(GP) (MSK)

Overview

• Also commonly referred to as pinched nerve root, refers to a set of conditions in which one or more nerves are affected and do not work properly
• Arise when surrounding bone or tissue, such as cartilage, muscles or tendons, put pressure on the nerve and disrupt its function
• Causes → mechanical compression of nerve root, intervertebral disk herniation, degenerative disc disease, osteoarthritis

<aside> 💡 Issue with nerve roots (rather than neuropathy which is issue with nerves)

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Making Diagnosis

Clinical Features:

• Key Features
  • Pain = often starts from area where spinal nerve roots are dysfunctional and radiates down to dermatome (shooting pain)
• Motor ⇒ LMN symptoms for muscles innervated by this spinal root (eg. hyporeflexia)
• Sensory ⇒ dermatomal pattern of pain and numbness
  • Cervical Radiculopathy → neck pain commonly associated. May also be accompanied by headache and shoulder pain.
    • Cervical Radiculopathies
  • Lumbosacral Radiuculopathy → lower back pain and leg pain, characteristically worse on sitting.
    • Foot Drop (L5 Radiculopathy) ⇒ weakness/paralysis of dorsiflexion and eversion of foot. L5 root lesion (radiculopathy) is most common cause due to lumbosacral disc herniation. Sensory loss over L5 dermatome (big toe). May also be caused by common peroneal nerve lesion (secondary to compression at neck of fibula). Lower back pain that will shoot down the leg.
    • Lumbosacral Radiculopathies
    • PassMed Table

<aside> 💡 Nerve Root Pain ⇒ dermatomal distribution and associated neurological defect (ie. sensory changes and weakness)

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• Dermatomes of Body (Reduced Sensation)
• Reflexes (May be Reduced)

Investigations: