine’s natural curvatures facilitate shock absorption and balance, making the spine stronger, more flexible, and maintained by a network of tendons, ligaments, and muscles.

Now that we’ve discussed some basic spinal anatomy and the main structures involved in maintaining the spine’s natural curvatures let’s move on to the role of the spinal nerves.

Spinal Nerves

As mentioned, the brain and spine work together as the body’s central nervous system.

Each section of the spine contains spinal nerves. The cervical spine (neck), thoracic spine (middle/upper back), and lumbar spine (lower back) are the spine’s main sections, and there is also the sacrum (triangular-shaped bone connecting the spine to the hips), and the coccyx (tailbone).

The body’s nerves control many bodily functions and systems, including organs, movement, and sensation; the nervous system does this by facilitating communication between the brain and the rest of the body.

The brain supplies the nervous system with information, and the body responds appropriately both internally and externally.

The brain is the home of 12 cranial nerves (5 motor, 3 sensory, and 4 motor/sensory), and the spinal cord extends from right below the brainstem to the coccyx.

The spinal cord consists of 31 pairs of spinal nerves. There are 8 pairs in the cervical spine, 12 in the thoracic spine, 5 in the lumbar section, sacral spine houses 5, and the coccyx has 1.

The CNS extends to the peripheral nervous system (PNS): a network of nerves that branch off from the spinal cord, brain, and brainstem.

The PNS includes the somatic nervous system (SNS) and the autonomic nervous system (ANS) and transports information to and from the CNS; the SNS contains nerves that serve the musculoskeletal system and the skin, while the ANS works to maintain homeostasis (normal consistent functioning) within the body.

The spinal cord, containing the spinal nerves, ends just below the last vertebra of the thoracic spine and the first vertebra of the lumbar spine at what’s known as the conus medullaris; from here, the spinal nerves are known as the cauda equina, are suspended in cerebrospinal fluid (CSF), and extend to the coccyx.

The spinal nerve roots exit the spinal canal, where they feed the areas in front of (anterior), or behind (posterior) the spine.

The anterior nerve roots affect the limbs, while the posterior nerve roots affect the muscles behind the spine.

As you can see, the spinal nerves facilitate the function of many body parts and important systems at work within the body.

as nerves are like branches 400As nerves are like branches on a tree, fanning off in multiple directions, any condition that affects the nerves can affect multiple areas of the body, not just the area directly surrounding an affected nerve.

So now that we’ve talked about spinal anatomy and explored how the nerves facilitate communication between the brain and the rest of the body, as well as how the PNS carries information to and from the CNS, let’s discuss what can happen when one of those nerves are pinched.

What is Radiculopathy?

When a nerve root is irritated and/or compressed, this is known as radiculopathy, and it can cause a variety of symptoms felt anywhere along its pathway, which is why nerve-related conditions are not always easy to diagnose.

For example, the sciatic nerve is the human body’s largest nerve formed by the merging of 5 nerve roots; it starts in the lumbar spine, and its pathway extends down the buttock, back of the thigh, and into the heel and sole of the foot.

The sciatic nerve connects the spinal cord with the skin and muscles of the thigh, leg, and foot, so if the sciatic nerve is irritated in the lower back, where it originates, it can cause pain and symptoms felt anywhere along its pathway, which is extensive.

For an average person experiencing unexplained foot pain, it’s understandable that they would assume it’s related to a foot issue/injury, when in fact, the source of the problem is nerve compression, inflammation, and/or irritation that occurs far from the site of experienced pain in the foot.

Clearly, with the extensive network of nerves throughout the body, radiculopathy, depending on the site of the affected nerve(s), can have a number of causes.

Radiculopathy Causes

radiculopathy can have a 400Radiculopathy can have a number of causes, from spinal injury/trauma to the development of various spinal conditions, many of which involve a loss of nerve space caused by structural changes within the spine itself.

Some of the most common causes of radiculopathy include:

As mentioned earlier, the spinal discs play important roles in preserving the spine’s overall health and function, so a variety of disc issues/conditions, including bulging, herniated, and/or degenerative disc disease, can impact surrounding nerves.

Abnormal bone growths such as bone spurs can also invade nerve space and cause radiculopathy.

The presence of spinal tumors pressing on the spine can irritate its nerves, and conditions like osteoarthritis that affect the joints of the spine can weaken the vertebrae and cause a number of issues and injuries like compression fractures.

Spinal conditions that involve a narrowing of the spaces within the spine, like spinal stenosis, can cause radiculopathy by exposing the nerves within to uneven pressure.

Diabetic neuropathy is a form of nerve damage caused by high blood sugar and poor circulation, which can injure nerves, most commonly the nerves in the legs and feet.

Structural spinal conditions like scoliosis are also linked to radiculopathy. The development of an unnatural sideways spinal curvature, with rotation, introduces a lot of uneven forces to the body, particularly the spine and its surrounding ligaments, muscles, and nerves.

Additional radiculopathy risk factors include age-related spinal degeneration, obesity, chronic poor posture, repeatedly lifting heavy objects incorrectly that lead to uneven wear and strain, overuse injuries, and/or a genetic predisposition to degenerative bone conditions like osteoarthritis and osteoporosis.

So now that we have defined radiculopathy and discussed some of its most common causative sources, what are its symptoms?

Radiculopathy Symptoms

As mentioned, nerve-related conditions can affect the body in a myriad of ways, and symptoms are related to a number of important patient/condition characteristics: patient age and overall health, including spinal health and function, causation, severity, and location of the affected nerve.

As the spinal nerves extend from the spinal cord and travel throughout the body, symptoms will vary, and the location of nerve compression in the spine is a big determining factor.

As mentioned, the spine has different sections, so let’s talk about how the different types of radiculopathy are related to the location of the affected nerve.

Cervical Radiculopathy

The cervical spine refers to the neck region and consists of seven vertebrae (C1-C7).

When a nerve in the neck or upper back is facing compression, this is cervical radiculopathy, and while severity can range from one patient to the next, common symptoms include:

  • Neck pain
  • Shoulder pain
  • Upper back pain
  • Arm pain
  • Weakness and/or numbness, most often on one side of the body

Thoracic Radiculopathy

The spine's thoracic region is the longest and most complex section with 12 vertebrae (T1-T12); it includes the middle/upper back and connects the cervical spine above to the lumbar spine below.

The thoracic spine extends from the base of the neck to the abdomen and is the only spinal section that attaches to the ribcage.

When nerve compression and/or irritation occurs in the middle/upper back region, the following symptoms are common:

  • Chest pain
  • Torso pain
  • Burning and/or shooting pain in the rib cage, sides, and/or abdomen
  • Numbness and/or tingling in the back and affected areas

Lumbar Radiculopathy

The lumbar spine consists of 5 vertebral bodies (L1-L5) and is designed to bear the brunt of the body’s weight.

The lumbar spine is very strong and protects the highly-sensitive spinal cord and its nerve roots. It’s also very flexible, enabling mobility in different anatomical planes: extension, flexion, side bending, and rotation.

When a nerve is compressed and/or irritated in the lower back, it can cause a number of symptoms, particularly in relation to the lower body.

While every case of lumbar radiculopathy is unique, symptoms tend to get worse during long periods of sitting or standing and commonly include:

  • Sciatic nerve pain
  • Lower back pain
  • Leg pain
  • Hip pain
  • Buttocks pain
  • Foot pain
  • Numbness and/or weakness in the leg and foot
  • Numbness and/or tingling in the back or leg
  • Changes to sensation and reflex

In some cases, and particularly when severe, lumbar radiculopathy can affect bowel and bladder function, causing bowel and bladder incontinence and a loss of control.

Sciatica is a form of lumbar radiculopathy because, as mentioned earlier, the sciatic nerve is the largest nerve in the body, formed by the union of  5 nerve roots located in the lumbar spine.

Regardless of which section of the spine contains the compressed nerve, sleep problems can be a general symptom of radiculopathy, so let’s address this common condition-related topic.

How to Sleep with Radiculopathy

Any condition that causes pain can disrupt sleep. Pain can make it difficult to get comfortable, and when radiculopathy interferes with how the body functions, it can make getting a good night’s rest even more challenging.

While not every person with nerve pain is guaranteed to experience significant sleep issues, radiculopathy can affect the body in many different ways, including the ability to get comfortable, both when awake and asleep.

Nerve-related pain is known as one of the most debilitating forms of back pain, so for those experiencing it, when it comes to sleep, it’s about finding a position that can help relieve the pressure on affected nerves so they feel more comfortable.

Interestingly enough, the best sleep positions for people with back issues, including nerve-related conditions, are the same as for people with healthy spines. The best sleep positions for alleviating back pain are the positions that promote neutral and healthy spinal alignment, don’t expose the spine to uneven pressure, and reduce pressure points (where the body meets the mattress and has to support the body’s weight).

The best sleep position in terms of preserving spinal health and function is flat on the back because this position offers optimal spinal support by evenly distributing the body’s weight, so pressure points are minimized.

A cervical pillow can also increase spinal support, and particularly for those suffering from cervical radiculopathy, extra neck support can help reduce pressure on affected nerves in the neck.

The next-best sleep position for spinal health is side sleeping. If someone is experiencing radiculopathy pain on the left side, sleeping on the right can reduce the pressure points on the affected area and relieve pressure.

In addition, placing a pillow between the knees can also help align the spine and alleviate uneven pressure on nerves.

Also, don’t underestimate the power of a good mattress when it comes to reducing nerve-related back pain: one that minimizes pressure points has a comfortable firmness and decent flex (how quickly a mattress conforms to the body after a position change).

The level of flex can be a helpful feature for those suffering from radiculopathy as frequent position changes in an attempt to get comfortable can be common.

Temperature regulation is another feature a good mattress can offer, and for some people, this can greatly improve comfort during sleep.

So now that we’ve defined radiculopathy and discussed its causes, symptoms, and how to sleep with the condition, let’s discuss treatment options.

Radiculopathy Treatment

While each case is unique and there are no treatment guarantees, most patients’ radiculopathy can be treated nonsurgically.

While there are always medications that can be used to ease inflammation and manage pain, here at the Scoliosis Reduction Center, I always opt for a proactive approach that addresses the underlying condition and not just its symptoms.

Part of proactively treating a condition is addressing its underlying cause, as causation has to be the driving force behind the design of effective treatment plans.

Patients at the Scoliosis Reduction Center benefit from customized treatment plans that involve combining different disciplines for the best potential results, so depending on what’s caused the radiculopathy, I can work towards providing pain relief by addressing its underlying cause.

If intervertebral disc deterioration is the underlying cause, I work towards improving the function of the affected disc as this will improve the health of its surroundings, including nerves. This can be done by addressing relevant lifestyle issues such as maintaining a healthy weight and activity level and the ergonomics of how to lift heavy objects without repeatedly straining the back.

I can also work towards improving the health of the affected disc’s surroundings by increasing core strength so the spine is optimally supported and stabilized, circulation is increased, and through chiropractic care, vertebral adjustments/remodeling can induce a structural change that can take pressure off an affected disc, making improvements to its position, so related compression on nearby nerves is reduced.

When a structural spinal condition like scoliosis is the underlying cause, first and foremost, I want to impact the condition on a structural level through chiropractic care, and through physical therapy and condition-specific exercises, increasing core strength means the spine, and its individual parts, don’t have to work so hard to maintain its natural curvatures and alignment.

If a spinal injury or trauma is the cause of compressed nerves, treating the injury proactively will impact symptoms such as nerve compression and pain.

In addition to proactive treatment for radiculopathy, prevention is an effective means of preserving the health and function of the spine and its nerves.

Radiculopathy Prevention

The old adage that a pound of prevention is worth an ounce of cure is as true today as it’s always been, but as lives get busier and more complex, it can become harder to live by.

Every human body is going to experience natural age-related degeneration, but the cumulative effect of certain lifestyle choices can either minimize or maximize those effects.

In addition, being proactive with health means being responsible, which lessens the likelihood of sustaining a spinal injury/trauma, along with the many complications and conditions that can arise.

The best way to approach radiculopathy is to prevent its development in the first place, and this can be worked towards in a number of ways: by making proactive and healthy lifestyle choices that are known to protect the spine.

From maintaining a healthy weight and activity level, increasing core strength, practicing good posture, lifting heavy objects properly, staying hydrated, stretching, to always being aware of how movement affects the spine, these are choices that can help protect and preserve the essential spinal nerves.

Conclusion

The term radiculopathy refers to a wide range of symptoms caused by a spinal nerve being pinched.

A pinched spinal nerve can occur in any spinal section (cervical, thoracic, and lumbar) and produce a number of symptoms that can include localized and/or radicular pain that ranges from mild to debilitating and can include weakness, tingling, and/or numbness.

There are different severity levels and causes of radiculopathy, including disc issues and a variety of spinal conditions that cause a loss of space within the spine and result in nerve compression.

When nerves are exposed to compression, they can become irritated and inflamed, and effective radiculopathy treatment has to address the underlying cause of the compression.

Here at the Scoliosis Reduction Center, I combine multiple forms of treatment, including a variety of therapies and chiropractic care, to work towards increasing core strength, so the spine is optimally supported, taking pressure off the spine and its discs, spinal adjustments/remodeling to induce a structural change, and providing lifestyle guidance.

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Dr. Tony Nalda
Doctor of Chiropractic
Severe migraines as a young teen introduced Dr. Nalda to chiropractic care. After experiencing life changing results, he set his sights on helping others who face debilitating illness through providing more natural approaches.

After receiving an undergraduate degree in psychology and his Doctorate of Chiropractic from Life University, Dr. Nalda settled in Celebration, Florida and proceeded to build one of Central Florida’s most successful chiropractic clinics.

His experience with patients suffering from scoliosis, and the confusion and frustration they faced, led him to seek a specialty in scoliosis care. In 2006 he completed his Intensive Care Certification from CLEAR Institute, a leading scoliosis educational and certification center.
About Scoliosis Reduction Center
Welcome to Scoliosis Reduction Center. Our team, under the leadership of Dr. Tony Nalda, is focused on treating your scoliosis in the most patient-centered, effective manner possible.
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