Radicular syndrome: causes, symptoms, diagnosis, treatment

Radicular syndrome is a common neurological disorder that occurs during the compression of the nerves of the spinal cord. In medical practice, the term radiculopathy is also used, which is most often observed in the lumbosacral spine area, less often cervical and thoracic.90% of the incidence falls on the age after 35 years.

Although now experts note an increase in the number of complaints from young patients - from 18 years and older.

The tasks of modern neurology and vertebrology are to timely identify and eliminate the factor that caused the squeezing of the spine, as this syndrome in itself is a sign of a variety of different diseases.

What causes a violation?

Radicular syndrome causes the following diseases:

• herniated intervertebral disc;
• facet arthropathy;
• trauma and swelling of the spine;
• Pott's disease;
• osteomyelitis;
• congenital disorders of the development of the spine;
• spondylolisthesis.

Contributing factors:

• age;
• genetic predisposition;
• work associated with frequent sharp turns of the trunk and lifting of weights;
• body hypothermia:
• wearing uncomfortable shoes and as a consequence of flat feet;
• hormonal failures;
• improperly organized workplace, causing for a long time to be in a position uncomfortable for a person;
• improper meager nutrition and insufficient drinking regimen;
• is overweight.

Osteochondrosis as a factor provoker

Osteochondrosis often develops together with the radicular syndrome, which is acquired over several years as the pathological process progresses in this or that part of the spine.

Osteochondrosis causes aging and destruction of the vertebrae, as well as narrowing of the bony canals, which is the main cause of compression of the spinal nerves.

Complications of the disease, such as the intervertebral hernia, osteophytes, discogenic myelopathy, spinal cord infarction, etc., also cause radiculopathy.

Symptoms and features of the

Clinic The common symptoms that accompany the radicular syndrome are:

• pain - first shooting sharp, then dull aching;
• paresthesia in the site with the affected spine;
• sensation of weakness;
• hair loss, dry flaky skin, excessive sweating.

Symptoms of affection of separate roots

Radiculopathy of the cervical spine is manifested as follows:

• acute shooting pain in the neck region, radiating to the nape, shoulder blade, arm;
• pain enhancement during sharp turns or head turns;
• numbness of the fingers;
• cervical muscle wasting.

In the thoracic spine, the syndrome manifests itself as follows:

• pain occurs with attacks, armpit extends, arms up to the elbow;
• a feeling of pain can penetrate even into the heart, intestines, stomach, liver;
• there is an increase in discomfort during a conversation, a deep breath, a cough or sneezing.

Radiculopathy of the lumbosacral spine has the following symptoms:

• the pain arises unexpectedly, increases with trunk movements;
• paresthesia in the area of ​​the affected root;
• decrease in leg muscle tone;
• sometimes there are irregularities in the work of the pelvic organs.

Possible localizations of the "clamping" of the spine

The human spine consists of 33 vertebrae. Symptoms of radicular syndrome differ depending on the vertebrae in which the nerve clamp is localized:

1. C1-C2 .Pain begins in the back of the head, often with dizziness and nausea. Paresthesia of these areas is observed.
2. C3 .Rare localization. The pain is concentrated on the nape, passes into the neck, gives into the tongue, the forehead.
3. C4 .The pain begins in the area of ​​the forearm and shoulder blade. Paresthesia is observed in these zones.
4. C5 .Infrequent localization. The disease here is manifested by the symptoms of the defeat of the hand.
5. C6-C8 .Numbness and malnutrition of the muscles go from the neck and shoulder to the shoulder area, reaching the fingers of the hand.
6. T1 .Pain and paresthesia in the armpit, can go under the collarbone and into the arms to the elbow. Dryness in the pharynx is observed.
7. T2-T6 .Pain and numbness occur on the entire surface along the spine.
8. T7-T8 .Painful sensations are also shrouded in nature, since they come from the shoulder blades and reach the epigastric region.
9. T9-T12 .Discomfort is observed in the lower part of the body, sometimes the pain reaches the inguinal area.
10. L1-L3 .Painful spasms along with paresthesia in the lower abdomen, in the groin area.
11. L4 .The pain is localized on the front inner surface of the thigh.
12. L5 .Painful sensations occur all over the surface of the affected leg and can reach the foot. The patient sometimes can not even rely on the lower limb.
13. S1 .Pain in the lower lumbar region and sacrum radiating to the lower leg, to the foot and toes. The calf and thigh muscles decrease in size.
14. S2-S5 .When squeezing these roots, the phenomenon of sacral caudopathy occurs. Pain sensations begin in the sacrum area, pass to the back of the thigh and lower leg, foot and thumb. Sometimes there are convulsions of the muscles of the thigh.

Symptoms and treatment of radiculopathy L4 L5 S1 vertebrae:

Diagnostic criteria and methods

A neurologist or vertebrologist uses the following methods when making a diagnosis:

• anamnesis;
• examination of the patient by a doctor;
• myelography;
• discography;
• MRI;
• a roentgen of a backbone in two projections;
• computed tomography;
• electrophysiological studies.

Complex of medical care

Treatment of radicular syndrome is similar to methods of fighting osteochondrosis.

Drug therapy

Depending on the stage, type and location for the treatment of radiculopathy, the following medicinal products are used:

• analgesics ( Ibuprofen, Diclofenac) - for relief of pain;with severe pain, the doctor can prescribe blockades with novocaine or lidocaine:
• non-steroidal anti-inflammatory drugs ( NSAIDs) - to reduce inflammation( Nimesulide, Diclofenac, Naise-gel);
• anesthetic and analgesic ointments ( Menovazine, Finalgon);
• muscle relaxants for arresting muscle spasms( Baclofen, Midokalm, Sirdalud);
• neurometabolic ( group B vitamins and multivitamins) - to improve the general condition of the patient;
• antidepressants ( Desipramine, Duloxetine);
• ganglion blockers - for pain relief( Benzogexonium, Ganglefen);
• chondroprotectors - stop the destructive processes in the cartilaginous tissue( Arteparon, Teraflex);
• anticholinesterase preparations ( Prozerin, Dibasol);
• dehydrating agents to reduce edema of the nerve roots( Furosemide, Hypothiazide)
• tranquilizers ( Seduxen, Relanium, Sibazon);
• antispasmodics ( No-shpa);
• antipsychotics .

Physiotherapeutic treatment

The following procedures have proven themselves in the treatment of radicular syndrome, they are especially effective in the lumbar and sacral region:

• galvanization and electrophoresis;
• phonophoresis;
• diadynamic currents;
• manual traction or using the Glisson loop;
• magnetotherapy;
• reflexotherapy;
• underwater hydromassage;
• Ultrasound therapy;
• mud treatment;
• applications;
• balneotherapy;
• exercise therapy;
• manual therapy;
• inductothermy;
• isometric kinesiotherapy;
• massage;
• acupuncture.

Surgical approach

The operative method of treatment with radiculopathy is used only in complex advanced cases and consists in the removal of a tumor or a hernia pressing on the spine.

Such a safe and effective surgical procedure as nucleoplasty( cold plasma, hydroplastic, laser vaporization) is very popular. The essence of this minimally invasive procedure is that the nucleus of the intervertebral disc is affected by cold plasma, laser or saline solution.

Microdiscectomy is sometimes recommended. The essence of this operation is to remove the intervertebral disc together with the hernia.

Traditional medicine

For the treatment of radicular syndrome, folk medicine is also used, whose action is aimed at reducing inflammation and pain:

• decoction of birch and aspen bark;
• hirudotherapy;
• rubbing with ointment based on turpentine;
• lotions from walnuts, crushed and mixed with kerosene;
• hot saline applications;
• various herbal and berry decoctions and teas;
• honey-alcohol rubbing.

Prediction and consequences of

The possibility of complete disposal of radiculopathy depends on the underlying disease and the degree of compression of the nerve. If a person does not go to the doctor on time, and tries to get rid of pain and inflammation at home, the prognosis in such a situation will be unfavorable - the treatment will be long and complicated.

In addition, the underlying disease will progress, which in the future can lead to disability.

Casual about the main thing - preventive measures

After the disorder is cured, you should not relax, it is necessary to prevent it every day.

In addition to having to undergo a routine examination and procedures offered by a neurologist, vertebrologist, osteopath or reflexologist, it is necessary to observe the basics of the basics:

• reducing the load on the spine;
• strengthening of the back muscles with the help of exercise therapy and massage;
• weight loss( in case of excess weight in the patient).

It is advisable to undergo treatment in special centers and hospitals, because at home there is not always an opportunity to observe a diet, sleep, rest and medication, and not all are able to independently practice exercise therapy