Radiculopathy

Question 1

What is radiculopathy

Answer 1

Conduction block in the axons of a spinal nerve or its roots

Question 2

What is the difference between radiculopathy and radicular pain

Answer 2

Radiculopathy is a state of neurological loss

Radicular pain is pain deriving from damage or irritation of the spinal nerve particularly the DRG

Question 3

What are the common causes of radiculopathy

Answer 3

Intervertebral disc prolapse

Degenerative diseases of the spine ( cervical spine stenosis )

Fracture

Malignancy

Infection

Question 4

What are the two features of radiculopathy

Answer 4

Sensory features - paraesthesia, numbness

Motor features - weakness

Radicular pain is also often present

Question 5

What are differential diagnosis of radicular pain

Answer 5

Referred pain - into the arm from myocardial ischaemia, the right shoulder from hepatobiliary disease, or the flank, groin, or thigh from urinary tract

Myofascial pain: hip muscles can mimic lumbar radiculopathy

Thoracic outlet syndrome

Greater trochanter bursitis

IT band syndrome

Meralgia paraesthetica

Piriformis syndrome

Question 6

What is the treatment for radiculopathy

Answer 6

Managed non operatively if no pain

But if pain then analgesia based on WHO pain ladder
> neuropathic pain killers can be used

First line: amitriptylline, which may be added to GABA antagonists

Physiotherapy