Radiculitis is a medical term describing the inflammation or irritation of a spinal nerve root. It is a symptom indicating a problem where a nerve exits the spinal column. This condition typically results in sharp, radiating pain that travels away from the spine and into the areas of the body supplied by the affected nerve. The symptoms arise because the nerve root is sensitive to mechanical pressure and chemical irritants released from surrounding tissues.
Understanding Nerve Root Irritation
The spinal cord runs down the center of the vertebral column. At each level, pairs of spinal nerve roots branch off. These roots exit the spine through small bony openings called intervertebral foramina to form the peripheral nerves. When one of these nerve roots becomes inflamed, the resulting condition is radiculitis, combining “radix” (root) with the suffix “-itis” (inflammation).
The irritation can be caused by direct pressure, but inflammation often dictates the intensity of the pain. Unlike general back pain (myalgia), which is typically a dull ache localized to the muscles, radiculitis produces pain that follows a distinct path. This radiating pain is often described as burning, electrical, or searing, extending into a limb or across the torso.
Radiculitis is distinct from radiculopathy, although the terms are often used interchangeably. Radiculopathy refers to the functional loss or neurological deficits that occur when a nerve root is severely compressed or damaged. This advanced stage includes symptoms like measurable muscle weakness or numbness. Radiculitis, conversely, focuses on the inflammatory component that causes pain and sensory changes like tingling, often triggered by chemical substances released from a damaged disc.
Types of Radiculitis and Associated Symptoms
The location of the affected nerve root determines the type of radiculitis and where symptoms will be felt. Since each nerve root supplies sensation to a specific area of skin, the pain follows a predictable pattern. Clinicians categorize the condition based on the three main regions of the spine: cervical, thoracic, and lumbar.
Cervical radiculitis occurs in the neck and is characterized by pain radiating down into the shoulder, arm, hand, or fingers. The nerve roots most frequently involved are C6 and C7, causing symptoms like pain and numbness that extend into the thumb or middle finger. Patients may also experience a deep, aching pain in the neck or shoulder blade region, often accompanied by tingling.
Thoracic radiculitis affects the mid-back and is the least common form. Symptoms typically present as pain that wraps around the chest or torso, following the path of a rib. This presentation can sometimes be mistaken for other medical issues, such as heart or abdominal problems, making diagnosis challenging. The pain may feel like a tight band or a persistent, sharp ache localized to one side.
Lumbar radiculitis affects the lower back and is the most frequently encountered type, commonly known as sciatica. The pain often originates in the buttocks and travels down the back of the leg, sometimes reaching the calf or foot. This involves the L4, L5, or S1 nerve roots, which contribute to the formation of the large sciatic nerve. Sciatica is often described as a shooting or electric pain exacerbated by sitting or standing for long periods.
Primary Causes of Nerve Compression
The irritation leading to radiculitis is generally caused by structural changes within the spinal column that narrow the space around the nerve root. The most frequent cause is a herniated or bulging intervertebral disc. When the soft center of a disc pushes out through a tear, it can directly press on a neighboring nerve root. The extruded material also contains inflammatory chemicals that directly irritate the nerve, contributing to the pain.
Another common cause is spinal stenosis, a narrowing of the spinal canal or the intervertebral foramen through which the nerve roots exit. This narrowing often results from age-related degenerative changes. As people age, discs lose water content and height, causing vertebrae to shift and spaces to constrict.
Osteophytes, or bone spurs, also contribute. These bony growths form as the body attempts to stabilize joints affected by degenerative disc disease or osteoarthritis. The spurs can encroach upon the foramen, reducing space for the nerve root and leading to chronic compression and inflammation. Less common causes include trauma, spinal infections, or tumors, which irritate the nerve root by occupying space or triggering inflammation.
Diagnosing and Managing Radiculitis
Diagnosis begins with a detailed physical and neurological examination. A doctor assesses the patient’s reflexes, muscle strength, and sensory perception to pinpoint the affected nerve root. Specific movements or positions that reproduce the radiating pain help confirm the diagnosis and localize the irritation to a particular spinal level.
While X-rays show bone structure, such as bone spurs or disc space collapse, magnetic resonance imaging (MRI) is the preferred tool for confirming radiculitis. An MRI provides clear images of soft tissues, allowing the doctor to visualize a herniated disc, ligament thickening, or other sources of nerve root compression. This imaging helps rule out other conditions and guides the treatment strategy.
Most radiculitis cases are successfully managed with conservative, non-surgical treatments. Initial care typically includes a short period of rest and activity modification to avoid aggravating movements. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) or short courses of oral steroids are often used to reduce inflammation directly at the nerve root.
Physical therapy is a fundamental component of recovery, focusing on exercises to strengthen core muscles, improve posture, and enhance spinal flexibility. For persistent pain, targeted treatments like epidural steroid injections may be administered. These injections deliver potent anti-inflammatory medication directly near the irritated nerve root. If conservative management fails after several weeks or months, or if a patient develops progressive weakness, surgery may be considered to physically decompress the nerve.