Radiculitis acute pain. Symptoms of radiculitis. Diseases of the intervertebral joints

Patients with radiculitis (or radiculopathy) encounter various manifestations depending on the location, type and level of damage to the nerve roots extending from the spinal cord.

This may include pain of varying intensity, sensory disturbances, muscle atrophy and weakness.

The symptoms of radiculopathy are often similar to other diseases of internal organs or cancer, so for an accurate diagnosis of radiculitis it is important to distinguish and take into account all available signs.

They can be combined into 3 main groups:

• Sensations associated with pain. With radiculitis, pain can be constant or temporary, occurring periodically; sharp and dull, aching; local and spreading to various organs and parts of the body. The presence of pain is a signal that a damaging effect has been exerted on the nerve fibers. This may be mechanical compression and inflammatory processes. When performing movements that cause stretching of the affected roots, the pain may intensify.
• Impairment and partial loss of sensitivity. Feelings of burning, tingling and numbness in the limbs indicate that the conduction of nerve impulses is disrupted due to compression of the spinal cord roots and nerve processes, and the nerve connection between the muscles and the brain is interrupted in some area.
• Muscle weakness. The presence of this symptom is associated with the stopping of impulses from the brain to the muscles, which, due to lack of work, begin to atrophy. Sometimes flaccid paresis occurs.

The cause of the development of radiculitis may be degenerative changes in the intervertebral discs and trauma.

Due to disruption of the activity of one or more spinal cord roots, certain symptoms of radiculitis occur.

Types of radiculopathy

Radiculitis can be classified according to several criteria.

Based on the type of pain syndrome development, it is customary to distinguish between acute and chronic radiculitis.

The acute form is also called “lumbago”.

Due to the sharp and acute pain, the person cannot even move and freezes in the position in which the attack occurred.

The development of chronic radiculitis is usually preceded by single attacks of pain, alternating with a complete absence of pain.

Based on the location of the affected nerve roots relative to the parts of the spine, they are conventionally distinguished:

If the affected area covers several neighboring areas, then they speak of cervicothoracic, cervicobrachial, or lumbosacral radiculitis.

Each of them can be acute or chronic and differ in the characteristics of their manifestation.

Cervical region

Cervical radiculitis is slightly less common than other forms of radiculopathy, but the symptoms are more painful and more severe than with thoracic and lumbar radiculopathy.

It develops as a result of damage to the roots that extend from the spinal cord in the area of ​​the upper cervical vertebrae.

I am worried about pain in the neck and back of the head. When coughing and turning the head, the pain symptom intensifies. The patient reflexively takes a protective position, throwing his head back.

Any careless sudden movement increases the pain many times over.

The pain syndrome can spread to the muscles of the left or right arm and fingers if the root through which the innervation pathways of the upper extremities pass is pinched.

During sleep, it is difficult to find a comfortable position; you always feel tingling in the muscles of the neck and arms, and numbness. The strength of the arm muscles may even decrease and sensitivity may be lost.

Sometimes, due to severe pain, the patient takes a certain position in which individual muscles experience prolonged tension.

If this happens reflexively and the muscle does not rest, then a local increase in temperature may be observed.

If cervical radiculopathy occurs against the background of spondylosis or osteochondrosis, then dizziness, unsteady gait and hearing impairment may also be observed.

All these symptoms indicate a lack of blood supply to the brain.

The causes of cervical radiculitis can also be:

• inflammation of the ligaments and muscles located near the nerve root;
• development of intervertebral disc herniation;
• changes in the shape of vertebral bodies associated with age.

When both the lower and upper cervical roots are affected, cervicobrachial radiculitis develops.

In this form, severe shooting pain spreads to the neck, shoulder girdle and arms. Due to movements made with the hands, bending and turning the head, as well as during coughing and taking a deep breath, the pain increases sharply.

If you bend your arm at the elbow joint and press it to your body, you can slightly reduce the pain. Heat also helps to reduce it.

Often with cervicobrachial radiculitis, pain in the arm is accompanied by other symptoms:

• tension in the pectoral and neck muscles;
• pain in the scapula area;
• pain in the upper chest;
• decreased sensitivity of the occipital region with a shift towards the pinched roots;
• ear pain;
• visual impairment.

To diagnose radiculopathy of the cervical, cervicobrachial region, an examination by a neurologist is necessary, who assesses the condition of the muscles, the preservation of reflexes and the level of pinching of the roots.

Additionally, radiography, computed tomography and magnetic resonance imaging are performed.

Other research methods can be prescribed at the discretion of the doctor and depending on the patient’s condition.

Acute radiculitis

Acute radiculitis is manifested by an attack of sudden and intense pain. This significantly limits mobility.

The slightest sudden movement causes acute pain in the cervical spine, which can radiate to the shoulder blades, collarbones, arms and sternum. If the cause of pinched nerve roots is not eliminated, then forced limitation of mobility leads to muscle atrophy.

At night, attacks of pain tend to intensify.

Spasm of cerebral vessels causes migraine-like headaches and attacks of nausea.

Brain performance may decrease, attention and memory may deteriorate.

Cervical radiculitis can occur due to infectious and viral diseases, influenza, colds, and tuberculosis.

With proper and timely treatment of the acute form, relapses do not occur.

Chronic radiculitis

In the chronic form, all the symptoms of cervical radiculitis seem to be slightly smoothed out and extended over time.

Chronic radiculitis of the cervical spine occurs with periodic increases in pain and its decline. Over time, the cervical curve smoothes out. Due to poor posture, the shock-absorbing function of the spine is reduced, and its condition is further aggravated.

That is why, if sharp pain appears in the spine, a visit to the doctor cannot be postponed.

It is much easier to cope with an acute primary attack and prevent the development of unpleasant consequences.

Thoracic radiculitis

With thoracic radiculitis, the nerve roots extending from the spinal cord in the thoracic region of the spinal column are pinched.

A neurological examination reveals various symptoms of radiculitis of the thoracic spine. They depend on the degree of damage to the roots.

The pain is localized along the intercostal nerve tracts; with deep inspiration, sneezing and coughing, walking and other movements, it intensifies significantly.

Despite the fact that this form of radiculitis is much less common than the lumbar and cervical forms, the possibility of its development cannot be excluded.

If there is characteristic pain in the ribs, trauma to this part of the spine in the past, or other degenerative and inflammatory processes in the thoracic region, it is necessary to conduct a full examination in order to confirm or exclude such a diagnosis.

This requires an examination by a neurologist, CT and MRI.

The thoracic region is less susceptible to pathological changes than others, but there are a number of reasons that may contribute to the development of radiculitis in this area:

• age-related changes in the structure of bone tissue;
• inflammation and degenerative changes in the ligaments and joints of the spine;
• injuries;
• excessive physical activity associated with heavy lifting;
• osteochondrosis;
• disc herniation;
• herpetic infection;
• hypothermia;
• diseases of internal organs.

The term “intercostal neuralgia” is synonymous with thoracic radiculitis.

This is due to the fact that the main symptom of this form of radiculopathy is severe girdling pain that extends to the midline of the abdomen or to the sternum from the spine, that is, where the intercostal nerves pass.

Since the intercostal nerves run from the spine to the chest along the ribs, pain can be felt in both the side and front of the chest.

When the left roots are pinched, the pain spreads to the heart area and may be accompanied by an increased feeling of anxiety and rapid heartbeat.

This often becomes the reason that the patient begins to take heart medications unnecessarily, having misdiagnosed himself.

Right-sided thoracic radiculitis may suggest the development of diseases in the lungs.

Acute radiculitis

Acute thoracic radiculitis manifests itself as a sharp attack.

The symptoms are vivid and constant. With palpation and light pressure on the skin along the ribs and in the area of ​​the thoracic vertebrae, the pain intensifies even more. With severe compression of the nerve root, numbness of the hands and impaired sensitivity may occur.

The cause of the development of acute forms of thoracic radiculitis is often infectious diseases and inflammatory processes.

Chronic radiculitis

If the signs of intercostal neuralgia are paroxysmal in nature, and new attacks do not always appear clearly, but their regularity can be traced, then we can talk about the development of a chronic form of thoracic radiculopathy.

The patient is forced to bend the spine towards the affected and compressed root in order to somehow control the pain.

As a result, poor posture is formed.

Radiculitis in the lower back

Lumbar and lumbosacral radiculitis are the most common types of radiculopathy.

Symptoms occur similar to those characteristic of sciatica of the upper spine: pain, loss of sensation and muscle weakness. But they are localized in the lower part of the body and spread to the stomach and legs.

Depending on what part of the body the pinched root innervates, pain may occur in the lower abdomen, gluteal and lumbar regions, side, back and front, on the hips, lower legs or in the foot.

The causes of lumbar radiculopathy are very diverse:

• hernias;
• osteochondrosis;
• compression fracture;
• dystrophic and degenerative processes in the spine;
• tuberculosis;
• flu;
• meningitis (cerebrospinal form);
• syphilis and other diseases.

A characteristic symptom of lumbosacral radiculitis is pain that limits movement in the lumbar region.

It is customary to distinguish 3 types of pain syndromes in lumbar radiculitis:

• or lumbago. The occurrence of acute pain in the lower back, resulting from physical exertion, overheating or cooling of the muscles, can last from several hours or minutes to several days.
• Sciatica. The intensity of pain can vary: from tolerable to very intense, interfering with sleep, sitting, and moving. Due to damage to the largest nerve in the body - the sciatic - there is a shooting, similar to an electrical discharge, pain in the buttock, the muscles located on the back of the leg, in the big toe, heel, and the back of the foot.
• Sciatica. From the name it is clear that this type of pain is a cross between sciatica and lumbago. The pain symptom begins in the lumbar region and spreads along the buttock to the back and outer muscles of the leg, without reaching the foot. The pain in the leg is increasing and burning.

Acute radiculitis

Acute lumbar radiculitis is characterized by sharp pain in the lower back that occurs unexpectedly at the moment of movement or lifting.

During an attack, a person freezes helplessly in a certain position.

This problem cannot be solved only by limiting movements and performing everyday activities. Treatment and consultation with a specialist is necessary.

Chronic radiculitis

After several single attacks of pain in the lumbar region and in the absence of treatment, chronic radiculitis develops.

It is characterized by alternating attacks of pain with periods of remission. Depending on which nerve root is damaged and how involved it is in the pathological process, symptoms spread further along the nerve pathways from the lumbosacral paravertebral region, to the buttocks, thighs, legs and feet.

Over time, the flexibility and mobility of the spine in the area where the nerves are pinched decreases.

The ability to easily turn and bend also disappears. The muscles weaken. When pressing on the vertebrae, the pain is felt with greater force.

Discogenic lumbosacral radiculitis

If the cause of lower back pain is a prolapsed disc, then they talk about the development of discogenic radiculitis.

This pathology occurs quite often in people whose work involves stress on the lumbar spine and poor working conditions: high humidity, frequent fluctuations in room temperature, uncomfortable working posture.

The mechanism of this type of radiculitis is based on secondary compression of the nerve root due to rupture or stretching of the fibrous ring.

Manifestations may occur after mechanical impact or an infectious disease.

Symptoms of discogenic radiculitis of the lumbar region are:

• pain;
• muscle sensitivity disorders;
• movement disorders;
• changes in tendon reflexes occur in the legs;
• vegetative disorders occur;
• the emotional mood changes, this can affect behavior.

Pain occurs suddenly and acutely, or a few days after exposure to provoking factors. It often radiates to the groin, one or both legs.

Depending on the location of the rupture or protrusion, it can be unilateral or bilateral. If the pain syndrome is severe, the patient is forced to remain in bed for several days.

Pressing the bent leg to the stomach slightly relieves the attack. Coughing, trying to push, even talking, on the contrary, intensifies it.

How to recognize the disease during pregnancy?

Often pregnant women confuse lower back pain with symptoms of radiculitis.

But in the later stages of pregnancy, when the fetus has significantly increased its weight, the center of gravity shifts and the load on the lumbar spine increases significantly.

In addition, the hormonal changes that occur during this period in a woman’s body affect the composition of bone tissue and the condition of the vertebrae.

All this can cause the development of radiculitis during pregnancy.

The reasons may be hidden much deeper and are associated with dystrophic processes and degenerative changes that occurred in a woman long before pregnancy.

Do not forget also that abdominal pain, even if it is accompanied by a painful symptom and spreads to the buttocks and legs, can be not only a symptom of radiculitis during pregnancy, but also a sign of another pathology.

Therefore, you need to consult with your obstetrician-gynecologist and neurologist.

It is much easier to diagnose radiculopathy during pregnancy if the woman has previously had attacks of radiculitis and has concomitant spinal diseases that contribute to its development.

If doctors have confirmed the diagnosis of radiculitis, they recommend rest and limitation of physical activity, since the use of many drugs during this period is contraindicated.

Statistics show that almost all women during pregnancy experience various pains in the lumbar region, compression of the sciatic nerve occurs, from which pain radiates to the abdomen and one or both legs, but only 25–30% of them have a confirmed diagnosis - radiculopathy.

Symptoms of radiculitis are varied and similar to those of other spinal diseases.

Therefore, when you feel the first signs of radiculitis, you need to consult a doctor, conduct a full examination to make an accurate diagnosis and identify the true cause of the disease, and begin treatment.

By doing this in a timely manner, you will prevent the possibility of a single acute attack of this disease developing into a long-term and difficult to treat chronic form.

Video: what to do for back pain?

People suffering from any forms of radiculitis, they know firsthand what pain is.

Painful sensations can come suddenly and spoil your plans, putting you to bed and covering you with heating pads and painkillers.

Most often, people do not have enough time to deal with this disease; they rely on the fact that “it will somehow go away on its own” or “well, I’ll start treatment next Monday.”

But neither on Monday, nor on Tuesday, nor even on Wednesday, treatment begins, and the trip to the doctor is completely postponed until the next month, or even a year. Radiculitis is not a disease whose treatment should be shelved; it needs to be dealt with, and in a comprehensive manner. How can you cope with annoying pain and finally stop being afraid of sudden attacks?

What is sciatica?

The word "sciatica" comes from the Latin language. Literally translated, this word means “spine.” Radiculitis is a disease that affects the roots of the spinal cord and causes motor and autonomic disruptions. The main symptom of radiculitis is acute, sharp pain, which is sometimes very difficult to endure.

Radiculitis deserves the title of the most common disease in people of all ages. Despite the fact that in this article we call radiculitis a disease, it is not an independent disease.

Radiculitis is more of a set of symptoms, which manifests itself when the spinal roots are compressed, so radiculitis is more likely a consequence of another disease that led to pinching of the nerve roots.

Such initial diseases may be osteochondrosis , spondylosis, spinal anomalies of various types. In addition, hypothermia, various types of back injuries, and infectious diseases (syphilis, tuberculosis, meningitis, tick-borne encephalitis, etc.) can cause inflammation.

The pain is sudden in nature and can occur with heavy load on the spine (for example, when lifting heavy objects), with awkward and sudden movement, as well as due to a cold or infection.

Traditional medicine distinguishes several types of radiculitis depending on the location of the disease.

Radiculitis happens:

• lumbosacral (sometimes called simply lumbar).

These varieties, in turn, can appear in two different forms: chronic And acute.

Also sometimes there is a division of this disease into primary type And secondary type. Primary radiculitis is a disease caused by an infectious or toxic factor. The secondary type includes radiculitis, which appears due to disorders in the spinal column and spinal cord.

What is acute radiculitis?

In the acute form of radiculitis, painful attacks begin suddenly, and the symptoms are usually pronounced. Inflammation of the roots can occur at different levels of the spine. The inflammatory process affects the inner part of the nerve sheath (extrasheath).

Causes of acute radiculitis

The most common cause of painful attacks of acute radiculitis is sudden, awkward movement or heavy lifting. Such an attack is also called the simple word “lumbago”. Such a lumbago appears when the spine is bent (tilted) with a turn to the side.

The causes of acute radiculitis are divided into two categories: congenital And acquired.

Congenital causes most often include abnormalities in the development of the spine, for example:

• neoplasms of various origins;
• proliferation of fibrous tissue;
• formation of adhesions.

Acquired reasons most often are chronic. This group includes all degenerative changes that occur in the joints and vertebrae over a long period of time (spondylosis, osteochondrosis, etc.).

Most often, such changes lead to the appearance of osteophytes (the growth of the vertebrae and the appearance of a kind of spines on them), which compress the spinal roots. These processes lead to the formation of intervertebral hernias and hypertrophy of the yellow ligament.

In addition, acquired causes include infectious diseases various types (tuberculosis, HIV, tick-borne borreliosis, epidural abscess, osteomyelitis), various malignant tumors on the spine(tumors, cysts), endocrine and metabolic disorders(diabetes mellitus, acromegaly, etc.), spinal injuries, hypothermia (and sudden temperature changes), high physical activity and etc.

The most common forms of acute radiculitis are the lumbosacral and cervical types. It is these parts of the spine that bear the majority of all loads.

Important! An acute attack of radiculitis is not always the first manifestation of the disease; it is quite possible that it is an exacerbation of an already developed pathology, so you should not delay examination and treatment.

Symptoms of acute radiculitis

An acute attack of radiculitis is accompanied by acute pain, which may have different localization. Depending on the location of pain, we can talk about manifestations of a certain type of radiculitis.

Acute radiculitis of the lumbosacral type

Many people are interested in the question of whether there can be a temperature at. On the one hand, fever indicates infectious, inflammatory or oncological diseases, to which osteochondrosis does not apply. On the other hand, many people with this pathology experience a moderately elevated temperature. Is this phenomenon dangerous, what can it indicate?

Let's find out whether there is a temperature with osteochondrosis, to what numbers it can rise, what are the causes of short-term fever that occurs against the background of diseases of the spine.

Can the temperature rise with osteochondrosis?

The term “osteochondrosis” combines a set of degenerative changes in the intervertebral discs (IVDs) that occur under the influence of traumatic factors or as a result of natural aging of the body. The disease is non-inflammatory in nature and cannot in itself cause fever.

Initial deformities of the thoracic spine.

However, over time, osteochondrosis becomes more complicated, etc. All this leads to a change in the distance between the vertebrae, narrowing of the spinal canal, and the formation of osteophytes. Pinching of the spinal roots or trauma to soft tissues is often accompanied by the development of an inflammatory process and a slight increase in temperature.

Can there be a fever with osteochondrosis? Yes, but it does not arise due to the disease itself, but as a result of complications that arise. The cause may be nonspecific or specific diseases of the spine.

Before we talk about the rise in temperature, let's find out its normal values. Many of you are sure that the norm is a thermometer reading of 36.6. But everything is a little different: normal body temperature can be between 36.5-37.2 degrees Celsius. By the way, its fluctuations throughout the day are absolutely physiological: by measuring the temperature in the evening, you can get higher numbers.

Osteochondrosis and a temperature of 37 degrees are normal for many people. If you do not have other alarming symptoms, there is no point in being scared and worried.

Causes of a slight increase in body temperature

Sometimes with osteochondrosis the temperature rises sharply to 37-38 degrees. Along with this, difficulties appear in flexing and extending the spine, a feeling of stiffness, severe back pain, radiating to different parts of the body. Such symptoms usually indicate the development of nonspecific complications of osteochondrosis. Let's see what they are like.

Table 1. Nonspecific diseases of the spine, accompanied by a temporary increase in body temperature

Does temperature occur with uncomplicated or? Yes, this happens with a long course of the disease, accompanied by pronounced destructive processes in the spinal column. There are cases where people with osteochondrosis maintained a temperature of 37.5 degrees for many months.

Herniated discs

An IVD herniation is a rupture of the annulus fibrosus of the disc with subsequent displacement of the nucleus pulposus. The cause may be heavy lifting, sudden clumsy movement or heavy physical work. The formation of a hernia is usually accompanied by the development of an inflammatory process. Sometimes the spinal root is pinched, which also leads to the appearance of neurological symptoms.

• sharp sudden pain in the lower back, often radiating to the lower limb;
• difficulties in flexion and extension of the spine;
• inability to perform daily work or lead a normal lifestyle.

Lumbar hernia.

Characteristic signs of IVD herniation of the cervical spine:

• neck pain spreading to the back of the head and upper limb;
• feeling of stiffness, numbness in the cervical region;
• minor;
• , weakness in the upper limbs.

Hernias of the thoracic region are manifested by painful sensations and limited mobility of the spine. Because of this, it becomes difficult for the patient to sit in the same position for a long time. Such hernias appear in people with scoliosis, kyphosis, or kyphoscoliosis. The reason for their formation is excessive load on the IVD due to spinal curvature.

A sudden increase in temperature during osteochondrosis of the cervical and lumbar spine often indicates the presence of complications. If this symptom appears, you need to go to the doctor and get examined.

Spinal canal stenosis

Develops predominantly in the lumbosacral spine. The causes may be osteochondrosis, congenital malformations, ankylosing spondylitis, or previous spinal column surgeries. Spinal canal stenosis can lead to trauma to the nerve roots and the development of an inflammatory process in them.

Causes of pathology:

• formation of intervertebral hernias;
• displacement of the vertebrae relative to each other;
• ossification of the ligamentum flavum;
• proliferation of marginal osteophytes;
• deformation of intervertebral joints due to spondyloarthrosis.

High temperature with osteochondrosis of the thoracic spine is an extremely alarming symptom. Protrusions, hernias and pinched nerve roots in this section are very rare. Fever and may indicate tuberculosis or a spinal tumor.

Nerve root damage

Radiculitis can develop due to pinching of the spinal roots by IVD hernias. It can also be caused by hypothermia, acute intoxication, or compression of nerves by spasmed muscles of the back or neck.

With radiculitis, the temperature can rise to 37-37.2 degrees. If it rises above these numbers, a more serious pathology should be suspected. Under the mask of radiculitis, urolithiasis, pyelonephritis, glomerulonephritis, tumors or tuberculosis of the spine, rheumatic diseases, etc. can be hidden.

Do not confuse elevated temperature due to cervical osteochondrosis with occipital neuralgia caused by hypothermia. The latter is manifested by severe runny nose, cough and other colds.

Inflammation of muscles and ligaments

The inflammatory process can develop in ligaments or muscles against the background of long-term osteochondrosis, complicated by spondyloarthrosis or myofascial pain syndrome. Inflammation can spread from the affected intervertebral joints or develop in the muscles due to their constant spasm. The pathology is accompanied by aching pain and stiffness in the back.

High temperature with osteochondrosis

In 1-2% of cases, pain in the back and the appearance of fever are the result of specific diseases of the spine. These include tuberculous spondylitis, ankylosing spondylitis, malignant and benign neoplasms. In this case, the temperature rises above 37.8 degrees, and other alarming symptoms appear.

The presence of specific diseases can be suspected in the following cases:

• the appearance of the first back pain at the age of less than 20 or more than 50 years;
• a history of serious spinal injuries;
• past history of cancer;
• causeless loss of body weight;
• cough, hemoptysis;
• chronic pain that worsens over time and is not associated with physical activity;
• pathological changes in blood tests;
• the presence of destruction of the vertebrae during an X-ray examination of the spine;
• lack of response to treatment for 1 month or more.

If the temperature rises above the permissible norm for a long time and alarming symptoms appear, go to the hospital immediately. Timely detection will help you identify life-threatening diseases on time and begin treatment as early as possible.

What to do when the temperature rises

If you have a fever and back pain, you should see a doctor anyway. He will examine you and prescribe the necessary tests. This will help determine the cause of the fever and make sure there are no serious illnesses.

The diagnostic program should include general clinical examinations. With their help, you can detect kidney diseases, tuberculosis, rheumatological diseases, inflammatory processes in the body, etc.

Pathological changes in the spine can be detected using radiography or magnetic resonance imaging. The first method is more accessible and cheaper, but less informative. With its help, only advanced osteochondrosis complicated by spondylosis is detected. The disease can be diagnosed in the early stages only thanks to MRI, which allows one to see almost any changes in the IVD and intervertebral joints.

If there is a slight increase in body temperature, there is no point in taking antipyretics. Drugs from the group can be used to relieve symptoms caused by. It is better to use them after consulting a doctor.

Acute radiculitis is an inflammatory disease of the nerve roots of the spinal cord, manifested by severe pain, muscle weakness and sometimes loss of sensation. It is one of the common diseases of the lumbar region, observed mainly in people over 40 years of age.

Many reasons cause the development of radiculitis. The most common ones are the following:

• Hernial protrusion of intervertebral discs (space-occupying formation that physically compresses individual roots, causing symptoms, primarily pain).
• Osteochondrosis of the spine (when the discs between the vertebrae are destroyed, their height decreases, as a result, the exit holes of the roots decrease in size and they are compressed).
• Spinal injuries (body deformations, scars causing compression).
• Tumors (space-occupying formations causing compression).
• Inflammatory processes (tissue swelling that occurs during various bacterial and viral infections).
• Various rheumatic diseases (rheumatoid arthritis, spondyloarthritis, ankylosing spondylitis).
• Nutritional disorders of the spine due to vascular damage (diabetes mellitus, vasculitis).

Types of radiculitis

The lumbar (lumbar) spine is the most common location for sciatica. But besides him, there are others:

1. Cervical (or cervical). Process at the level of the first 4 cervical segments of the spinal cord.
2. Cervico-brachial. When the 4th to 6th cervical segments of the spinal cord are affected.
3. Cervicothoracic. The process affects segments from 6 cervical to 1 thoracic.
4. Thoracic (thoracic) – at the level of the thoracic segments.

The exact location of the disease can be determined based on clinical manifestations and examination by a doctor.

Clinical manifestations of an acute attack of radiculitis

The main symptoms are typical for the disease; when they appear, it is necessary to provide first aid and then immediately consult a doctor. An attack can be triggered by hypothermia, overheating, injury, a sharp turn of the body or a sharp tilt of the body followed by heavy lifting. An acute attack of radiculitis is characterized by:

• A person experiences severe pain, it is burning, sharp, “shooting” in nature, and radiates along the nerve. The patient can neither sit nor lie down. Takes a forced position in order to relieve pain. The pain does not go away on its own.
• Weakness of the back muscles, decreased tone, feeling of heaviness and discomfort.
• Feeling of numbness, crawling, tingling, loss of sensitivity to pain, temperature.

The above symptoms can be found in all types of radiculitis. The lumbar type is distinguished by the localization of pain in the lumbar region and irradiation (radiates to the buttocks, thighs, and groin area). Most often, the patient has to take a forced position, for example, half-bend, turn to the side. Sometimes, due to severe pain, the patient cannot straighten up without assistance and experiences pain when coughing or sneezing.

Increased temperature with radiculitis

For inflammatory disease of the spinal cord roots, along with the occurrence of pain, the appearance of elevated temperature is typical, but not more than 37–37.2 degrees. If the temperature rises above the permissible values, you should urgently go to a specialist, as this may indicate an infection.

Also, under the mask of radiculitis, serious renal pathologies (pyelonephritis, glomerulonephritis, urolithiasis) can be hidden, which also manifest themselves as severe pain in the lumbar region and fever. In addition, it is possible to suspect other diseases localized in the spine, which are characterized by a rise in temperature (rheumatic diseases, spinal tuberculosis, tumors, osteomyelitis).

First aid for an attack of lumbar radiculitis

It is important to call a doctor if symptoms of acute radiculitis develop. Do not make sudden movements on your own, so as not to increase the feeling of pain, call someone close to help. The correct thing to do during an attack is:

• Secure your lower back using a bandage belt, fabric, sheet or any other means currently at hand.
• Place the patient on a hard surface (for example, a hard bed). At the same time, be extremely careful. It is necessary to support the patient, allow him to lean on you with his hand. Lay correctly on the bed on your back, place a pillow or bolster under your lower limbs. During an attack, it is important to maintain bed rest.
• It is necessary to relieve the pain attack. If you have the skill to administer intramuscular injections, it is necessary to administer drugs from the NSAID group (non-steroidal anti-inflammatory drugs). Examples of drugs: ibuprofen (Nurofen), diclofenac (Voltaren), nimesulide (Nise, Nimesil, Nimulid), meloxicam (Movalis), indomethacin. If you do not have the skill to administer injections, you need to give the drugs in tablet form, in accordance with the instructions for use.
• It is possible to use a patch with an anti-inflammatory component in the composition, for example, a Voltaren patch containing diclofenac, or Nanoplast (containing magnetic powder). It provides gradual administration of the drug throughout the day. This method of pain relief is suitable for people with mild symptoms of the disease.
• Be sure to reassure the patient. If necessary, you can use valerian or motherwort preparations, in tinctures or tablets.
• Apply anti-inflammatory ointments or gels to the area where pain is felt: containing diclofenac (Voltaren Emulgel 1 and 2%), ibuprofen (Nurofen gel, Dolgit), ketoprofen derivatives (Fastumgel, Bystrumgel, Ketonal), nimesulide (Nise gel). It is recommended to use ointments with a warming effect, since pain relief occurs due to improved blood circulation, relieving swelling and the irritating effect of the components. For example, you can use: Finalgon, Capsicam. Also gels with a combined effect: Dolobene or Fitobene and others.
• Preparations of B vitamins (Neuromultivit, Milgamma compositum, Neurodiclovit: B vitamins (B1, B2, B6, B12) in combination with diclofenac).

The relaxation massage technique should be used very carefully.

Assistance in a medical facility

It is important to remember that with the problem of radiculitis, it is imperative to contact a specialist by calling him at home or going to a clinic at your place of residence. Which doctor treats sciatica? As a rule, a neurologist consults on this problem in a clinic. If the etiological factors for the development of the disease are established, then based on them, rheumatologists, oncologists, allergists, hematologists, traumatologists, and surgeons can deal with the problem of radiculitis. Also specialists in reflexology, manual therapy, physiotherapists.

The doctor learns in detail the complaints, the dynamics of the development of symptoms, and conducts an examination. When examined by a doctor, the following may be detected: increased knee reflexes, increased pain in the lumbar region when lifting an extended leg upward while lying on the back (tension symptom). He also prescribes additional diagnostic methods: x-ray of the lumbar spine, CT (computed tomography) and MRI (magnetic resonance imaging). By summarizing the data, the doctor makes a final diagnosis of the disease.

First aid for an attack of lumbar radiculitis by a doctor is supplemented by blockades using anesthetics: lidocaine, novocaine, procaine and others. This method requires certain skills and qualifications. The anesthetic is injected into the tissue at certain points in the affected area and to a certain depth necessary to turn off the nerve endings. The procedure has a short-term effect, but significantly alleviates the patient’s condition. If necessary, several procedures can be performed. Physiotherapy, acupuncture and physical therapy procedures are prescribed.

After relief of symptoms, the patient can be discharged, receive treatment recommendations, and be seen by the attending physician once every 6 months. An unscheduled visit is also possible with each new case of exacerbation.

Prevention of radiculitis

It is necessary to follow a number of rules to prevent the occurrence or exacerbation of radiculitis. Important ones:

1. Rationally dose work and rest.
2. Do not overcool or overheat.
3. Lift weights correctly (bending your legs at the knees and hips, with your back straight).
4. Use a comfortable bed with an orthopedic mattress and pillow for sleep and rest.
5. Control body weight.
6. Do physical activity.
7. There must be timely diagnosis and treatment of diseases that may contribute to the development of radiculitis.

It is important to detect symptoms in the early stages of the disease, consult a doctor in time, and try to self-medicate as little as possible.

Our body feels and moves, our internal organs work in their own mode, without requiring volitional control from us. Everything happens as if by itself, if not for one small “but”.

When this small “but” fails, the entire orderly organization of the human body falls apart and it becomes obvious that the body is, first of all, a thin network of intertwined nerve fibers with a single control center.

With radiculitis, the spinal nerves become inflamed

Each nerve supplying one or another part of the body originates from the spinal cord (individual nerves from the brain), and is responsible either for motor function, or for sensory function, or for ensuring the functioning of internal organs.

Before leaving the spinal column, which is the bony sheath of the spinal cord, nerves with different functional loads are united into a bundle or root (radiculus). The root, before breaking up into branches, passes through the intervertebral foramina.

The inflammatory process that accompanies any damage to the nerve root is called radiculitis.

The spinal cord has 5 segments; accordingly, the spinal nerves emerging from one or another segment regulate a strictly defined area of ​​the body.

Having a general understanding of the structure of the nerve root, you can now find out what causes radiculitis. The common philistine opinion that radiculitis occurs from a draft is only half true. In fact, hypothermia is a permissive factor, just like physical strain on the back muscles. The immediate causes of radiculitis, in most cases, are diseases of the spine.

For more information about what radiculitis is, watch the video:

The first in frequency of occurrence, as a causative factor, is osteochondrosis. Even by determining the cause-and-effect relationship, it is clear what the difference is between radiculitis and osteochondrosis.

Osteochondrosis is a disease characterized by degenerative changes in the intervertebral cartilaginous disc, as a result of which the height of the vertebrae above each other decreases and, as a result, the intervertebral foramen narrows.

Subsequently, the nerve root is pinched with impaired circulation and the development of aseptic inflammation. Thus, radiculitis is a complication of osteochondrosis.
Other causes of radiculitis may include:

• Deforming, which refers to vertebrogenic causes of damage to the nerve root, i.e., depending on the condition of the vertebrae;
• Injuries;
• Acute and chronic infectious processes. Herpes zoster is an especially common infectious cause of inflammation of the nerve root;
• Various neoplasms;
• Congenital malformations of the spinal column.

Acute or chronic process

An attack of acute radiculitis occurs either for the first time or characterizes the picture of exacerbation of chronic radiculitis. The very definition of “acute” speaks of vivid clinical symptoms that arise suddenly, without warning.
Chronic radiculitis is characterized by an endless series of improvements with exacerbations.

If we talk about the temporary division of acute and chronic diseases, then if the cure of the process is within a month, then we are talking about an acute course of the disease, if signs of suffering persist after 4 weeks, then the pathological process takes on a chronic course.

How long an attack of radiculitis will last depends on the cause that caused the inflammation of the root, and on the concomitant pathology, and on the therapeutic measures taken. In most cases, with an uncomplicated course and the adequacy of the measures taken, the disease can be dealt with in 7-10 days.
But it is not possible to deal with the causes of radiculitis within such a period of time. For the most part, these are chronic diseases that require long-term and ambiguous treatment.

Clinic of the disease depending on the level of damage

General symptoms of nerve root inflammation are divided into three groups:

• Painful;
• Neurological;
• Muscular-tonic or reflex.

The pain with radiculitis is acute, sharp, like an electric shock, localized on the side of the pinched area and can spread along the nerve. The pain is often accompanied by paresthesia, i.e. tingling, burning or numbness of the affected area of ​​the body and causes protective muscle tension.

Pain occurs due to inflammation of the nerve roots and causes muscle tension

The symptoms of cervical radiculitis, in addition to those described above, include vertebral artery syndrome, which occurs due to pinched vessels in the lumens of the transverse processes of the cervical vertebrae, which is the cause of vertebrobasilar insufficiency.

Vertebro-basilar insufficiency manifests itself with dizziness, headache, blurred vision, hearing, nausea and vomiting.

Considering the fact that the brachial nerve plexus originates from the cervical segment of the spinal cord, with cervical radiculitis, a weakening of muscle strength and tone of the muscles of the upper extremities appears, reflexes evoked from the hands decrease, and the symptom of “frozen shoulder” appears.

Motor and sensory disturbances are accompanied by autonomic disorders (dryness, pallor of the skin with an emphasized vascular pattern, decreased local body temperature) with the development of Horner’s triad: narrowing of the pupil, palpebral fissure and some retraction of the eyeball.

Symptoms of thoracic radiculitis are manifested by pain between the shoulder blades, in the intercostal spaces and may be accompanied by dysfunction of the internal organs, which must be differentiated from true somatic pathology.

Thoracic radiculitis, like any other, is characterized by a forced posture of the patient (bending on the side of the pinched roots with minimal physical activity), which reduces pain.

Thoracic radiculitis may be accompanied by dysfunction of internal organs

Symptoms of thoracic radiculitis often become a manifestation of nerve damage from the herpes zoster virus. In this case and with any other infectious lesions with radiculitis, the temperature rises. The height of the numbers depends on the pathogenic power of the microorganism and on the reactivity of the patient’s body.

Cervicothoracic radiculitis is accompanied by mixed symptoms of damage to both the cervical and thoracic nerve roots.

And yet, the maximum percentage of clinical symptoms of radiculitis falls on the lumbosacral spine.
This fact is due to the large physical loads placed on the lower back.
It is not difficult for a person familiar with shooting pain in the lower back to explain what lumbar radiculitis is, which is popularly known as lumbar radiculitis.
Almost every fourth inhabitant of the planet is familiar with the clinic of sacral radiculitis. Regardless of what level, lumbar or sacral, the nerve roots are pinched, the clinical picture will be basically the same.

What kind of pain will occur with radiculitis depends on the speed and intensity of the onset of circulatory disorders in the root. The lumbago characterizes an acute process with pronounced swelling of the perineural tissues and a lack of blood supply to the nerve root.

Symptoms of radiculitis of the sacral region are familiar to many

In a chronic process, when some adaptation of the suffering tissues to the lack of oxygen occurs, the pain is dull and, depending on the degree of damage to the nerve fibers, a neurological deficit will come to the fore, manifested in muscle atrophy, disturbances in independent movement and the functioning of the pelvic organs.

If you don’t treat, but just dull the pain

The consequences of vertebrogenic lumbosacral radiculitis can be:

• Paresis or paralysis of the lower extremities;
• Trophic ulcers of the skin of the lower extremities;
• Urinary and fecal incontinence;
• Sexual dysfunction.

The lower back is the place of referred pain

Despite the fact that lower back pain is the main complaint with inflammation of the nerve roots, it should be remembered that the lumbar region is also a zone of pain projection in case of kidney damage.

Urolithiasis and pyelonephritis are often signaled by lower back pain. But there is no answer to the question of how to distinguish nephroptosis from radiculitis. Because nephroptosis, in itself, does not hurt.

And only in the presence of an inflection of the ureter, leading to acute dilation and inflammation of the pelvis, does a precedent arise for differential diagnosis with radiculitis.
Positive symptoms of tension will speak in favor of radiculitis. But even in this case, it is possible to exclude the parallel course of two pathologies only with a complete clinical and laboratory examination of the patient including.

Men and women with sciatica, is there a difference?

Provocative questions include the question about the signs of lumbar radiculitis in women. In these cases, more often we are not talking about the symptoms of radiculitis in women, but about whether the lower abdomen can hurt with radiculitis. The lower abdomen is a sacred female area and, hypothetically, it can be assumed that the source of pain lies in the pinching of the sacral nerve roots.

As a rule, radiculitis does not manifest itself as pain in the lower abdomen

But in practice, pain in the lower abdomen is caused by inflammation, often chronic, of the internal female genital organs.

The occurrence of radiculitis during pregnancy can be assumed due to the increased load on the lower back in the later stages of gestation.

But the internal changes in a woman’s body during pregnancy are multifaceted and their impact on the course of a particular disease is unpredictable.

In some cases, a pregnant woman experiences exacerbation after exacerbation, threatening the pregnancy of the child, and in others, the lower back only reminds itself of itself during labor.

If there are any pathological conditions of the spine that were identified earlier in pregnancy, you should start attending water aerobics classes for pregnant women, sleep with special orthopedic devices, wear comfortable shoes, and avoid physical activities that require back strain.

If we talk about the second half of humanity, the signs of radiculitis in men do not differ from those in women, with the only nuance that the symptoms of damage to the nerve roots of the lumbosacral region include the clinic of impotence and erectile dysfunction.

Muscle tension as a result of unresolved negative emotions

Pain in the back (neck) is the main complaint with which people come to see a neurologist for a diagnosis. But, often the manifestations of radiculitis are driven by psychosomatics.

It has been noticed that stress in people prone to the accumulation of negative emotions is manifested by prolonged muscle spasms of all muscles that can contract.

Muscular tension in the back can lead to pinched roots, although not with such severe manifestations and consequences as if the cause were an organic pathology of the spine.

When a bath is like a life-saving remedy

In matters of treatment of acute conditions and at the onset of the disease, you should resort to qualified help. But radiculitis is often a complication of a chronic, long-term underlying disease.
And in this case, with an established diagnosis and mild symptoms (something shot through, somewhere sipping), it makes sense to try traditional methods of alleviating your condition instead of absorbing impressive amounts of painkillers.
Don't forget about a bathhouse with a birch or pine broom.

The bath will ease the pain of radiculitis

And for those who doubt whether it is possible to take a steam bath for radiculitis, you can authoritatively say: “It’s not only possible, but also necessary.” Again, we remember the severity of the pathological process.

If the condition is acute, accompanied by a sharp pain syndrome that makes your eyes numb, you should urgently consult a doctor.

We remember that heat dilates blood vessels, which can contribute to an increase in swelling of the perineural tissues and aggravate the lack of blood supply to the nerve roots.

Prevention

Prevention of radiculitis is considered to be physical hygiene and avoidance of drafts. But everyday life is full of surprises and devoid of conventions, so sooner or later you can either get caught in a stream of cold air or tear a heavy object off the floor, which will provoke another attack of radiculitis.
In terms of longer-term prevention, it is important to compensate for the underlying disease leading to inflammation of the nerve roots.

Hanging on the bar is a good prevention of radiculitis

In case of osteochondrosis, to stretch the distance between the vertebrae and prevent compression of the roots, you can hang on the crossbar as a preventive measure for radiculitis.

Conclusion

Radiculitis has no clinical features depending on the gender of the patient, with the exception of sexual dysfunction. Its manifestations fit into a certain structure of symptoms.

Clinical manifestations depend on the level of compression of the nerve roots, but do not depend on the cause that caused them.

Treatment of radicular syndrome should begin only after examination and after listening to the recommendations of the attending physician.