Radiculopathy

• Radiculopathy:

  • ‘Neurological state in which conduction is blocked along the spinal nerve or its root’ (Bogduk, 2009)
  • Hypoactivity / negative neural symptoms, anaesthesia , Loss of strength/weakness
• Radiculopathy - Mechanical causes:

  • Disc herniation is the most common and inflammation of the affected nerve
  • Facet joint hypertrophy
  • Ligamentum flavum hypertrophy
  • Osteophytes
  • its an actual mechanical blockage or pressure on the nerve or nerve root
• Radiculopathy - Chemical causes:

  • Nociceptive stimuli to nerve / nerve root and its surrounding areas
• Clinical Presentation of Radiculopathy - History and MOI:

  • Traumatic or gradual insidious pain
• Clinical Presentation of Radiculopathy - Subjective Features:

  • Report neurological sigs and symptoms - numbness (anaesthesia), pins&needles (paraesthesia), motor weakness
  • Must rule out other red flags and Upper Motor Neuron involvement (though neural integrity test) during assessment
  • With or without referred pain
  • Can present with morning stiffness
  • Aggs and Eases depend on involved structures (if any)
• Clinical Presentation of Radiculopathy - Objective Features:

  • Pain
  • Positive neuro integrity (Lower Motor Neuron)
  • Weakness / progressive weakness
  • Numbness and/or pins and needles (can be progressive)
  • Reduced reflexes
• Clinical Presentation of Radiculopathy - Key impairments:

  • Pain / weakness / decreased muscle power and consequently ROM
  • depending on affected nerve root level(s)
• Clinical Presentation of Radiculopathy - Does this patient warrant a scan?

  • only if we suspect serious pathologies or a progressive neurological presentation