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What is Radiculopathy/Pinched Nerves?
Back pain can result from a wide range of causes. Skeletal degradation, injury, degenerative disorders of the spine—all of these can generate back pain. However, there are some spinal conditions that can produce discomfort in other regions of the body.
Radiculopathy occurs when a spinal nerve suffers damage, causing radicular pain to radiate from the irritated nerve to another region of the body, such as the arms or legs. Radiculopathy—also known as pinched nerve pain—can result from several possible causes.
The most common culprit of radiculopathy is a slipped (or herniated) intervertebral disc. When an intervertebral disc that cushions the vertebrae of the spine ruptures, the expelled contents can impinge upon neighboring nerves that supply sensation to the upper and lower limbs.
Another common cause of radiculopathy is foraminal stenosis, or the narrowing of nerve passageways—known as foramina—that permit spinal nerves to branch outward from the spinal cord. Tightening of the foramina can lead to nerve compression and the telltale signs of radicular pain (or radiculitis).
However, radiculopathy can emerge any time that a spinal vertebra or an accessary structure of the spine causes painful nerve impingement to a nerve root. Other common sources of spinal nerve compression include: spondylolisthesis (a slipped vertebra), bone spurs, spinal tumors, or the accumulation of scar tissue from injuries or failed spine surgery.
In addition, radiculopathy is often classified according to the region of spinal nerve involvement. You may hear of radiculopathy described as: lumbar (lower back), cervical (neck), or thoracic (middle back) radiculopathy.
When radiculopathy originates in the lumbar (lower back) region of the spine, a distinctive set of symptoms will emerge in the buttocks, legs, and feet of the lower body. In contrast, when radiculopathy is introduced at the cervical (neck) level of the spine, distinguishing symptoms will appear in the shoulders, arms, and hands.
However, regardless of the cause or point of origin of your radiculopathy, one constant holds true: Untreated radiculopathy can develop into a debilitating condition that interferes with your ability to lead a pain-free life.
Interested in stopping radiculopathy in its tracks? Dr. Frazier—board certified orthopedic surgeon and respected lecturer—has earned the title of “New York Super Doctor” on two separate occasions for his commitment to minimally invasive spine care!
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What are the Symptoms of Radiculopathy/Pinched Nerves?
Radiculopathy can be sustained at any level of the spine, although cervical (neck) or lumbar (lower back) radiculopathy is more common than thoracic (mid-spine). The ensuing pain, however, is usually felt more intensely in the limbs than at the origin of spinal nerve compression. Common symptoms of radiculopathy, or pinched nerve pain, may include:
- Radiating Pain: White-hot pain that emanates from the cervical (neck) or lumbar (lower back) spine and into the arms and hands or legs and feet, respectively
- Sciatica: Scalding pain that shoots from the sciatic nerve of the lower back into the buttocks, hamstrings, calves, and soles of the feet; sciatic pain may intensify while sitting or standing and abate only while lying down
- Cervical Radiculopathy: Tingling pain that diffuses from the area of nerve compression in the neck and into the shoulders, biceps, forearms, or fingertips
- Numbness: Tingling, numbness, or prickling sensations in the extremities—particularly, in the hands or feet
- Loss of Strength: Progressive weakness in the muscle groups that are supplied by the irritated nerve tissue; for example: cervical radiculopathy may cause symptoms of biceps or triceps weakness or loss of hand grip
- Loss of Motor Control: Difficulty engaging the large muscles of the arms and legs (gross motor skills) or the specialized muscles of the hands and feet (fine motor skills)
- Stiffness: Decreased mobility in the neck or lower back as chronic pain intensifies
- Lower Back Pain (Lumbago): In addition to producing leg pain, lumbar radiculopathy may generate pain at the site of nerve impingement in the spine
- Emergency Symptoms: Seek immediate medical attention if your pain becomes unbearable or symptoms of muscular weakness advance to include: paralysis; incontinence (loss of bowel and bladder control); or saddle anesthesia (loss of sensation in your buttocks, groin, or inner thighs).
Researching solutions to cervical or lumbar radiculopathy? Dr. Frazier—Harvard Medical School graduate and spine technology consultant—has earned over 20 years of minimally invasive surgical experience in resolving radicular pain!
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What are the Treatments for Radiculopathy/Pinched Nerves?
Preliminary treatments for radiculopathy should blend the most effective aspects of at home care, physician-directed pain management, and alternative therapy. Physical therapy—which teaches activity modifications, stretches, and spinal strengthening exercises—is particularly effective at relieving radicular pain. Other methods of non-surgical relief include: chiropractic care, medication management, and selective steroidal injections at the site of lumbar or cervical nerve impingement.
If noninvasive treatment options fail to provide adequate pain relief after six months of continuous treatment, your doctor may propose surgical solutions to your radiculopathy. Dr. Frazier—acclaimed by New York Times Magazine as a “Super Doctor”—may suggest the following interventions:
- Artificial Disc Replacement: Since radiculopathy is primarily caused by the inability of a herniated disc to maintain proper space between vertebrae, replacing the damaged disc with an artificial model is a common surgical solution. An artificial disc replacement is a minimally invasive surgical procedure that can be performed on an outpatient basis—to optimize recovery times.
- Laminoforaminotomy: A laminoforaminotomy combines two minimally invasive procedures to ensure lasting relief for radiculopathy: A laminectomy (which involves removal of the lamina—or backside portion of a vertebra—to relieve spinal cord compression) and a foraminotomy (broadening of the foramina to release nerve compression from foraminal stenosis).
- Cervical Posterior Foraminotomy: During a Cervical Posterior Foraminotomy (CPF), your surgeon decompresses pinched nerves in the cervical spine by accessing the affected nerve from the backside of the neck. Your surgeon then removes fragments of enlarged or protruding bone and cartilage that interrupts normal nerve functioning in the shoulders, arms, or hands.
Interested in receiving sophisticated—and effective—solutions to radiculopathy? Our award-winning surgeon, Dr. Frazier, is an expert at redefining relief. Well-versed in traditional and cutting-edge surgical techniques, Dr. Frazier offers dozens of surgical and non-surgical treatments to reverse radiculopathy.
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Dr. Frazier is a Harvard-trained, board-certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment and continues to consult for several international spine companies.
After completing undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.
Education & Training
MD / Cum Laude
Harvard Medical School
Mass. General Hospital
Spinal Deformity Fellowship
Doctor’s Hospital (Miami, FL)