Radiculopathy

Question 1

What is a radiculopathy?

Answer 1

conduction block in the axons of a spinal nerve or its roots causing weakness and paraesthesia/ anaesthesia

Question 2

Radiculopathies are typically caused by nerve compression - give 5 causes of nerve compression:

Answer 2

1) intervertebral disc prolapse
2) degenerative disease of the spine
3) fracture
4) malignancy
5) infection

Question 3

Describe how an intervertebral disc prolapse can compress a nerve:

Answer 3

the annulus fibrosus is ruptured due to stress, allowing the nucleus pulposus jelly to herniate out and compress the nerve

Question 4

In which region of the spine is disc prolapse most common?

Answer 4

Lumbar

Question 5

In which region of the spine is degenerative change most common?

Answer 5

cervical

Question 6

Give 2 examples of infections that can compress nerves:

Answer 6

1) extradural abscesses
2) osteomyelitis

Question 7

Give 3 clinical features of radiculopathies:

Answer 7

1) paraesthesia and numbness
2) weakness
3) radicular pain

Question 8

Describe the sensation of radicular pain:

Answer 8

burning, deep, strap-like pain

Question 9

Give 3 red flags for cauda equina syndrome:

Answer 9

1) faecal incontinence
2) urinary retention
3) saddle anaesthesia

Question 10

True or false: radiculopathies are mostly clinical diagnoses

Answer 10

True

Question 11

Give two investigations that can be used to find out more about a radiculopathy:

Answer 11

1) electromyography
2) nerve conduction studies

Question 12

What is the first line analgesia for radiculopathies?

Answer 12

amitriptyline

Question 13

Other than amitriptyline, give two other analgesics used for radiculopathies:

Answer 13

1) pregabalin
2) gabapentin

Question 14

What drug may a patient with muscle spasm radiculopathies be given?

Answer 14

benzodiazepines (diazepam)

Question 15

What non-pharmaceutical management plan may be offered to patients with radiculopathies?

Answer 15

physiotherapy