Radicular pain

Radicular pain


Radicular pain, or radiculitis, is pain “radiated”
along the dermatome of a nerve due to inflammation or other irritation of the nerve root at its
connection to the spinal column. A common form of radiculitis is sciatica – radicular
pain that radiates along the sciatic nerve from the lower spine to the lower back, gluteal
muscles, back of the upper thigh, calf, and foot as often secondary to nerve root irritation
from a spinal disc herniation or from osteophytes in the lumbar region of the spine. Treatment options
Seeking treatment for radiculitis should not be delayed. Depending on the severity, certain muscles
may start to atrophy over time, which in turn requires physical therapy for recovery. Also, radiculitis is known to cause patients
to “favor” certain muscles which can result in the overdevelopment of those muscles relative
to others, causing abnormal torque on joints that can cause degenerative damage. Initial treatment for the pain may involve
one or a combination of the following interventions: One or two days of rest, if the pain is severe
Application of ice and/or heat Non-steroidal anti-inflammatory drugs, such
as ibuprofen or nabumetone Acetaminophen, e.g. Tylenol, which helps reduce
the pain signals in the brain Spinal manipulation or mobilization when lumbar
spine related Gabapentin or the newer prescription medicine
pregabalin Analgesics or pain killers, such as Vicodin,
Percocet, or, in severe cases, a low dosage of Methadone
Muscle relaxers, such as cyclobenzaprine or methocarbamol
Epidural steroidal injections, which involves injecting a steroid directly into the problem
area in the back to treat the inflammation that is irritating the nerve root
Once the initial period of severe pain is under control, a variety of treatments may
be employed to address the underlying cause of the pain, such as a disc herniation, lumbar
spinal stenosis, or degenerative disc disease: Physical therapy: stretching and physical
exercise; often recommended after a period of one to two days of rest and treatment to
get the pain under control. Massage therapy can be a useful adjunct in
relieving pain; myofascial release may be helpful. Yoga therapy by a skilled yoga therapist is
another excellent adjunct treatment. Chiropractic
Acupuncture Modifying personal habits and lifestyle to
prevent future exacerbation of the underlying cause of the pain is also important. For example, maintaining an appropriate body
weight that’s known not to aggravate the discs as well as changing the way one goes about
bending over for objects on the ground. Another important lifestyle change that is
usually recommended is to maintain a regular stretching and exercise program. There are also a variety of surgeries that
can be employed to treat severe cases of radicular pain, depending on the underlying condition
that the surgery addresses. To treat a disc herniation, which may cause
persistent radiating pain, a microdiscectomy surgery is usually performed. This is a minimally invasive approach that
removes the portion of the disc that presses against the nerve root. The surgery has a high success rate, minimal
healing time, and usually provides immediate relief of the sciatica and other symptoms
caused by a herniated disc. This surgery may be recommended after several
weeks of non-surgical treatment, or even earlier if the pain and other sciatica symptoms are
severe. However, even in discal herniations, the long
term outcomes do not differ between those who undergo surgery and those who do not. The decision to undergo surgery is not trivial,
and is preferably made in consultation with two or more physicians. See also
Intervertebral disc Sciatica
Spinal disc herniation References

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