Radiculopathy, commonly known as a pinched nerve, is a condition caused by the compression or irritation of a nerve root where it exits the spine.

This compression can lead to a variety of neurological symptoms in the areas served by that specific nerve.

The symptoms of radiculopathy depend on where in the spine the nerve is compressed. The three main types are:

• Cervical Radiculopathy: Occurs in the neck (cervical spine). Symptoms may include pain, numbness, tingling, or weakness radiating into the shoulder, arm, or hand. It can worsen with certain head positions or extreme neck motion.
• Thoracic Radiculopathy: The least common type, affecting the mid-back (thoracic spine). Symptoms may involve pain and numbness wrapping around the chest or abdomen.
• Lumbar Radiculopathy: The most common type, affecting the lower back (lumbar spine). Symptoms include pain, numbness, or weakness radiating down the leg into the foot. A well-known example is sciatica, which occurs when compression involves nerves contributing to the sciatic nerve.

Compression of a nerve root is most often the result of age-related degenerative changes, but acute injuries can also contribute. Common causes include:

• Herniated discs: When the soft inner part of a spinal disc pushes through its outer layer and presses on a nerve root.
• Spinal and foraminal stenosis: A narrowing of the spinal canal or the openings where nerves exit, which can be caused by bone spurs or thickened ligaments.
• Facet cysts: Joint fluid can leak out from abnormal joint motion, which creates sacks called cysts that can pinch nearby nerves.

Symptoms can range from mild to severe, and typically include:

• Pain: Sharp, burning, or aching pain radiating along the affected nerve pathway.
• Tingling or paresthesia: A "pins and needles" sensation.
• Muscle weakness or reflex loss: In the area served by the compressed nerve.
• Symptom triggers: Pain often worsens with movements like coughing, sneezing, or prolonged static positioning of the neck or back.

Most cases of radiculopathy improve with conservative treatment. The goals are to relieve pain and reduce nerve pressure.

• Physical Therapy and Exercise: Strengthening core/back muscles and performing nerve gliding stretches.
• Lifestyle modifications: Maintaining a healthy weight, avoiding aggravating activities, and practicing good lifting mechanics.
• Medications: Over-the-counter anti-inflammatory drugs (ibuprofen, naproxen). If ineffective, stronger prescriptions may include nerve pain medications or short-term oral steroids.
• Injections: Steroid injections can sometimes reduce inflammation around the foramen and nerve.

Surgery is considered as a last resort when non-surgical options have failed or if the patient is experiencing severe, debilitating pain or concerning neurologic deficits.