Radiculitis (inflammation of the root of one of the spinal nerves). Inflammation of the nerve roots or radiculitis, how to do it correctly

If you are worried about back pain, do not rush to go for a CT scan, MRI, to be afraid of Schmorl’s hernias and diagnoses of “osteochondrosis”. Visit a good massage therapist or a specialist who knows soft manual techniques.

“Currently, the idea of ​​the causes of pain in the torso, especially the back, as well as the extremities, if they are localized outside the joints, is based on the globally established idea of ​​the pathology of the intervertebral discs (discogenic pain), they are blamed on osteochondrosis of the spine, which allegedly damages spinal nerve roots. Herniated discs are classified as osteochondrosis. Pain in the joints is attributed to arthrosis.

In fact, there is no place in the human body where the spinal nerve roots could be damaged.

In general, there are no spinal nerve roots outside the spinal canal (“dural sac”). The roots of the spinal nerves can be compressed together with the “dural sac” only in their entire mass and only in the lumbar region in case of severe fractures of this part of the spine, tumors and inflammatory abscesses in the spinal canal.

Such damage to the entire mass of the roots is called “cauda equina syndrome,” which is accompanied by loss of motor and sensory functions of the lower extremities and pelvic organs, and not pain at all. Loss of these functions, and not pain, characterizes any damage to any nerve conductors.

Thus, if individual roots of the spinal nerves cannot be damaged, then no “radiculitis” or “radicular” syndromes exist in nature, just as there are no vertebrogenic peripheral pain syndromes. Clarification of these circumstances radically changes not only the diagnosis, but also the treatment and prognosis of the disease.

Diagnosis is simplified, treatment is reduced from several months to several days, the prognosis from pessimistic or uncertain becomes, in most cases, absolutely favorable.

Therefore, searching for the cause of pain syndromes in the spine is a waste of time and money, especially on expensive and time-consuming radiation research methods.

From speculative thinking to knowledge

Unfortunately, not only clinicians do not read morphological and physiological literature, but also anatomists, pathologists, physiologists, and pathophysiologists do not read clinical literature, otherwise they would find a lot of interesting things for themselves. And they would also be convinced that they teach students poorly, that their pedagogical work has zero output.

Thus, after reading the literature on back pain, anatomists would discover that the authors are only familiar with the student course on the normal anatomy of the spine and spinal cord, that many of them do not know the differences between the vertebral and spinal canals, that, thinking about the roots of the spinal cord nerves, do not know what it is and where the roots are located, and even call them spinal roots. The roots, meanwhile, are located on the nerves, and not on the spinal cord.

Pathologists might also discover that the authors of numerous monographs on osteochondrosis also do not know what it is, and therefore pain in the back and even limbs is attributed to spinal osteochondrosis, and many simply call these pains osteochondrosis. They would also know that the authors of many reputable manuals do not know that bones, cartilage, nerve conductors, the spinal cord and brain do not have pain receptors, and therefore their damage, and especially slow, chronic damage, does not produce pain symptoms.

Therefore, the conversation about the etiology and pathogenesis of pain syndromes comes down to speculative thoughts and drawing the same speculative diagrams, where bones exposed from cartilage rub against each other, where drawn hernias infringe on ephemeral roots and thereby supposedly cause excruciating pain.

The role of the spinal column is, of course, great in providing support and movement, protecting the spinal cord and spinal nerve roots. But there is no reason to blame all our troubles on him. To prove this, first of all, a few words about the normal clinical anatomy of the spine and the neurological structures contained in it.

Educational program for specialists

Spinal columnforms the spinal canal, limited anteriorly by the vertebral bodies and intervertebral discs covered by the posterior longitudinal ligament.

On the sides and back, the spinal canal is limited by the vertebral arches and the yellow ligaments between them.

Inside the spinal canal is the spinal canal (“dural sac”), which contains the spinal cord (from the base of the skull to the 2nd lumbar vertebra), and from the 2nd vertebra - the roots of the spinal nerves (“cauda equina”).

The space between the walls of the vertebral and spinal canals is filled with loose connective tissue, allowing the “dural sac” to easily move in all directions. So on a corpse, during flexion-extension movements of the head, the “dural sac” moves in the longitudinal direction by 3-5 cm.

The spinal canal is filled with cerebrospinal fluid, in which the spinal cord “floats”, and below the first lumbar vertebra - the roots of the spinal nerves. With any pressure on the “dural sac,” the roots are displaced in the cerebrospinal fluid, easily escaping the compression.

The roots of the spinal nerves (anterior and posterior, i.e. motor and sensory) exist separately only in the spinal canal, beyond which they extend in pairs in one sheath and are called the spinal nerve.

This nerve is directed to the intervertebral foramen and exits through its upper part, directly from under the arch of the vertebra of the same name, that is, significantly above the intervertebral disc. In other words, the spinal nerve and the disc are located in different transverse planes.

Therefore, not only disc bulges, but also any hernias cannot damage the spinal nerve. It is curious that American anatomists have known this for a long time and even created a special training model showing the impossibility of such compression. And despite this, the largest number of operations to remove herniated intervertebral discs is performed in the United States.

A few words about the pathological anatomy of osteochondrosis

Osteochondrosis is a pathomorphological term introduced by Schmorl in 1932 and means a dystrophic change in the cartilage and adjacent bone, that is, it can occur anywhere there is cartilage and bone - in the spine, joint, symphysis, ribs, etc. Moreover, the degenerative process always begins with cartilage. The cartilaginous phase is called Schmorl's chondrosis. Essentially, osteochondrosis is a process of aging – “timely” or premature.

This is not a disease, but a slowly developing pathomorphological condition, the same as graying, baldness, senile skin changes, etc.

Having fun with speculative exercises, many authors argue that osteochondrosis marginal bone growths of vertebral bodies can injure the spinal cord or spinal nerve roots. In this regard, it should be said that such growths in the posterior direction practically do not occur. Osteochondrotic growths go forward and to the sides, along the protruding discs. In addition, as already mentioned, spinal nerves (and not roots!) and bone growths at the level of intervertebral discs are located in different transverse planes.

Thus, neither disc herniations nor osteochondrosis bone growths can damage the spinal nerves either in the spinal canal or in the intervertebral foramina (at least in the thoracic and lumbar spine), much less the roots of the spinal nerves for the simple reason that the roots there is no “dural sac” outside.

The cause of the pain would probably have been established long ago if, when examining a patient, they had examined what hurt, rather than looking for the cause in the spine or even in the head. Now we are already faced with such facts when, having not found any pathology in the spine, they believe that there is no morphological basis for the pain, which means that the pain is psychogenic. The joint treatment of such chronic patients with psychiatrists is presented as the latest achievement of neurological science. And this is no longer a difficulty, but a disgrace to medicine. Many clinicians rejected the discogenic concept of pain syndromes.

J.F.Brailsford (1955), G.S.Hackett (1956), R.Wartenberg (1958), G.Keller (1962) paid attention to the pathology of muscles, fibrous tissues (tendons: ligaments, fascia) of the limbs and torso and receptors in them.

This position, especially by G. Keller, was subjected to merciless criticism by J. Popelyansky (1974), which he called “eloquent attacks on the discogenic theory of sciatica.” Indeed, the weakness of the positions of these authors was that they relied only on their extensive clinical experience, although critically comprehended, but not confirmed by anatomical studies.

Therefore, despite some critical works, the discogenic concept of pain syndromes in the torso and limbs gradually won more and more supporters, and by the 80s of the twentieth century it began to dominate almost completely. If discogenic lesions of the roots appear in foreign literature, then in domestic literature and practice, thanks to the authoritative works of Ya. Popelyansky and his school, the view of lumbar pain as a result of spinal osteochondrosis, which includes disc herniations, has become established.

Breaking the Deadlock

The deadlock into which neurology and orthopedics have reached in the diagnosis and treatment of pain syndromes is explained by the fact that instead of the straight and clear path of a conscientious clinical study of the patient, they followed the path of speculative, far-fetched concepts and “theories” about the fault of the spine in general and osteochondrosis and herniated discs in in particular. After this, all accidental findings in the spine, ranging from osteochondrosis to normal variants, began to be attributed to pain syndromes. And when it became possible to detect bulging and herniated discs using CT and MRI, all the troubles were blamed on them.

In almost no case history of a patient with back pain, one cannot find information about the exact localization of the pain point or even the zone, not to mention palpation examination of the zone indicated by the patient. And this can be understood: why would a doctor overloaded with patients conduct such research if everyone knows that pain is caused by osteochondrosis or a herniated disc. That’s why the patient is immediately sent for an “X-ray”, a CT scan, an MRI.

In front of many neurologists' and orthopedists' offices, notices are posted that patients with back pain will not be accepted without X-rays of the spine. And from the radiologist, patients come with a conclusion that they have been diagnosed with “common osteochondrosis.” The qualifications of radiologists, RCT and MRI specialists are a special topic.

Of the 1,490 patients we examined, who were referred by various specialists for radiography, CT, and MRI, 82% were not undressed or examined at all.

We were able to show and prove that the cause of pain in the musculoskeletal system does not lie in the spine at all, but in trivial mechanical damage to ligaments, tendons, and muscles, most often already altered by the dystrophic process. But all these anatomical structures are not located in the spine, but in those places that hurt. These areas must be identified clinically and radiographs of the entire area around the painful area must be taken so as not to miss inflammatory or tumor pathology.

The main result of our work was the conclusion that the source of pain can only be those anatomical structures in which there are pain receptors. There are no pain receptors in the vertebrae, intervertebral discs, bones, articular cartilage, spinal cord, spinal nerve roots, or the nerves themselves, just as there are none in nails and hair. They are present in small quantities only in the membranes of the brain and nerves (perineurium). But they are saturated with ligaments, muscle tendons, the muscles themselves, the periosteum, and blood vessels. It is the anatomical formations that have pain receptors that are the source of pain in all systems of the body.

Wake up from hypnosis

Our studies have shown the complete inconsistency of concepts based on incorrect speculative anatomical ideas. Ignorance of the exact anatomical details and topography of the nervous system of the spine led to fictitious “compression” of the roots of the spinal nerves and, accordingly, diagnoses of “radiculitis” and “radicular syndromes”, and hence to the search for osteochondrosis and disc herniations.

Since, according to supporters of this concept, hernias are the cause of pain, they must be removed, and often not only the hernia, but the entire disc, and even the vertebral bodies adjacent to it.

On this false theoretical basis, an entire industry for the diagnosis and treatment of pain syndromes in the musculoskeletal system has grown. Here are the latest diagnostic studies, high-tech operations, the production of complex endoprostheses, and most importantly, hundreds of pharmaceuticals.

All this together is a colossal business “and nothing personal.” In such a business, the interests of patients are not taken into account.

I believe that Russian neurology sincerely does not know what it is doing, being under the hypnosis of “advanced Western medicine.” The wave of abuses in the prescription of surgical interventions and expensive pharmaceuticals is quite large and is growing steadily, especially in the field of paid medicine.

When it comes to Western medicine, business appears to have defeated the Hippocratic Oath. Russia is being actively introduced to the ideology - maximum profit by any means available in the given situation. The introduction of such an ideology is easier the less competent and more immoral the environment for its implementation. The task of public health care is to create a situation in which the desire for immoral profit not only of ours, but also of Western medical businessmen on our territory, would be nipped in the bud. published

P.S. And remember, just by changing your consciousness, we are changing the world together! © econet

In this case, a complex of pathological symptoms called neuralgia develops.

Neuralgia is painful sensations along the affected nerve. The term should be distinguished from radiculitis, which is common among people. The latter is an inflammatory process in the area of ​​the spinal nerve root; radiculitis is manifested not only by pain (neuralgia), but also by other characteristic symptoms.

It is worth saying that, although neuralgia can affect any nervous structure of the body, most often it accompanies radiculitis.

Reasons

What reasons can cause inflammation of nerve endings and roots? The causes of radiculitis and vertebral neuralgia may be the following conditions:

• Infectious diseases of the spine.
• Injuries, accidents, traffic accidents.
• Osteochondrosis of the spine.
• Osteoporosis and calcium deficiency.
• Intervertebral disc herniation.
• Spondylolisthesis is a displacement of a vertebra.
• Narrowing of the spinal canal.
• Spondylitis.
• Spondyloarthrosis and bone osteophytes.
• Spinal tumors.
• Spinal osteomyelitis.

It is worth considering that inflammation can be caused by an infectious agent or a violation of anatomical interactions. In the second case, aseptic inflammation occurs, the treatment of which does not require the use of antibiotics; anti-inflammatory drugs are sufficient.

Your doctor will help you determine the true cause of radiculitis.

Symptoms

If the spinal column and spinal nerve roots are suddenly exposed to excessive force, acute radiculitis occurs, the main symptom of the disease will be vertebral neuralgia.

With degenerative and metabolic disorders, the process is chronic; pressure from an osteophyte, hernia, tumor or other formation is gradually exerted on the roots. Symptoms will gradually increase as the disease progresses.

It is worth understanding how radiculitis in various parts of the spine will manifest itself, since further diagnosis and treatment will depend on this. Inflammation of the roots of the cervical and lumbosacral regions, for example, will have a completely different clinical picture.

Cervical radiculitis

Diseases of the cervical spine are not uncommon, since this segment of the back is actively involved in holding the head when walking, running, sitting at a table, or working at a computer. The vertebrae in this part of the spine have a rather vulnerable structure, and at the same time they are in close interaction with important vessels and nerves.

If a spinal disease has led to inflammation of the nerve root in the cervical back, the following manifestations are likely to occur:

1. Pain in the back of the head and neck, aggravated by exertion or prolonged immobile work.
2. Pain in the shoulder blade, along the collarbone, in the area of ​​the shoulder joint.
3. Numbness, pain, loss of sensitivity in the hand. Radiculitis of the lower parts of the neck is manifested by disruption of the brachial plexus, which is responsible for the innervation of the upper limb.
4. Loss of muscle strength in the arm.
5. Headaches, migraines, dizziness are a sign of insufficient blood flow through the vertebral artery.
6. Blood pressure disorders.

Most often, the disease manifests itself as neuralgia - pain at the exit site of the root and along the nerve fibers. Other signs appear if there is strong pressure on the nerve structures, or the inflammatory process becomes extensive.

Radiculitis of the thoracic region

The rarest form of radiculitis is damage to the thoracic region. The reason for this phenomenon is that a large number of vertebrae in the thoracic floor of the back take on part of the lost function, and the disease takes a long time to compensate.

In addition, in the thoracic region there are no such important structures as nerve plexuses or cauda equina, so only the spinal roots are involved in the process. Radiculitis of the thoracic region is manifested by the following symptoms:

1. Pain in the thoracic part of the back, aggravated by exercise.
2. Shootings along the chest, following the course of the ribs.
3. Intercostal neuralgia can even mimic heart disease, occurring in the left side of the chest.
4. Difficulty taking a deep breath due to chest pain.

Poor symptoms lead to the pathological process not being diagnosed for a long time. Dangerous diseases can be detected too late, so at the first symptoms you need to consult a doctor.

Radiculitis of the lumbosacral region

The most common location of radiculitis is the lumbosacral segment. This explains the large number of patients complaining of lower back pain.

The thing is that it is on the area of ​​the lumbosacral floor that most of the load falls during active movements, lifting weights, and playing sports. Under the influence of these factors, degeneration occurs, which leads to aseptic inflammation of the nerve roots. Symptoms of lumbar radiculitis:

1. Pain in the lower back after exertion, bending, standing for a long time, or lifting heavy objects.
2. Shooting pain along the spine - in the buttock, thigh, and other parts of the lower limb.
3. Impaired skin sensitivity in the leg, numbness, “crawling” feeling.
4. Pain when pressing on the spinous process of the involved vertebra.
5. Inability to stand for long periods of time.
6. Pain when trying to straighten your back during an attack of neuralgia.

Radiculitis itself causes a lot of inconvenience, but it is also a manifestation of another disease. If the cause of neuralgia progresses, it may involve the nerve structure of the cauda equina, which is responsible for the innervation of the bladder and rectum.

Low back pain has been ignored by patients for a long time, but can be a symptom of a serious illness. It is necessary to consult a doctor in time for a full diagnosis of the disease.

Diagnostics

The diagnostic search for a doctor begins with a conversation and questioning of clinical symptoms, then the doctor will conduct an objective examination of the spine and specify neurological symptoms. Often, to determine the cause of the disease, a consultation with a neurologist may be required.

The next step is to examine the patient's tests. A general blood and urine test will allow you to exclude or confirm an infectious process. In case of aseptic inflammation of the roots, tests are not very informative. After laboratory testing, the patient will be referred for instrumental procedures. These include:

1. X-ray of the affected part of the spine - excludes or confirms the pathology of bone formations, including spondyloarthritis, vertebral fractures, osteophytes, spondylolisthesis.
2. CT and MRI are highly accurate methods that can detect the process at the initial stage. MRI perfectly detects vertebral pathology, therefore it is the best method for diagnosing osteochondrosis.
3. X-ray contrast methods – myelography. Rarely used due to the risk of possible complications.
4. Electromyography is an assessment of the conduction of electrical impulses during excitation of muscle fibers. It is used in the presence of symptoms from the upper or lower extremities.
5. Cerebrospinal fluid analysis. Puncture is associated with certain difficulties and the risk of complications, so it is used if necessary, if infectious causes are suspected.

The listed list of studies changes depending on the data received and the doctor’s suspicion of the presence of a certain pathology.

Treatment

The therapeutic approach to the treatment of radiculitis has changed significantly in recent years. Today, the priority is to find the cause of the disease and treat it, and not just eliminate the symptoms. The complex of treatment measures may include:

• Drug treatment.
• Spinal immobilization.
• Physiotherapy.
• Therapeutic exercise.
• Massage.
• Surgical treatment.

Various methods are used only if there are indications for their use. Independent choice of treatment method is unacceptable.

Drug treatment

Tablets, injections and ointments can relieve the inflammatory syndrome, eliminate the manifestations of radiculitis, but do not get rid of the cause. Therefore, you should not limit yourself to just using medications. Medicines aimed at eliminating radiculitis include:

• Non-steroidal anti-inflammatory drugs.
• Analgesics.
• Group vitamins
• Muscle relaxants.
• Chondroprotectors.

The method of using medications depends on the severity of the pain syndrome. For low-intensity pain, applying ointments and gels to the area of ​​the affected segment is sufficient. With severe neuralgia, you have to resort to using injectable forms.

Immobilization

In some diseases, for example, injuries and osteochondrosis, pain from the nerve root is associated with pressure on it from bone structures. In this case, it is necessary to relieve tension using the immobilization method.

The vertebrae can be separated from each other using skeletal traction - this is used for injuries and fractures.

To immobilize the motion segment, you can also use corset structures - a Shants collar for the neck, a lumbar belt for the lower back.

Providing rest for the nerve root allows you to reduce symptoms and eliminate the cause of the disease without further progression.

Physiotherapeutic treatment

Modern medical practice recognizes the significant influence of physiotherapy on the course of the inflammatory process. Thermal methods of exposure can reduce the intensity of the inflammatory reaction by increasing blood flow in the affected area and relaxing muscle fibers. Possible procedures:

• Paraffin applications.
• Mud applications.
• Radon and hydrogen sulfide baths.
• Electromyostimulation.
• Electro- and phonophoresis of drugs.

It is worth remembering that the use of physiotherapy is dangerous in the presence of an infectious process. The doctor must prescribe treatment in accordance with contraindications.

Exercise therapy and massage

Therapeutic exercise allows you to restore spinal function after immobilization or surgical treatment. Exercise therapy also has a beneficial effect on the prognosis for osteochondrosis, disc herniation, and spondylolisthesis. By eliminating the above reasons, the likelihood of progression of radiculitis and the frequency of its exacerbations are reduced.

It is worth visiting a qualified massage therapist after a complex of exercise therapy. Massage allows you to relax muscle fibers and reduce the intensity of back pain.

Surgical treatment

If these treatments are not effective, your doctor may recommend surgery to decompress the nerve root.

Some diseases leading to radiculitis may be absolute indications for surgery. These include tumors, vertebral fractures, severe forms of osteochondrosis, osteophytes and other pathological processes.

Inflammation of the spine of another location

Some patients associate back pain exclusively with sciatica. However, the inflammatory process in the spine may be of a different location. The following structures may be affected by inflammation:

• Vertebral bodies.
• Intervertebral joints.
• Intervertebral discs.
• Ligaments of the spine.
• Back muscles.
• Spinal cord, nerve plexuses.
• Meninges.

Qualified specialists will help you differentiate between diseases and choose the optimal treatment.

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Radicular syndrome: symptoms and treatment

Radicular syndrome - main symptoms:

• Skin redness
• Lower back pain
• Stomach pain
• Sweating
• Muscle atrophy
• Pain in the heart
• Spinal pain
• Pain syndrome
• Numbness in the affected area
• Swelling of the skin
• Pain in limbs
• Loss of sensation
• Pain sensitivity disorder
• Difficulty making movements
• Shooting pain

Radicular syndrome is a complex of symptoms that occur as a result of compression of the spinal roots (that is, nerves) in the places where they branch from the spinal cord. Radicular syndrome, the symptoms of which are somewhat contradictory in its definition, is itself a sign of many different diseases, which is why timely diagnosis and appropriate treatment become important.

General description

The neurological syndrome we are considering is quite common. Compression (squeezing) of nerves leads to a wide variety of pain, which, accordingly, occurs in a variety of places: in the limbs, in the neck, in the lower back. Often pain can also occur in the area of ​​certain internal organs, for example, in the stomach or heart.

Below we can consider what the spinal root looks like externally and, accordingly, determine the effect of the lesion if it occurs.

Causes of radicular syndrome

Damage to the spinal roots can be caused by a number of conditions, including the following:

• Spina bifida;
• Osteochondrosis;
• Certain types of birth defects relevant to the structure of the spine;
• Constant overloads affecting the spinal column;
• Sedentary lifestyle;
• Spondyloarthrosis;
• Injuries, scarring and tumors;
• Vertebral fractures resulting from osteoporosis;
• Changes in hormonal status;
• Damage to the vertebrae of an infectious nature (for example, changes caused by osteomyelitis or tuberculosis);
• Hypothermia.

As a rule, radicular syndrome does not occur immediately after exposure to one or another specified cause. Initially, it is preceded by the development of changes in the area of ​​the intervertebral discs, which, in turn, provoke the occurrence of hernias. Further, the hernia, with its own displacement, begins to compress the spinal root, which leads to difficulty in the outflow of venous blood from it. This subsequently leads to the development of non-infectious inflammation. Thus, the nerve and the tissue around it begin to surround the formed adhesions.

Radicular syndrome: symptoms

The first, and most characteristic symptom of radicular syndrome is the appearance of pain, which is concentrated along the course of a particular nerve. So, when a process develops in the cervical region, pain, accordingly, occurs in the arm and neck. The process in the thoracic region provokes back pain; in some cases, pain concentrated in the stomach or heart becomes possible (these pain disappears only when the radicular syndrome itself is eliminated). The process in the lumbar region leads to pain in the lower back and buttocks, as well as the lower extremities.

Movement, like lifting heavy objects, leads to increased pain. In some cases, the pain is characterized as “shooting”, which is accompanied by its spread to various parts of the body, this is partly due to the location of a particular nerve. A lumbago that occurs in the lumbar region is called lumbago. In this case, the pain may be constant, but it intensifies in any case if any careless movement is made.

Not only physical stress, but also emotional stress can provoke attacks of pain; in addition, hypothermia also influences its appearance. In some cases, pain occurs at night, as well as during sleep, which is particularly accompanied by swelling of the skin and its redness, and increased sweating is also noted.

Another symptom accompanying radicular syndrome manifests itself as a sensitivity disorder that occurs in the zone of innervation of the nerve in question. Thus, a slight tingling sensation with a needle in the indicated area is accompanied by a sharp decrease in sensitivity, which is observed when compared with a similar area, but located on the other side.

Additionally, the symptoms also include movement disorders that occur with muscle changes. The latter are provoked by damage to the nerves that innervate them. The muscles dry out and, accordingly, they atrophy. In addition, their weakness is noted, which in some cases is determined visually, especially when comparing both limbs.

Diagnosis of radicular syndrome

In diagnosing radicular syndrome, it is initially important to determine the cause that provokes compression of the spinal nerve. Thanks to studies regarding movement and sensitivity disorders, it is determined within which vertebrae the damage occurred. For example, if compression of the root occurs in the area of ​​the fifth lumbar vertebra, then this provokes lower back pain (i.e. lumbodynia). This pain, accordingly, radiates along the outer surface of the thigh, as well as along the lower leg to the toes (2,3,4). Already this symptom acquires a slightly different definition - lumbar ischialgia.

When nerves are damaged due to infectious diseases, the process may be accompanied by additional symptoms in the form of fever and increased temperature, which, in particular, is concentrated in the area of ​​the root involved in the pathological process.

General radiography of the spine is used as a standard instrumental method that makes it possible to diagnose the syndrome we are considering. In particular, the diagnostic focus covers the results of radiography in the lateral and anterior projections. Meanwhile, the most informative and at the same time sensitive diagnostic method today is MRI (magnetic resonance imaging). Whatever diagnostic method is chosen, the basis for determining the diagnosis is still directly those clinical symptoms that are relevant in each specific case for the patient.

Treatment of radicular syndrome

Treatment methods for radicular syndrome are determined solely on the basis of considering possible causes, as well as identifying the main one, that is, the one that actually provoked this syndrome. Patients are prescribed strict bed rest, during which they should lie exclusively on a hard surface. Additionally assigned:

• Analgesics (ketorol, baralgin). Their use allows you to eliminate/reduce severe painful manifestations.
• Anti-inflammatory non-steroidal drugs (nurofen, diclofenac, movalis). With their help, they not only reduce the inflammation that has formed in areas with damaged nerves, but also relieve pain. Their long-term use, however, is associated with a number of side effects. By the way, the use of drugs of this type is possible in the form of ointments, gels (fastum, ketonal), which, accordingly, provides for their external use while simultaneously reducing possible adverse effects.
• Muscle relaxants are drugs designed to relieve muscle spasms. They can only be used as prescribed by a doctor.
• Vitamins corresponding to group B. Their action is aimed at improving metabolic processes in nerve tissues.
• Chondroprotectors are drugs for stimulating restoration processes and slowing down cartilage destruction in the area of ​​intervertebral joints.
• Non-drug treatment (massage, gymnastics, physiotherapy, reflexology). These treatment options are relevant in all cases except tumors.

Some diseases may require surgical intervention, which is possible with neoplasms and intervertebral hernias.

To diagnose radicular syndrome, as well as to prescribe adequate treatment, you need to consult a neurologist.

If you think that you have Radicular Syndrome and the symptoms characteristic of this disease, then a neurologist can help you.

We also suggest using our online disease diagnostic service, which selects probable diseases based on the entered symptoms.

Intercostal neuralgia is a painful condition caused by irritation of the intercostal nerves or their compression. Intercostal neuralgia, the symptoms of which are usually observed in older people, is explained by age-related changes that are relevant to the condition of their blood vessels. As for children, this disease is extremely rare in them.

Radiculitis is a disease of the nervous system in which the roots of the spinal nerves are affected. Radiculitis, the main symptom of which is pain in the neck or back (depending on the lesion), can also be referred to in medical practice as radiculopathy.

Sciatica is an inflammation of the sciatic nerve. In some sources, the disease may be referred to as sciatic neuralgia or lumbosacral radiculitis. The most characteristic symptom for this disease is back pain, which radiates to the lower limb. The main risk group is people over 30 years of age. At an earlier age, the disease is almost never diagnosed.

Lymphocytic leukemia is a malignant lesion that arises in the lymphatic tissue. It is characterized by the accumulation of tumor lymphocytes in the lymph nodes, in the peripheral blood and in the bone marrow. The acute form of lymphocytic leukemia has recently been classified as a “childhood” disease due to its susceptibility mainly to patients aged two to four years. Today, lymphocytic leukemia, the symptoms of which are characterized by their own specificity, is observed more often among adults.

Raynaud's disease is a paroxysmal disorder in the arterial blood supply to the feet and/or hands that occurs due to prolonged exposure to stress, cold and some other factors. Raynaud's disease, the symptoms of which appear more often among women, is distinguished primarily by the symmetry of damage to the extremities.

With the help of exercise and abstinence, most people can do without medicine.

Symptoms and treatment of human diseases

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Questions and suggestions:

Inflammation of the nerve roots or radixitis, which is correct?

Many people have heard about such a disease as radiculitis. However, its full name sounds like inflammation of the nerve roots or radicular syndrome (the concept of radiculitis does not apply to all roots). This disease is typical for any age and is manifested by severe pain in the area of ​​inflammation, however, first things first.

General description

The human nervous system is a complex mechanism that has a branched structure. At the end of this structure there is a root and similar roots in the body 62, in addition, the system includes fibers and bundles. These nerve fiber roots and bundles act as messengers. In the event of any impact on the body (heat, cold, pain, etc.), this impulse is transmitted to the spinal cord, after which it is transmitted to the brain. This happens almost instantly.

The anatomy of nerve roots is simple. There are two subspecies:

The anterior ones are formed by the axons of efferent neurons. The main function performed by the anterior roots is motor activity and reflex contractions.

Damage to the anterior roots does not cause pain in a person, but leads to motor disturbances and disturbances in reflexes. Nevertheless, among this group there are also afferent fibers (responsible for sensitivity). There are not many of them, but if they are damaged, severe pain can occur. These fibers can exit in the area of ​​the dorsal roots.

The dorsal roots, in turn, consist of afferent fibers and are responsible for sensitivity and pain. It is damage to these nerves that causes severe pain. In addition to the pain reaction, there may be a loss of sensation in the part of the body controlled by the affected nerve.

It is precisely because of the internal structure that inflammation of the nerve roots is primarily associated with spinal disorders (lower back pain, etc.)

In addition, according to their location, the roots are divided into:

• cervical (cervical, cervicobrachial, cervicothoracic);
• Gvental (innervate the chest around);
• lumbar;
• sacral (innervates the sacrum);
• coccygeal

The roots located in the lumbar and sacral regions are often combined into one subtype - the lumbosacral.

Reasons

There are several reasons that can provoke inflammation, from banal pinching of a nerve root in the lumbar spine to the presence of a hidden disease that provokes the formation of a hernia or tumor.

The root can become inflamed for the following reasons:

• infectious diseases affecting the vertebra;
• trauma (in this situation, a splinter or a displaced vertebra can pinch the nerve);
• spinal osteochondrosis;
• osteoporosis;
• intervertebral disc herniation;
• vertebral displacement;
• narrowing of the spinal canal;
• osteomyelitis;
• tumor in the spine;
• hypothermia (in this situation, there is no infringement as such, perhaps the development of an inflammatory process);
• hormonal disorders;
• sedentary lifestyle;
• birth defects (narrow opening through which a nerve passes, etc.).

The presence of a concomitant problem in the body does not immediately cause neuralgia; it takes time. For example, an intervertebral hernia begins to grow and gradually compresses the nerve root, thereby pinching it, disrupting the function of transmission of nerve impulses.

Symptoms

The nerve roots of the spine are located in certain places in the body, which indicates the classification of the inflammatory process. Thus, the following variants of the disease are distinguished:

• cervical;
• chest;
• lumbar;
• mixed (cervico-brachial, lumbosacral, etc.).

The inflammatory process can occur as a result of external influence on the root, then we are talking about a secondary type of illness, and directly due to problems with the nervous system, then we are talking about a primary type of illness.

Symptoms for each subtype are individual, but there are symptoms that are characteristic of all, including:

• increase in body temperature;
• pain along the route of the nerve;
• increased pain with sudden turns of the body, coughing;
• restriction in movement (depending on the type of illness);
• decreased sensitivity;
• weakness;
• increased pain upon palpation of the spinal process of the spine.

Cervical sciatica

The cervical spine is located as close as possible to the vessels of the head, therefore, when the roots of the cervical spine are compressed, the pain spreads towards the back of the head and the parietal region. In addition, pain in the shoulder blade or arm may be diagnosed.

Signs of cervical radiculitis:

• loss of sensation in the fingertips;
• pain when changing the position of the arms or moving the shoulder blades;
• difficulty breathing;
• heart-like pain;
• burning, tingling and tension in the neck muscles;
• poor posture;
• change in cervical curvature.

Due to the close location of the neck to the head, the following manifestations are possible:

• migraine;
• nausea;
• vomit;
• dizziness;
• increase in pressure.

Thoracic radiculitis

The least common disease, since inflammation in the thoracic region is one of the rarest manifestations. As a rule, it is associated with the presence of infectious diseases of the respiratory system, as well as herpes ganglia.

• aching pain;
• breathing problems (the patient has difficulty inhaling);
• the pain is localized in the ribs;
• increase or decrease in sensitivity at the pinched site;
• possibly a vegetative manifestation (blistering rash at the pinched site).

Lumbar sciatica

This disease is one of the most common. The nerve roots of the lumbar region suffer from pinching more often than others due to heavy loads on this region and have the following symptoms:

• lower back muscle tension;
• sudden and gradually increasing pain;
• shooting pain in the leg or buttock;
• numbness of toes;
• pain syndrome when straightening the back.

The pain does not allow the patient to stand for a long time, forcing him to take a sitting or lying position.

Diagnostics

The study of the patient's condition begins with collecting the patient's medical history. So, the doctor conducts a survey and initial examination of the patient, paying special attention to the location of the pain and the nature of its occurrence.

The standard set of tests for all medical institutions (general clinical blood test, urine test) is not very informative and the specialist prescribes an advanced diagnosis, which includes:

• X-ray of the inflamed spine;
• computed tomography (CT);
• magnetic resonance imaging (MRI);
• study of spinal fluid through spinal cord puncture;
• electromyography;
• myelography (a study based on the use of contrast fluid).

Treatment

Currently, the approach to treating inflammation or pinched roots has changed significantly. The basis is not the elimination (blockade) of the pain syndrome, but the identification and elimination of the cause of the pain.

The following treatment options are available:

1. Drug (conservative) treatment.
2. Operative (surgical) intervention.

The above options are the basis, and additionally physiotherapeutic procedures, immobilization therapy, as well as folk remedies can be used.

Drug therapy

This set of treatment procedures is designed not to treat the cause, but to eliminate the consequence, and includes the prescription of the following drugs:

• non-steroidal anti-inflammatory drugs;
• analgesics;
• complex of vitamins;
• muscle relaxants;
• chondroprotectors.

Depending on the severity of the disease, certain medications are used. For example, with moderate pain, it is enough to apply ointment or take a pill to the site of pain, while severe pain requires administration of medicine through an injection (injection).

Concomitant treatment

In the case of radiculitis, you cannot get by with tablets and ointments alone; complex treatment is necessary, which includes:

• physiotherapeutic treatment (UHF, ultraviolet irradiation, mud applications, radon and hydrogen sulfide baths, electrical myostimulation, phonophoresis, electrophoresis);
• physical therapy (physical therapy);
• therapeutic massage;
• immobilization.

Physiotherapy has a beneficial effect on the body, helping to relieve inflammation, relaxing muscle fibers and increasing blood flow.

Immobilization is carried out through the use of various corsets and restraint devices.

As for exercise therapy and massage, they are necessary for the rehabilitation of the patient after immobilization and surgery.

Surgical method

This method is necessary in cases where it is impossible to eliminate the cause in any other way. It is not always possible to change a patient’s condition with pills alone.

Thus, one of the most common operations is nerve root decompression. Decompression is necessary when it is not possible to relieve it from pressure through physical procedures or immobilization (as a rule, this occurs due to injury or tumor processes).

Prevention and prognosis

After completion of drug or surgical treatment, it is necessary to exclude the possibility of recurrence of the disease, for which the patient is required to comply with the following recommendations:

• weight loss (carried out as part of reducing the load on the spine and legs);
• reduce lifting;
• take advantage of more opportunities for walking;
• avoid hypothermia;
• pay attention to posture (curvature of the spine is unacceptable).

The prognosis of this disease is favorable in most cases. However, in case of untimely treatment or its complete absence, sciatica can develop into a chronic phase, which takes longer to treat than usual.

So, inflammation of the nerve roots is a rather unpleasant, but curable disease that must be treated under the supervision of a specialist. In the absence of proper treatment, severe pain cannot be ruled out. Don't joke with your body, treat yourself correctly!

Inflammation of the spinal nerve roots - where and how they are pinched, causes, treatment

The spine is an organ responsible for the normal functioning of the musculoskeletal system and internal organs, each of which has a network of nerve endings.

Nerve trunks originate from roots coming from the posterior and anterior horns of the spinal cord.

There are 62 nerve roots in the spine, respectively, there are 31 pairs of them.

The roots of the spinal nerves transmit signals coming from the internal organs to the spinal cord, and then to the brain - the central “control system” of the body.

“Commands” coming from the brain are first received by the spinal cord, which distributes them throughout the body through nerve endings.

Functions of the spinal roots and deviations from the norm

The indicated number of paired roots is determined by the structure of the spinal column. The spinal roots extend from the vertebrae of the neck (8 pairs), from the vertebral segments of the chest (12 pairs), lower back (5 pairs), sacrum (5 pairs), and coccyx (1 pair).

Inflammatory processes in these areas lead to pinched nerve fibers, severe pain and disruption of the innervation of internal organs, arms, legs, and skin.

• The dorsal roots regulate the activity of pain receptors and are responsible for sensory perception. They consist of afferent fibers. When the dorsal roots are damaged, neurological disorders are observed. With strong compression of these fibers, acute pain syndrome develops and muscle trophism is disrupted. With any attempt to move, the pain intensifies as the compression on the spinal nerve increases. If it is damaged, motor functions are preserved, but the sensitivity of skin receptors is lost.
• The anterior roots are formed by the axons of efferent neurons. They are responsible for movements and reflexes, contractions of ligaments. Without these fibers, motor activity would be impossible: a person would not be able to pick up objects, walk, run, or perform physical work. The nerve formed from the anterior roots of the spinal cord, when damaged and excised, does not cause pain, except in cases of return reception (in the anterior root of the spinal nerve one can find afferent fibers passing through it, then turning into the posterior root and leaving for the spinal cord). Their damage causes severe pain, which disappears when 2-3 dorsal roots are excised.

Compression and pinching of the posterior and anterior roots not only causes a painful condition, but also leads to disability if left untreated.

If an arm or leg loses sensation, “pins and needles” and numbness appear in the soft tissues, and movements in them are limited, you should urgently consult a doctor to establish an accurate diagnosis.

A disease in an advanced stage may require a radical method of solving the problem - surgery.

Reasons

Since the roots contain fibers on which the receptor sensitivity of soft tissues and the functioning of the musculoskeletal system depend, immediate hospitalization and a thorough examination of the patient allows us to avoid the worst thing - paralysis of the arms and legs, atrophy of muscle tissue.

In the process of diagnostic measures, the true causes of the pathological condition are established. This:

• Protrusion and herniation of intervertebral discs.
• Injuries.
• Degenerative changes in bone tissue caused by osteochondrosis, spondylosis, osteoporosis, arthritis.
• Tumor formations.
• Postoperative complications.
• Incorrect posture.
• A long-term static pose in which a person stays regularly for several hours.

Data from MRI, CT, X-ray and ultrasound examinations and other diagnostic measures make it possible to assess the degree of damage to the spinal roots, determine the location of the process, after which specialists decide on the direction of treatment and prescribe a set of treatment procedures.

Treatment

Traditional methods of therapy consist of taking painkillers and non-steroidal anti-inflammatory drugs, limiting physical activity, using muscle relaxants, and vitamin supplements.

But if the symptoms do not lose their severity and continue to increase, then specialists may decide on the advisability of surgical intervention. These could be:

• Microdiscectomy.
• Surgical decompression of the roots.
• Pulsed radiofrequency ablation (the Latin word “ablation” translates as “taking away”).

Microdiscectomy is a minimally invasive method that does not disturb the structure of the nerve fibers, but allows you to free them from compression by removing part of the bone tissue, due to which the inflammatory process began.

Surgical decompression of the roots is used for hernias and tumors, which, increasing in size, cause pinching of nerve fibers. The purpose of the operation is to remove partially or completely these formations.

Pulsed radiofrequency ablation in 80% of cases gives the desired result, because the integrity of the spinal segments is not compromised during the operation.

By puncture, an electrode is inserted into the area of ​​the hernial formation, and cold plasma pulses are sent through it. The hernia begins to “melt”, noticeably decreases in size and in some cases is reduced back.

But this is possible if the fibrous ring has not ruptured and the gelatinous contents remain within this membrane.

Vertebral pathologies are dangerous because any delay and ignoring the worsening condition can lead to a real disaster. The spinal cord is inextricably linked with the brain structures of the head.

Sympathetic nerve fibers running from the spinal segments to the internal organs transmit signals about problems to the “main center”.

And if the work of any of the links in this chain is disrupted, then the consequences of a late visit to the doctors may have to be corrected throughout the remaining years.

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The spinal roots are the main structures of the autonomic nervous system, responsible for the innervation of the entire human body. Unfortunately, they are often subject to compression, which causes damage and inflammation. They are divided into front and rear pairs and carry a certain set of functions. Depending on the type of damage and its location, sensitivity may deteriorate or motor functions may be impaired.

Inflammation of the spinal roots is called radiculitis. This condition is a symptom complex that accompanies the exacerbation of osteochondrosis and the development of its complications. If you do not carry out effective and timely treatment, you can lead your condition to partial or complete loss of sensitivity in certain parts of the body, dysfunction of the internal organs of the abdominal or thoracic cavity, and changes in the functioning of the coronary system. If the motor pairs of the root nerves are damaged, paralysis of the upper or lower extremities may develop, which will ultimately lead to disability.

Anterior and posterior, motor and nerve roots of the spinal cord

The axon plexuses extending from the spinal cord are divided into innervation and motor. The function is determined by the localization of the nerve fiber. The anterior roots of the spinal cord (ventral) consist mainly of efferent formations of axons. They are divided into gangliolar and pregangliolar neurons. This allows them to carry out motor function in the autonomic nervous system. In practice, this means that the motor roots of the spinal cord transmit impulses from the structures of the brain to the muscles of the upper or lower extremities, the back frame and anterior abdominal wall, the diaphragm and intercostal muscles.

This impulse contains information that the myocytes should contract or relax. Depending on the set of such impulses, the rhythmicity or randomness of movements depends. Damaged ventral (anterior) root nerves of the spinal cord lead to partial or complete impairment of motor activity.

The dorsal roots of the spinal cord are called dorsal and are responsible for sensitivity. These are the so-called nerve roots of the spinal cord, due to the function of which the human body has a certain threshold of sensitivity. A person can determine the temperature and structure, texture and shape of various objects. It is possible to assess environmental conditions tactilely. Pain syndrome protects you from danger. And the dorsal or posterior root nerves of the spinal cord are responsible for all these manifestations of the work of the autonomic nervous system.

Naturally, when they are compressed or damaged in other ways, the first thing that occurs is a loss of sensitivity. In the area of ​​the innervation zone, skin sensitivity disappears; the epidermis may even become cooler to the touch. Although at the initial stage this manifests itself on the contrary, as hypoesthesia - increased sensitivity, a feeling of goosebumps, etc.

Causes of damage to the spinal cord roots: compression or degeneration

Damage to the spinal cord roots can accompany various diseases. This may be osteochondrosis and the gradual destruction of the intervertebral disc, which protects the nerve fiber from pressure from the vertebral bodies and their spinous processes. In this case, compression of the spinal cord roots occurs, leading to a secondary inflammatory process and radiculitis.

Other causes of damage to the spinal cord roots may include the following negative factors:

• axonal degeneration due to a deficiency in the diet of certain trace elements (magnesium), vitamins (pyridoxine) and amino acids;
• development of sclerotic changes in the soft tissues surrounding the spinal column;
• diseases of the spinal cord (myelitis, poliomyelitis, tick-borne encephalitis, etc.);
• spine and spinal cord injuries;
• amyotrophic lateral sclerosis, leading to permanent disability in a short time;
• spondylosis and spondyloarthrosis;
• instability of the position of the vertebral bodies against the background of destruction of the ligamentous and tendon apparatus of the uncovertebral joints;
• Ankylosing spondylitis, rheumatoid polyarthritis and other diseases of inflammatory origin caused by autoimmune changes in the human body.

Finding and eliminating all suspected causes of the development of such pathologies is an integral stage of effective and timely treatment.

You can schedule a free initial consultation at our manual therapy clinic. Here you will be examined by an experienced doctor of the highest category. An accurate diagnosis will be made and we will tell you what needs to be done right now to start moving towards recovery.

Symptoms of damage and dysfunction of the spinal cord roots

The clinical picture may manifest itself in the form of radiculitis, decreased sensitivity or motor activity disorder. Symptoms depend on which particular root nerve of the spinal cord is damaged (posterior or anterior) and in which part of the spine it is located.

The most common injury to the spinal cord root is in the lumbar and lumbosacral spine. This condition leads to the following symptoms of the disease:

• severe pain in the lumbar region;
• the pain may radiate through the left or right leg;
• decreased skin sensitivity in the buttock, thigh, leg, foot;
• sensation of cramps in the lower extremities;
• disruption of the internal organs of the abdominal cavity and pelvis (retention of stool and urination may be observed);
• severe limitation of mobility, inability to independently bend and straighten the back.

The second most common area in which dysfunction of the spinal cord roots is observed is the neck and collar area. Here are the most important pairs of radicular nerves responsible for the innervation of the coronary system, lungs, diaphragm, intercostal muscles, thyroid gland, etc. Therefore, any damage to the anterior or posterior root nerves of the spinal cord is accompanied by a variety of clinical manifestations. Most often, patients report the following symptoms:

• headaches and dizziness, accompanied by decreased mental performance and a constant feeling of fatigue;
• increase and decrease in blood pressure levels, independent of external pathogenic factors;
• soreness of the muscles of the neck and collar area;
• pain and numbness in the upper extremities;
• heart rhythm disturbance;
• limited mobility of the left or right hand;
• compensatory change in posture with the formation of withers in the collar area.

Dysfunction and damage to the spinal cord roots in the thoracic spine are very rare. Most often, this phenomenon accompanies various back injuries. It manifests itself as severe pain in the chest, intensifying when taking a deep breath. There may be difficulty when trying to sharply bend, turn the body in one direction or another, etc.

An x-ray is used for diagnosis. If it is unsuccessful, a CT or MRI is prescribed. Differential diagnosis is carried out with inflammatory and tumor processes, injuries and various age-related degenerations.

Treatment of inflammation of the spinal cord roots

Inflammation of the spinal cord roots is radiculitis, a condition that is a symptom of the body's compensatory reaction in response to damage to the nerve fiber structure. An inflammatory reaction occurs with any injury, including compression by hard tissues of the spine against the background of protrusion of the intervertebral disc with a sharp decrease in its height.

In the inflammatory reaction, mechanisms are involved in attracting factors to the site of pathological change that provoke acceleration of capillary blood flow and the development of tissue swelling to eliminate the phenomenon of compression. As a result, severe pain, muscle fiber tension syndrome, spasm of blood vessels, numbness and limited range of motion occur.

Treatment of the spinal cord roots always begins with eliminating the cause of the development of the pathological process. It is important to remove compression. This can be done only in one way - with the help of traction traction of the spinal column. In some cases, such an effect can be replaced by an osteopathy session. It is almost impossible to relieve compression from the radicular nerve at home. Therefore, doctors in the clinic prescribe pharmacological drugs to their patients that eliminate not the cause itself, but the effect. These are non-steroidal anti-inflammatory drugs that fight the patient’s body. They block protective and compensatory reactions. This eliminates pain, swelling and inflammation. But in return, a person receives a manifold acceleration of the process of destruction of the cartilage tissue of the intervertebral discs.

The only effective way to treat and restore the radicular nerves of the spinal cord is manual therapy. The applied massage and osteopathy, reflexology and kinesitherapy, therapeutic exercises and laser help restore the healthy state of the spinal column. During the course of treatment, the patient completely restores his performance and mobility of the spine.

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Radicular syndrome or radiculopathy is a set of neurological symptoms that occur when the spinal nerves are compressed in the area of ​​the branch from. The pathological process is often encountered in medical practice and is a manifestation of a chronic progressive course, primarily of a degenerative nature - dorsopathies.

According to statistics, in 80% of cases, radicular syndrome of the lumbar spine is diagnosed due to mobility of the vertebrae, weakness of the musculo-ligamentous apparatus in this area and heavy load during physical activity.

Reasons

The most common cause of radicular syndromes is considered to be the progressive course of osteochondrosis with the formation of protrusions, hernias, and osteophytes. The disease is accompanied by deformation of the intervertebral discs as a result of metabolic disorders and insufficient blood supply. As a result, the height of the disc decreases, which moves beyond the boundaries of the vertebrae, compressing nearby soft tissues. In this case, the root is affected - the spinal nerve at the base of the spinal cord, passing in the bone canal before exiting the spine. The spinal root consists of sensory and motor nerve fibers and is in connection with the vertebral vessels. Compression of the neurovascular bundle by a hernia or osteophyte leads to the appearance of neurological symptoms.

Other causes of radiculopathy include:

• congenital pathology of the spinal column;
• spondyloarthrosis;
• vertebral fractures caused by osteoporosis (weakening of bone tissue);
• infections (osteomyelitis, tuberculosis);
• intense axial loads on the spine (carrying heavy objects, sports overloads);
• sedentary lifestyle (hypodynamia);
• long stay in static positions (working at a computer);
• frequent hypothermia;
• chronic stress;
• endocrine disorders, hormonal imbalance (obesity, diabetes);
• tumors, scar changes in the spinal column;
• injuries (fractures, bruises, sprains);
• flat feet.

Compression of the nerve root often occurs when a herniated protrusion of the intervertebral disc forms

In the development of degenerative-dystrophic processes of the spinal column in recent years, the role of a hereditary factor has been proven, which affects the defective development of connective tissue. As a result, spinal pathology develops with a rapidly progressive course and the formation of radiculopathy. Poor nutrition, nicotine addiction, and alcohol abuse are of no small importance in the onset of the disease.

Clinical picture

A constant manifestation of radicular syndrome is pain of varying intensity, which occurs at the site of infringement of the neurovascular bundle and in other parts of the body along the innervation of the affected nerve.

It can be aching, tugging, burning, cutting. Worsened by walking, bending, turning, sneezing or coughing. Sometimes the pain syndrome occurs in the form of a lumbago - a sharp pain from the lumbar region spreads along the path of the nerve. Characteristic phenomena of parasthesia are numbness, tingling, a sensation of “crawling goosebumps” in the lower extremities.

This condition is called lumbago, and periodically shooting pains are called lumbodynia. Lumbago can appear when turning awkwardly during night sleep, bending over, or lifting heavy objects. In this case, the pain is accompanied by autonomic disorders: redness of the skin, sweating, swelling over the area of ​​root compression. Depending on the level of damage to the lumbosacral region, pain can radiate to the groin, buttocks, lower limbs on the affected side, cause problems with urination, defecation and weaken potency.

On the MRI image, arrows indicate pathological changes in the intervertebral discs in the lumbar region

Sensory and motor nerve fibers pass through the spinal root. Their compression causes swelling and inflammation of the nervous tissue, disruption of the conduction of nerve impulses from the central sections to the periphery. As a result, the lower limb on the affected side suffers. In this case, sensitivity is impaired - the sensation of tactile touch, temperature and pain stimuli of the lower limb is weakened. The innervation of the muscle fibers of the thigh, lower leg, and foot also changes and their atrophy (“shrinkage”) develops. Weakening of the muscles causes impairment of the ability to move normally. Atrophied muscles decrease in volume, which can be seen when visually comparing the diseased and healthy legs.

Diagnostics

For the diagnosis of radicular syndrome, clinical data of the disease are of significant importance. The lumbosacral region is affected at different levels, and based on the specificity of the symptoms, it is highly likely to suggest the localization of the pathological process.

1. Compression of the spinal root at the level of 1-3 lumbar vertebrae (L1-L3) is accompanied by discomfort in the lower back, pain in the perineum, pubis, lower abdomen, inner and anterior thigh. Paresthesia and numbness of the skin are observed in this area.
2. Compression of the spinal roots at the level of the 4th lumbar vertebra (L4) is characterized by pain on the anterior and outer surface of the thigh, which descends to the knee joint and lower leg. There is a decrease in the volume of the thigh due to atrophy of the quadriceps muscle and weakening of movements in the knee. The gait changes and lameness develops.
3. Compression of the spinal roots at the level of the 5th lumbar vertebra (L5) causes pain along the outer surface of the thigh and lower leg, the inner part of the foot with damage to the big toe. Paresthesia in the foot area and weakening of the muscle strength of the lower limb are detected, which complicates the supporting and motor function of the affected leg.

Pain sensations decrease or completely stop when lying on the healthy side of the body.

To prescribe effective treatment, the etiological disease of the spine, which caused the appearance of radicular syndrome, is identified. They recommend instrumental examination methods that reveal the specifics and severity of the pathological process and clarify its localization:

• radiography in direct and lateral projection - determines disorders of the bone tissue of the spine, indirectly indicates narrowing of the intervertebral discs and pinched nerve roots;
• magnetic resonance imaging(MRI) is a more accurate and expensive diagnostic method that provides information about the condition of not only the vertebrae, but also the intervertebral discs, vessels, nerves, muscles, ligaments, and spinal cord;
• myelography - reveals the condition of the spinal cord and nerve roots using a contrast agent injected into the subarachnoid space, followed by fluoroscopy.

Correct diagnosis facilitates the prescription of adequate therapy, which prevents the development of complications and disability.

Treatment tactics

Treatment of radiculopathy is aimed at eliminating pain, reducing inflammation and swelling of the neurovascular bundle. After the acute process has stopped, therapy for the etiological disease is continued to prevent the progression of the pathology. Patients are prescribed bed rest on a hard, flat surface, which prevents spinal deformation and additional injury to soft tissues. Fried, salty, spicy, fatty foods are excluded from the diet. The diet is enriched with fresh vegetables, fruits, herbs, cereals and dairy products. For effective treatment, you should stop smoking and drinking alcoholic beverages.

Conservative therapy for radicular syndrome includes:

• analgesics for the purpose of relieving pain - baralgin, ketorol in solutions for intramuscular injections;
• non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammatory reaction in the affected area, eliminate swelling and pain - movalis, diclofenac, nimesulide for the first 5 days through intramuscular injections, then in tablet form for a course of 10-14 days;
• lubricating the lower back with anti-inflammatory and locally irritating ointments - capsicam, diclak-gel, finalgon;
• novocaine blockades with the addition of lidocaine, antibiotics, glucocorticoids for quick pain relief;
• muscle relaxants to relax spasmodic muscles in the area of ​​nerve compression, which has an analgesic effect, improves blood flow to tissues, reduces congestion - sirdalud, mydocalm;
• vitamin complexes based on preparations B 1, B 6, B 12 in order to normalize metabolic processes and trophism of nerve roots, improve the conduction of nerve impulses, regenerate damaged tissues - milgamma, neuromultivitis in injections or tablets;
• physiotherapy after the subsidence of acute pain to activate metabolism, normalize muscle tone, improve blood flow - magnetic therapy, UHF, electrophoresis, radon baths;
• physical therapy to restore the anatomically correct position of the spinal column and strengthen the muscular frame of the back;
• massage, acupuncture, reflexology - to strengthen the back muscles, normalize blood circulation, improve nutrition of the spine.

In severe cases of the disease, persistent symptoms develop that do not respond to conservative methods of therapy. In such cases, surgical treatment is resorted to.

Indications for surgical intervention include chronic pain syndrome, impaired motor activity (paresis, paralysis), pathology of the pelvic organs with urinary and fecal incontinence.

Massage and manual therapy are prescribed for the prevention of radiculopathy

Preference is given to minimally invasive methods, which are characterized by less damaging effects on healthy tissue and a short recovery period. For lumbar osteochondrosis complicated by protrusion, hernia, or proliferation of osteophytes, nucleoplasty, microdiscectomy, and removal of damaged spinal tissue with replacement with implants are prescribed.

Prevention

To prevent radiculopathy, it is necessary to promptly consult a doctor when the first alarming symptoms of the spinal column occur. Incarceration of the spinal root occurs against the background of a chronic course of the disease, untimely diagnosis and treatment of the pathological process. You should adhere to a balanced diet, give up bad habits, exercise, and monitor the maintenance of normal body weight. It is important to sleep on a firm mattress and wear comfortable low-heeled shoes. It is necessary to avoid heavy physical labor associated with axial load on the spine. It is useful to undergo therapeutic back massage courses twice a year.

Complexes of therapeutic exercises are prescribed during the recovery period of the disease

To prevent exacerbation of radiculopathy due to osteochondrosis, you can perform a set of exercises daily to strengthen the lumbar spine:

• lying on your back with your arms extended along your body and legs straight, contract your abdominal muscles 10-15 times;
• the starting position is the same, lift the upper half of the body from the floor, stay in this position for as long as possible and return to the previous position, number of repetitions - 10-12 times;
• lying on your back, bend your knees and place them to the right of your body, at the same time point your head and chest to the left, perform springing movements 6-8 times, and then do the same exercise, changing the sides of the head and legs;
• sit on the floor, stretch out one leg and bend the other at the knee joint and move it to the side, bend towards the straight leg and try to clasp your foot with your hands, swap your legs and repeat the exercise 5-6 times;
• in a position on all fours, alternately arch your back up and bend down until you feel a pleasant warmth in your lower back. Repeat the exercise 8-10 times.

If possible, hang on the horizontal bar several times a day for 10-15 minutes. Do a morning warm-up for all muscle groups before you begin active physical activity.

Radicular syndrome in the lumbar region causes intense pain, impairs sensitivity and motor ability of the limbs, disrupts pelvic functions and contributes to the appearance of sexual impotence. This significantly reduces the quality of life and can lead to disability. To prevent pathology, it is necessary to consult a doctor in a timely manner and undergo comprehensive treatment for diseases of the spinal column.

The neurological disease lumbar radicular syndrome can provoke disability and temporary incapacity for work. This is a complex of symptoms that occur when the spinal roots are compressed and inflamed. Another disease is known as radiculitis. The appearance of symptoms suggests that inflammation begins in the nerve bundles.

The main cause of the disease is problems with the spinal column caused by its disruption. The nutrients that intervertebral cartilage requires become depleted over time. The situation may worsen with age or with excess weight: this leads to subsidence of the vertebrae. The spinal nerve exits the cavity in the spinal column, due to which subsidence occurs, the openings narrow, and they are pinched.

In the area of ​​compression, inflammation of the roots begins, characterized by tissue swelling. The appearance of edema aggravates the condition and increases pain.

In addition to osteochondrosis, the development of the disease occurs in other processes:

• Intervertebral hernia. When the cartilage ruptures and the nucleus is squeezed beyond its boundaries, the exiting nerves are compressed;
• Disorders of the structure and diseases of the spine. These factors often become causative agents of radicular syndrome.
• Incorrect fusion of the vertebrae due to injury.
• Weakening of bone and cartilage tissue caused by infectious diseases.

More often, this disease appears in people with a sedentary lifestyle. There have been cases where the disease develops due to excessive physical exertion or a “back injury.” The appearance of the disease during hypothermia and the use of certain medications was also noted (such syndromes are called pseudoradicular).

The pain begins to spread into the exiting nerves, resulting in symptoms similar to organ dysfunction. For example, radicular syndrome in the chest area gives the impression of developing angina.

As for classification, there are no specific classes of the disease. The disease is divided conditionally, starting from the affected areas of the spine. This classification designates the disease:

• Cervical;
• Chest;
• Lumbar regions.

Less commonly, the disease affects the sacrum and coccyx, which excludes these parts from the classification. Informally, pathology is classified by degree of complexity. Sometimes pathology is equated to acquired and congenital, although such a division is quite rare, since the disease is predominantly acquired. Of all the departments listed, violations in this area are the most common.

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Causes and symptoms

What causes the lumbar spine to suffer more often? The source of pathology can be:

• Large load affecting the lumbar region. Heavy physical work is redistributed here. In addition, the lower back is loaded by other parts of the skeleton located above.
• The mentioned section is formed with the help of large vertebrae with rather wide openings that allow passage. When the shock-absorbing function is impaired, they are easily pinched.
• The fact that the lower back is more mobile than other areas also plays a role in the progression of the disease. Amplitude movements displace the vertebrae in relation to each other and provoke the appearance of pain or.

Muscle functionality may be impaired if lumbar osteochondrosis is not treated for a long time. This atrophies the muscles, as a result of which it becomes impossible to engage in physical work, as the muscles weaken significantly.

When nerves are pinched, symptoms of the disease will begin to appear soon. One of the common symptoms is shooting pain, which manifests itself unexpectedly after heavy physical exertion or injury. Pain syndrome often accompanies decreased sensitivity. This is observed in the place where the nerve is pinched.

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As practice shows, the radicular syndrome is predominantly “double” (sensitivity and level of irritation decrease at the same time).

The main signs of radicular spine syndrome:

• Painful sensations. They are intense, aching in the area of ​​​​compression, which spread to the limbs, in rare cases to organs;
• Reduced sensitivity. May manifest as paresthesia (goosebumps, coolness on the skin);
• Impaired muscle function or movement. Development occurs due to the death of the nerves responsible for a certain area. Develops muscle weakness and impaired performance.

Diagnostics

When diagnosing a disease, many factors are taken into account. To begin with, the patient’s complaints are specified, because they serve as the basis for assumptions about the place of development of the pathology. For more accurate information, it would not be superfluous to use palpation of the expected area of ​​​​pain localization - in this case, slight muscle tension is observed. Also, during palpation, the patient can lean towards the site of the lesion: this reduces the pain syndrome.

MRI of the lumbar region is considered an accurate diagnosis of the disease. It helps to identify the smallest pinched nerves and accurately determines the location of the pathology. The main difficulty of such diagnostics is the cost. The tomography procedure is not cheap, so not everyone agrees to have it performed.

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Treatment

What to do when lumbar radicular syndrome shows symptoms? Can treatment be started at home or should you make an appointment with a doctor? Treatment of lumbar radicular syndrome should be done without delay and under the supervision of a doctor. Like many diseases of the musculoskeletal system, radicular syndrome may include:

• Non-surgical therapy;
• Drug treatment;
• Surgical intervention.

When symptoms do not affect the usual rhythm of life, you can limit yourself to general methods: a balanced diet, limiting physical activity, attending massage sessions.

But if the disease begins to cause concern, the initial stage of treatment involves therapy with non-steroidal, anti-inflammatory drugs such as Diclofenac or Nimesulide. When the pain becomes intense and causes concern, it is recommended to use intervertebral blockades. If the condition worsens, you should see a doctor to determine the required therapy.

Physiotherapy

According to leading experts in the field of traumatology and neurology, it is quite possible to defeat certain diseases of the musculoskeletal system with physiotherapy, in particular, electrophoresis and electrical impulse points. Using electrophoresis in combination with certain medications helps:

• Reduce the inflammatory process;
• Eliminate pain;
• Improve the metabolism of affected nerves;
• Restore damaged muscle trophism.

Electropulse points are aimed at eliminating muscle tension and normalizing nutritional processes in atrophied tissues. The disease can be treated with acupuncture. This technique is not very popular in traditional medicine, but has proven its effectiveness for many patients.

Surgery

The main factor causing the disease is symptoms. Surgery is necessary if symptoms pose a threat to health. The operation is required if:

• Pain does not decrease with the use of non-steroidal anti-inflammatory drugs;
• The functionality of the limbs is impaired, in which there is a complete loss of activity;
• Irreversible changes occur in the osseous-ligamentous apparatus, which leads to compression;
• Exacerbation of intervertebral hernia.

The operation is performed in a specialized clinic under general anesthesia. During the procedure, the doctor removes parts of the vertebra that interfere with the natural position of the root. If a hernia has formed at the site, the prolapsed area is excised.

Complications and prevention

It is impossible to delay the treatment of pathology, because untimely seeking help can provoke complications:

• Development of lameness due to skeletal position. It often develops into flat feet and aggravates the patient’s condition;
• Brief or long-term mental instability. Constant pain will not allow you to relax at any time of the day. Overwork leads to neuroses and psychoses;
• Severe cases manifest as complete paralysis;
• The inflammatory process can reach the spinal cord and become an impetus for the spread of inflammation to other parts of the spine, which leads to even more severe diseases.

You can prevent the development of severe pathology by following simple rules:

• Do exercises in the morning: warm up your muscles, bring them back to normal;
• Try to keep your weight under control;
• If possible, attend massage sessions;
• Eat well. The disease is often provoked by the lack of nutrients for cartilage tissue;
• Learn to distribute work and rest: you will not overwork and reduce the risk of injury during exercise.

This disease can be classified as one that is better to defeat in the initial stage than to carry out full treatment. By following simple rules of prevention, you will avoid the occurrence of this unpleasant disease.

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