Radicular pain

Everyone is well aware of such a disease as radiculitis. Even a small child can show the gait of a grandmother or grandfather during attacks of this disease. The body is bent in half, the hand lies on the lower back, the movement is weak, limited, and more often, the person simply freezes in place at the moment of a sharp, shooting pain attack, spreading pain from the lower back to the foot. If we speak in medical language, then the attack is based on radicular pain. And it was a consequence of one of many possible diseases or some pathological factor. Any difficult situation requires making quick and correct decisions. All painful processes in the human body have an anatomical basis. Knowing the structure of a certain organ, on which all its vital activity is tied, you can reliably establish the causes of pain.

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Diseases that cause radicular pain

One of the first diseases that provokes the formation of radicular pain is osteochondrosis. Over the past decade, signs of osteochondrosis have begun to be observed in young people, although previously it was considered a disease of the elderly. In addition to osteochondrosis, the causes are hernias (one or multiple) of intervertebral cartilages (disks), lesions of the vertebrae themselves, their integrity or bone structure, tumors of the spinal cord, infectious diseases and tuberculosis of the bones, inflammatory diseases in the joints of the back. More complex and severe, both in terms of the degree of progression and treatment, are compression injuries of the spine, its bruises and especially fractures. In such cases, there is a partial or complete lesion of both the spinal cord and its neurovascular environment.

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Spinal roots: anatomical reference

The spinal cord is not an amorphous liquid, and not a liquid at all, but a very complex organ in its structure. Like the brain, the spinal cord has several membranes, is formed by gray and white matter and is surrounded by cerebrospinal fluid. Let us consider only those of its structural components, the pathology of which causes radicular pain.

Figuratively speaking, each vertebra contains a section of the spinal cord in its cavity, with nerve fibers or roots extending from it. In the bodies of the vertebrae, in their bone structure, there are small openings through which nerve fibers exit the intervertebral space. The spine is flexible, between the vertebrae there are cartilages - intervertebral discs. So, one of the factors causing radicular pain is precisely the compression of nerve fibers. It can occur due to a sharp displacement of the vertebra, a formed intervertebral hernia, or other reasons in which the bone-cartilaginous structure or soft tissues lead to compression of the space around the nerve, and the transmission of impulses along it has become difficult or even impossible. Pain occurs.

The nature of radicular pain

Radicular pain has its own specific manifestation, which facilitates, in many cases, diagnostics already at the stage of describing the pain syndrome. The nerve, leaving the spinal cord, is directed to the final destination, and each nerve has its own. So, in those cases when a failure occurs, a nerve is pinched, the pain is tracked along its entire length. An example for clarity. Pain, the main localization of which is in the gluteal region, shoots and gives to the foot, while its course is traced along the back of the leg, through the popliteal space. The pain intensifies with movement, reflecting on the lumbar region. The pain is either periodic, shooting, or constant, aching - stabbing. The next distinctive feature of this type of pain is partial or complete loss of skin sensitivity. Let's go back to the example given. If you test for sensitivity, lightly pricking the skin with a sharp object along the entire length of the affected nerve, you will find that the skin does not feel the pricking or feels it, but very weakly. Poor sensitivity, so to speak, in the form of a strip, runs along the back of the leg, showing the boundaries of the nerve branch. Such a manifestation indicates a radicular deficiency.

Now it's time for the third characteristic sign of damage to one of the roots, which is impaired mobility. With a long absence of normal, natural vital activity of the compressed nerve branch, pathological changes occur in the structures of the muscles and ligaments. Over time, the muscles become weak, atrophic, their mass gradually decreases, they seem to dry out. In such cases, people say that the arm or leg has dried up. There is an expression "syndrome of a drying limb."

The examples given in the text concern the extremities only for the sake of simplicity of explanation of the mechanism of development of the root cause, as a result of which radicular pain develops. But this does not mean at all that only those nerves whose innervation zone is the extremities are subject to such pathology. Any roots can be affected, in any part of the spinal cord, and only one root is affected at a time. Cases of damage to more than one root at once are very rare. In such cases, the pain manifests itself not in one leg, if we return to the above example, but in both legs at once.

Diagnostic methods for radicular syndrome

Neurologists and orthopedists are responsible for muscle pain. Any diagnosis begins with an initial examination and questioning the patient about all the details regarding the reason for his visit to the doctor. When did it start and why? What happened before and after? What measures were taken? What treatment was used and where did you go? Palpation (probing) of the painful area is carried out and the skin above it is checked for sensitivity to pain. The level of the main reflexes related to the affected area is checked. The most familiar reflex test to every person is a light blow with a hammer under the kneecap. The more severe the damage to the nerve responsible for this reflex, the weaker the movement of the leg. The degree of development of muscle mass, density and elasticity of the muscles along the painful area are checked.

Next, they move on to instrumental diagnostic methods. One of the best is still considered to be an X-ray of the spine, which shows many deviations from the norm, for example, herniated intervertebral cartilages, the main symptom of which is radicular pain. To help this method, there is magnetic resonance imaging, which allows you to get a more complete picture.

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How is radicular pain treated?

In acute attacks, especially if it is an attack of lumbar radiculitis, the first thing to do is to relieve the pain syndrome. This can be done even at home, before the doctor arrives.

The patient should be carefully laid on a flat, hard surface and given any painkiller in tablet form. Apply a warming ointment to the painful area, which will temporarily relieve the spasm. However, this is not enough. Most cases of radicular pain require treatment under the supervision of a doctor. Treatment courses are long. Depending on the complexity of the painful process, one or more drugs belonging to the group of non-steroidal anti-inflammatory drugs and strong analgesics are prescribed. Novocaine blockades (injection of the pain center with novocaine or its derivatives) are often required. If necessary, antibiotics, a vitamin complex, as well as support for physiotherapy, manual and massage courses are selected. All this is suitable in cases where radicular pain is provoked by causes that can be eliminated without resorting to surgical intervention. However, there are also diseases in which treatment begins with surgical procedures and only at the stage of postoperative recovery do they move on to the selection of drugs from the above groups.

Medical practice shows that most cases of radicular pain cannot be completely eliminated. Acute attacks are relieved, the pain subsides, and the disease may either not manifest itself for years or become chronic. In young and healthy people, with a strong, trained muscular frame, complete healing of minor problems is quite possible. The older a person is or the weaker the muscular elasticity, the more difficult it is to cope with ailments of any severity.

Prevention of radicular pain

• Maintaining health through regular training of the back muscle frame;
• Exercises aimed at developing joint flexibility;
• Proper nutrition that does not lead to an increase in body weight to critical levels and does not contribute to the deposition of fats and salts in the body’s “storerooms”;
• Correct distribution of the load on different muscle groups when lifting weights;
• Standardized work and rest schedule;
• Avoiding dangerous situations.

Here are the most appropriate preventive measures that can protect the body from the harmful effects of most pathogenic factors, because there is no such independent disease as radicular pain. This is just a symptom complex indicating the development of one or a number of diseases. Therefore, there are no special measures or procedures that, if followed, would guarantee protection from pain in the future.