radiculopathy Flashcards
what is a radiculopathy?
a conduction block in the axons of a spinal nerve or its roots
impacts motor axons causing weakness and on sensory axons causing paraestheisa/anaesthesia.
what is the difference between radiculopathy and radicular pain?
radiculopathy = neurological loss, may not be associated with radicular pain.
radicular pain = pain deriving from damage or irritation of the spinal nerve tissue, particularly the dorsal root ganglion (where sensory neurones run)
what can cause radiculopathy?
- intervertebral disc prolapse
- degenerative diseases of the spine
- fracture
- malignancy
- infection
what are the clinical features of radiculopathy
- sensory features e.g parathesia and numbness
- motor features e.g weakness
- radicular pain is often present, described as burning, deep, strap like or narrow.
- red flag symptoms for differentials should be asked to make sure
- asses dermatomal and myotomal involvement and evaluate for CES by assessing pinprick sensation in perianal dermatomes, anal tone and rectal pressure sensation
what are the differentials for radiculopathy?
- refered pain
- greater trochanteric bursitis
- Meralgia paraesthetica
- piriformis syndrome
- Thoracic outlet syndrome
how is radiculopathy managed?
long term depends on underyling cause
disc prolapses will be managed non operatively usually but in cases of unremitting pain and progressive myelopathy, can consider
what is the symptomatic management of radiculopathy?
- analgesia, use WHO ladder but also neuropathic pain meds are used a lot
- benzodiazepines e.g diazepam can help muscle spasms
- physiotherapy
what are the red flag clinical symptoms for CES?
- faecal incontinence
- Painless urinary retention
- saddle anaesthesia
what are the red flag clinical symptoms for infection causing radiculopathy?
- immunosuppresion
- IV drug use
- unexplained fever
