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How many times have you experienced a sudden or long-term pain in your back? This may be due to the nature of your work or some underlying health conditions. Such pain can hinder you from working efficiently and productively. One of these conditions is radicular pain. It is vital to learn its causes, symptoms, preventions, and treatment to avoid worse issues in the future.
In a simple definition, radicular pain is a type of pain that is felt from the back and radiates down to the hips and legs. That specific pain travels through the spinal nerve root. A person having this kind of pain can also experience muscle weakness, numbness, and tingling. Typically, radicular pain happens when the spinal nerve is pinched, inflamed, or compressed. Sciatica, or back pain due to an issue with the sciatica nerve, is one known type of radicular pain.
According to ScienceDirect, the primary causes of radicular pain syndrome include ruptured lumbar disc, spinal fracture, arachnoiditis, tumor, and spinal stenosis.
"Radicular pain occurs because of irritation of a sensitized nerve root, usually but not exclusively because of a prolapsed intervertebral disc. This pain is typically lancinating in quality, shooting down the leg like an electric shock. It affects a narrow band and has both deep and cutaneous components. It is often made worse by coughing or sneezing, which raises intradiscal pressure, and may be associated with neurological signs and symptoms through nerve root compression", Science Direct also added.
Patients with radicular pain often have difficulty determining where the pain is. The main problem is that the lumbar radicular is not actually back pain, but rather leg pain. Because of that, it needs a different medical approach to back pain.
Research updated in 2020 stated that the most common cause of radicular pain is a herniated disc.
"A herniated disc can cause nerve root compression. This process can be acute or can develop chronically over time. Imaging is not always a helpful modality in diagnosis. Almost 27% of patients without back pain have been found to have disc herniation on magnetic resonance imaging (MRI). Complicating the diagnosis of radicular pain is how an abnormality such as disc herniation found on an MRI does not appear to be predictive of future development of back pain. To diagnose a herniated disc as a source of a patient's pain, it is important to review the complete history and physical, making sure the symptoms fit the imaging results. Patients with lumbar radicular pain often respond to conservative management. Patients who do not respond to conservative therapies will likely undergo an MRI for further evaluation. Referral from the primary team to a specialist for alternative therapies such as an epidural glucocorticoid injection should be considered as well at that time, depending on the severity of symptoms", a part of the study mentioned.
Yes. Radicular pain can be worsened by some activities such as sitting or walking. Some people are required to sit for long hours because of the nature of their work. This is why ergonomic experts recommend making sure that workstations should be properly set up for comfort and productivity.
The most typical symptoms of radicular pain include the following:
- Loss of reflexes in the legs and arms
- Weakness in the arms or legs
- A sharp pain in the legs, shoulders, back, and arms that are worsened when sneezing or coughing
- Numbness and prickling of the skin
- Abnormal feeling or sensation in the legs or arms
When these symptoms occur, it is best to avoid heavy tasks and consult a physician for proper medication.
A person experiencing radicular pain must seek help from a medical expert. This is not just to relieve pain but also to prevent further damage in the future.
A 2016 study, "Novel Treatment of Radicular Pain With a Multi-Mechanistic Combination Topical Agent: A Case Series and Literature Review," concluded the following:
"The topical formulation of diclofenac, ibuprofen, baclofen, cyclobenzaprine, bupivacaine, gabapentin, and pentoxifylline addresses both neuropathic and inflammatory components of radicular pain. It was found to be well-tolerated, to reduce radicular pain as well as improve function and sleep in this case series of three patients who had failed other conservative or surgical treatment. Further study of the use of both single and combination topical agents for the treatment of radicular pain is warranted."
Treating of radicular pain includes treatment of the underlying cause. This also involves finding the proper pain management strategies. Treatments that do not require surgeries for radicular pain include:
- Epidural injections
- Physical therapies that will help in strengthening and strengthening the affected joints and muscles
- Alternative treatments, such as yoga and acupuncture
- Over-the-counter medicines, like ibuprofen and acetaminophen
Some pain management strategies can be applied to the part of the body that is affected by radicular pain. For instance, when the pain affects the hips, you may be advised to a specialist for hip pain management techniques. If the pain is affecting the back, your doctor may refer you to get spine pain management strategies.
In cases nonsurgical treatments didn't work, medical experts may recommend decompressive surgeries. It can be discectomy (a process to remove a disc in the vertebra) or laminectomy (a way to remove the vertebra's back area covering the spinal canal).
Surgical procedures for radicular pain may include repairing a herniated disc, removing the bone spur, fusing the bones, and widening the spinal canal space.
However, it is necessary to note that every radicular pain case may vary among patients. That is why an expert must comprehensively discuss surgical recommendations and medical prescriptions. The treatment to be used will depend on the cause of the pain and the person's overall well-being.
Medical News Today shared the following tips to avoid nerve compression that may lead to radicular pain:
Some strategies may prevent nerve compression pain. These include:
- Proper lifting procedures
- Doing regular physical activities
- Maintaining proper posture, especially when sitting, standing, or driving
- Keeping a healthy weight
- Establishing core strength
- Not tilting the head when talking over the phone
- Taking regular breaks, as well as doing some stretchings in your routines
It is also crucial to use ergonomic tools and accessories such as ergonomic chairs and standing desks to ensure proper posture. These types of equipment will help combat the adverse effects of sitting for long hours.