Radicular pain

Everybody knows the disease, like radiculitis. Even a small child will be able to show the gait of a grandmother or grandfather at the time of attacks of this disease. Bent in half the body, the hand lies on the lower back, the movement is weak, limited, and more often, the person simply freezes in place at the time of a sharp, shooting pain attack spreading the pain from the waist to the foot. If you say the medical language, then the basis of the attack is radicular pain. And it was the result of one of many possible diseases or some pathological factor. Any difficult situation requires the adoption of prompt and correct decisions. All the painful processes in the human body have an anatomical basis. Knowing the structure of a certain organ, on which all his vital activity is tied, it is possible to establish the causes of pain.

[1], [2], [3], [4], [5], [6]

Diseases that cause radicular pain

One of the first diseases, which is a provoker of the formation of radicular pain, is osteochondrosis. Over the past decade, signs of osteochondrosis began to occur in young people, although earlier it was considered a disease of the elderly. In addition to osteochondrosis, the causes are hernias (one or multiple) of intervertebral cartilages (discs), lesions of the vertebrae, their integrity or bone structure, spinal cord tumors, infectious diseases and tuberculosis of bones, inflammatory diseases in the joints of the back. More complex and severe, both in the degree of flow and in treatment, are compression injuries of the spine, bruises and especially fractures. In such cases, there is a partial or complete defeat of both the spinal cord and its neurovascular environment.

[7], [8], [9], [10], [11], [12], [13], [14]

Spinal roots: anatomical information

The spinal cord is not an amorphous liquid, nor is it a liquid at all, but rather a complex organ in its structure. Like the brain, the spinal cord has several shells, is formed by gray and white matter and is surrounded by cerebrospinal fluid. Consider only those of its structural components, in the pathology of which there is radicular pain.

Figuratively speaking, each vertebra contains a portion of the spinal cord in its cavity, with nerve fibers or roots spaced from it. In the bodies of the vertebrae, in their bone structure, there are small holes through which the nerve fibers exit from the intervertebral space. The spine has flexibility, between the vertebrae are located cartilages - intervertebral discs. So, one of the factors causing radicular pain is precisely the compression of nerve fibers. It can occur because of a sharp displacement of the vertebra, formed by the intervertebral hernia, or other causes in which the osteochondral structure or soft tissues led to a squeezing of the space around the nerve, and the transmission of impulse along it became difficult or completely impossible. There is pain.

The nature of radicular pain

Radicular pain has its own specific manifestation, which alleviates, in many cases, the diagnosis already at the stage of pain syndrome description. The nerve, leaving the spinal cord, is sent to the final destination point, and each nerve has its own. So, in those cases when the failure occurs, the nerve clamp, the soreness is tracked along its entire length. An example for clarity. Pain, the main localization of which is in the gluteal region, shoots and pushes the foot, while tracing its course on the back of the foot, through the popliteal space. Pain is painful when moving, reflecting on the lumbar region. The pain is either periodic, shooting, or permanent, nasal - stitching. The next distinguishing feature of this kind of pain is a partial or total loss of skin sensitivity. Again, we return to the example given. If you carry out a sensitivity check by gently pricking the skin with a sharp object all over the affected nerve, you will find that the skin does not feel tingled or feels, but very weakly. A poor sensitivity, relatively speaking, in the form of a strip, passes along the back surface of the leg, showing the boundaries of the nervous branch. This manifestation suggests a root deficit.

Now it's up to the third characteristic sign of the defeat of one of the roots, which is a violation of mobility. With prolonged absence of normal, natural vital activity of the clamped nervous branch, pathological changes occur in the structures of muscles and ligamentous apparatus. Muscles with time become weak, atrophic, their mass gradually decreases, they seem to dry up. In such cases, people say so, the arm, or the leg has dried up. There is the expression "dry limb syndrome".

The examples given in the text concern limbs only for the sake of simplicity of explanation of the mechanism of development of the original cause, as a result of which the radicular pain develops. But this does not mean at all that such a pathology affects only those nerves whose zones of innervation are limbs. Any roots can be affected, in any part of the spinal cord, with only one spine prone to a one-stage lesion. It is very rare cases of damage to more than one spine at once. In such cases, the pain does not appear on one leg, if you return to the above example, and immediately on two legs.

Diagnostic methods for rootlet syndrome

For muscular pains neurologists and orthopedists answer. Any diagnosis begins with a primary examination and questioning the patient about all the details of the reason for his address to the doctor. When did it start and where? What was before and after? What measures were taken? What were they treated for and where were they treated? Conduct palpation (palpation) of the painful area and check the skin over it for sensitivity to pain. Check the level of the main reflexes related to the affected area. The most well-known to every person check of a reflex is an easy blow to the knee cap with a hammer. The greater the damage to the nerve responsible for this reflex, the weaker the movement of the leg. Check the degree of development of muscle mass, density and elasticity of muscles along the path of the painful zone.

Then they proceed to instrumental methods of diagnostics. One of the best is still considered the X-ray of the spine, which shows many abnormalities, for example, herniated intervertebral cartilage, the main symptom of which is radicular pain. To assist this method, there is a magnetic resonance imaging, which allows you to get a more complete picture.

[15], [16], [17], [18], [19], [20]

How is root pain treated?

In acute attacks, especially if it is an attack of lumbar radiculitis, you first need to remove the pain syndrome. This can be done even at home, before the arrival of a doctor.

The patient should be placed gently on a flat, hard surface and give any tablets anesthetic. Apply a warming ointment on the affected area, which temporarily relieves spasm. However, this is not enough. Most cases of manifestation of radicular pain require treatment under the supervision of a doctor. Treatment courses are long. Depending on the degree of complexity of the painful process, one or more drugs are assigned to the group of non-steroidal anti-inflammatory drugs and strong analgesics. It is often necessary to carry out novocain blockades (chipping the center of pain with novocaine or its derivatives). If necessary, select antibiotics, a complex of vitamins, as well as support for physiotherapy, manual and massage courses. All this is suitable in cases where the root pain is provoked by causes that can be eliminated without resorting to surgical intervention. However, there are also such diseases in which treatment is started with operational procedures and only at the stage of postoperative recovery go to the selection of funds from the groups described above.

Medical practice shows that most cases of manifestation of radicular pain can not be completely eliminated. Acute seizures are removed, the pain subsides, and the disease may either not manifest itself for years, or go to the stage of chronicization. In young and healthy people, with a strong, trained muscle frame, a complete cure for minor problems is quite possible. The older the person or the weaker the muscle elasticity, the harder it is to cope with the ailments of any severity.

Preventing the occurrence of radicular pain

• Maintenance of health, by constant training of the muscular backbone;
• Exercises aimed at developing joint flexibility;
• Proper nutrition that does not lead to an increase in body weight to critical parameters and does not contribute to the deposition of fats and salts in the "bins" of the body;
• Correct distribution of the load on different muscle groups when lifting weights;
• Normalized schedule of work and rest;
• Avoiding traumatic situations.

Here are the most appropriate preventive measures that can protect the body from the harmful effects of most pathogenic factors, because there is no such independent disease - radicular pain. This is just a symptom complex, indicating the development of one or a number of diseases. Therefore, there are no special events or procedures, adhering to which, it could be guaranteed to protect themselves from the appearance of pain in the future.