Radiculopathy simply is a pinched nerve in your spine. It can happen in the cervical, lumbar or thoracic area.
Type of pain: Burning/Nerve pain: shocking stabbing, pins and needles. It can lead to numbness, weakness, and loss of function depending on how bad the nerve is being pinched.
Where is the pain? : That depends on what nerve you pinch. Each nerve goes to a certain area of the body, which is the reason why where you feel pain doesn’t always equal where the pain comes from.
Treatment options: We always start conservatively at first. To make the right diagnosis we do a full exam and MRI to locate the pinched nerve and what’s pinching it. It could easily be a disc problem or bone spurs, etc. Then the treatment options start of in a conservative fashion. Physical therapy, chiropractic, and possibly nerve pain medicines (Neurontin, Lyrica, Gralise, Cymbalta, Savella, etc). We always want to maximize conservative therapy before considering interventional options.
Next are epidural injections and transforaminal epidural injections. They speed up the recovery of the injured nerve and remove the inflammation to allow the patient to recover faster (similar to injecting a swollen knee). We always like patients to be treated with physical therapy and/or a chiropractor while getting injections. Injections do not make problem go away, but buy a window to maximize improvement (patients can do a lot more in therapy when not in pain after an injection).
The problem with epidurals is the steroids. We can only give so many safely, so they are limited. We like to stay around 4 epidural shots a year, assuming the patient is not getting other steroids from another physician. We can do up to 6 if the patient has no other options.
If a patient needs more than 4 injections, has failed therapy and medications, and things aren’t getting better; the point has been reached to possibly consider surgery or other options.
For a lumbar herniated disc causing the radiculopathy, Disc FX can be the answer. Other treatment options other than surgical referral are implanted pain pump or spinal cord stimulators.