Pain, numbness, tingling or weakness in an arm or leg may seem unrelated to your spine. But these symptoms can sometimes occur when a nerve root near the spine becomes compressed or irritated. This condition, called radiculopathy, can cause symptoms that travel into the shoulder, arm, hand, buttock, leg or foot, depending on which nerve is affected.
What causes a spinal nerve root to become irritated or compressed? Several conditions can contribute, from herniated discs to age-related changes in the spine. Understanding the cause can help guide the right approach to treatment.
This article explains what causes radiculopathy, how doctors determine whether a spinal problem is responsible for your symptoms and which treatments may help.
What Does Radiculopathy Feel Like?
Radiculopathy feels different from person to person, but a few symptoms are common:
- Sharp, shooting or burning pain that spreads from the spine along the path of the affected nerve
- Numbness or tingling, often described as a “pins and needles” sensation
- Muscle weakness that makes it harder to lift, grip or move a limb normally
Where these symptoms appear depends on which nerve root is affected.
- Cervical radiculopathy (neck): Symptoms may travel into the shoulder, arm or hand.
- Lumbar radiculopathy (lower back): Symptoms may travel into the buttock, leg or foot.
Many people refer to these symptoms as a “pinched nerve,” although radiculopathy specifically involves a nerve root near the spine.
What Causes Radiculopathy in the Spine?
Radiculopathy starts when something presses on or irritates a nerve root. Several spine conditions can cause this, and many are related to normal aging.
Common causes include:
- Herniated or bulging discs. The soft pads between spinal bones can push out and press on a nearby nerve root.
- Degenerative disc changes. Discs can lose height and flexibility over time, narrowing the space around the nerves.
- Bone spurs. Small growths of extra bone can crowd the areas where nerves exit the spine.
- Spinal stenosis. A narrowing of the spinal canal or the spaces where nerves travel can leave less room for the nerves.
- Other structural changes. Shifted vertebrae or other changes in the spine can also put pressure on a nerve root.
Who is more likely to develop lumbar radiculopathy?
Lumbar radiculopathy appears to be more common in men than women overall. Research suggests that symptoms may also develop at different ages, with men more likely to experience lumbar radiculopathy in their 40s and women more often affected in their 50s and 60s. However, the reasons for these differences are not fully understood, and factors such as occupation and physical demands may also influence risk.
Is Radiculopathy the Same as Sciatica?
These terms are related but not the same.
- Radiculopathy refers to irritation or compression of a spinal nerve root. It can happen in the neck or lower back.
- Sciatica describes pain and other symptoms that follow the path of the sciatic nerve — the large nerve that runs from the lower back through the buttock and into the leg.
Lumbar radiculopathy can cause sciatica, but the terms are not interchangeable. Not everyone with lumbar radiculopathy has classic sciatica symptoms.
How Is Radiculopathy Diagnosed?
Diagnosing radiculopathy means answering two questions: Is a nerve root affected? And what is causing it?
The process typically involves:
- Medical history. Your doctor will ask about your symptoms, when they started and how they affect your daily activities. They may also ask about previous injuries, spine problems or treatments.
- Physical and neurological exam. Your doctor will check your muscle strength, reflexes and feeling in the affected area to help identify which nerve may be involved.
- Imaging, such as an MRI. Imaging can provide a detailed look at the discs, bones and areas around the nerves when needed.
- Electromyography (EMG) or nerve conduction study (NCS) / nerve conduction velocity (NCV) tests. These tests evaluate how well your nerves and muscles are working. They may help determine whether a nerve is damaged or not functioning normally and can help identify which nerve or nerve root is affected.
Importantly, imaging does not always tell the whole story. Scans can show degenerative changes that are not actually causing your symptoms. Because these changes are common, doctors consider imaging results alongside your symptoms and physical exam to determine whether a spinal problem is affecting a nerve.
Can Radiculopathy Get Better Without Surgery?
For many people, yes. Radiculopathy can improve with nonsurgical treatment, depending on the severity of one’s symptoms.
Common nonsurgical treatments include:
- Physical therapy. Guided exercises to improve movement, strengthen supporting muscles and reduce stress on the affected area
- Activity modification. Adjusting movement or daily habits to avoid aggravating symptoms
- Medications. Used when appropriate to manage pain and inflammation
- Targeted injections. May be considered in some cases to help reduce pain and inflammation
The best treatment depends on the underlying problem and how your symptoms respond to treatment. Having radiculopathy does not automatically mean you need surgery.
When Does Radiculopathy Need Surgery?
Surgery may be considered when nonsurgical approaches have not provided enough relief or when nerve compression is causing significant problems.
Doctors may recommend surgery if:
- Symptoms persist despite conservative treatment
- Pain is severe or significantly limits daily life
- There is significant or worsening muscle weakness
- A clear structural problem is causing ongoing nerve compression
When Should I See a Doctor About Radiculopathy?
See a doctor if pain, numbness, tingling or weakness is persistent or getting worse. An evaluation can help identify the cause and determine whether treatment is needed.
Seek prompt medical attention if you experience:
- New or significant muscle weakness
- Loss of bladder or bowel control
- New numbness around the groin, buttocks or inner thighs
These symptoms can be warning signs of a serious spinal nerve problem and require immediate medical attention.
Frequently Asked Questions About Radiculopathy
Is radiculopathy serious?
Severity varies widely. Many cases can be managed successfully, but persistent or worsening neurological symptoms, such as increasing weakness or numbness, should be evaluated by a doctor.
How long does radiculopathy last?
There is no single recovery timeline. Some cases improve over weeks to months, while symptoms caused by ongoing nerve compression or an underlying structural problem may last longer and require additional treatment. Your recovery depends on the cause and how you respond to treatment.
Can radiculopathy come back?
Yes. Radiculopathy can return, particularly if the underlying spinal problem remains. Understanding and treating the cause of the nerve irritation can help reduce the risk of recurring symptoms.
Don’t Ignore the Source of Your Symptoms
If you’re experiencing persistent or worsening symptoms, getting an accurate diagnosis can help you understand what’s happening in your spine and what options may help you get back to the activities you enjoy.
At the Stony Brook Spine Institute, our multidisciplinary team of experts works together to provide seamless, patient-centered care for both children and adults. We’re committed to delivering advanced, personalized treatment through a collaborative approach that brings together specialists from across the institution, including neurosurgery, orthopedics, pain management and physiatry.
