Radiculopathy Treatment in Castle Rock
What is Radiculopathy?
Radiculopathy is the medical term for a pinched or irritated nerve root in the spine. When a nerve root is compressed - by a herniated disc, bone spur, or narrowing of the spinal canal - it can cause pain, numbness, tingling, or weakness that radiates along the path of that nerve into the arm or leg.
Radiculopathy is not a condition on its own but a description of what is happening: a nerve root is being irritated. The underlying cause can vary - disc herniations, spinal stenosis, bone spurs, or other structural changes can all produce radiculopathy. Identifying the specific cause and the specific nerve involved is key to effective treatment.
How is Radiculopathy Different from Sciatica?
Sciatica is actually a type of radiculopathy. It specifically refers to irritation of the sciatic nerve roots (L4, L5, or S1) in the lower back, causing pain that radiates down the leg. Radiculopathy is the broader term that includes pinched nerves anywhere in the spine.
Cervical radiculopathy: A pinched nerve in the neck causing pain, numbness, or weakness in the shoulder, arm, or hand. Common causes include cervical disc herniations and cervical foraminal stenosis.
Thoracic radiculopathy: A pinched nerve in the mid-back. Less common than cervical or lumbar radiculopathy. Can cause pain that wraps around the chest or abdomen.
Lumbar radiculopathy: A pinched nerve in the lower back causing pain, numbness, or weakness in the buttock, leg, or foot. When the sciatic nerve roots are involved, this is called sciatica.
More about sciatica specifically is available on the sciatica page.
What Causes Radiculopathy?
Disc herniation: The most common cause. Part of the disc pushes out and presses on a nerve root.
Foraminal stenosis: The bony opening where the nerve exits the spine narrows, compressing the nerve. Often caused by arthritis, bone spurs, or disc height loss.
Central stenosis: The spinal canal itself narrows, compressing multiple nerve roots. More common in older patients.
Degenerative disc disease: As discs lose height, the foramen can narrow and compress the exiting nerve root.
Spondylolisthesis: A vertebra slips forward on the one below it, potentially compressing nerve roots.
What are the Symptoms?
Pain radiating from the neck into the shoulder, arm, or hand (cervical radiculopathy)
Pain radiating from the lower back into the buttock, leg, or foot (lumbar radiculopathy / sciatica)
Numbness or tingling in a specific area of the arm or leg
Weakness in the affected arm or leg - difficulty gripping, foot drop, or leg giving way
Symptoms that follow a specific pattern corresponding to the affected nerve (called a dermatome)
When Should I Seek Immediate Medical Attention?
Most radiculopathy improves with treatment and does not require emergency care. However, seek immediate evaluation if you experience new or worsening loss of bowel or bladder control, rapidly progressive weakness in an arm or leg, severe numbness in the groin or saddle area, or symptoms in both legs that are getting worse quickly. These may indicate a more serious condition requiring urgent intervention.
How is Radiculopathy Diagnosed?
Dr. Carrera's team evaluates radiculopathy through a detailed history, neurological examination (testing reflexes, strength, and sensation), and imaging. An MRI is the most useful study because it shows both the nerve roots and the structures that may be compressing them. The exam helps the team correlate imaging findings with your symptoms to identify the specific nerve involved.
How is Radiculopathy Treated?
Treatment depends on the cause, severity, and duration of symptoms.
Conservative care: Many cases of radiculopathy improve within 6 to 12 weeks with physical therapy, activity modification, anti-inflammatory medications, and nerve-calming medications (such as gabapentin or pregabalin). This is especially true for radiculopathy from acute disc herniations.
Transforaminal epidural steroid injections (TFESI): When symptoms are severe or not improving with conservative care, a targeted epidural injection delivers anti-inflammatory medication directly to the irritated nerve root. This is the most common procedural treatment for radiculopathy and provides relief for most patients. More on the TFESI page.
Interlaminar or caudal epidural steroid injections: For bilateral symptoms or multi-level nerve involvement, broader epidural approaches may be more appropriate. For post-surgical patients, caudal epidurals are often preferred. More on the interlaminar epidural page and the caudal epidural page.
Spinal cord stimulation (SCS): For chronic radiculopathy that persists despite injections, medications, and physical therapy - particularly after spine surgery - spinal cord stimulation can provide significant relief. More on the SCS page.
Surgery: Surgery is considered when radiculopathy is accompanied by significant or progressive weakness, severe numbness, or bowel/bladder dysfunction, or when symptoms do not improve after an adequate trial of non-surgical treatments. Dr. Carrera's team coordinates with spine surgeons when surgical evaluation is appropriate.
For Referring Providers
If your patient has arm or leg pain consistent with radiculopathy and has not improved with initial conservative measures, Dr. Carrera's team can provide rapid access to diagnostic evaluation and targeted epidural injections. For patients referred specifically for an injection, the team can often schedule it within one week of the referral. Fax referrals to 720-455-3776. For patients with acute severe symptoms, call 720-455-3775 to expedite.
Patients in Castle Rock, Lone Tree, Parker, Highlands Ranch, Denver, Colorado Springs, and surrounding areas can call 720-455-3775 to schedule an evaluation.
Call 720-455-3775 to schedule an appointment