There are similarities and differences between radiculopathy vs. radiculitis.
What is Radiculopathy?
The condition of radiculopathy is actually a type of neuropathy, where a nerve or nerves work improperly. The injury is to the nerve root, leading to radicular pain, numbness, weakness, or trouble with controlling muscles. The pain may begin in the nerve root, but it radiates out. If there is a neck impingement in a cervical nerve, radial nerve pain in the forearm may occur.
Radiating back pain originating in the lower back might lead to radiating leg pain, affecting the foot. There is a difference between radiculopathy and “referred pain, which is different both in mechanism and clinical features”. If more than one spinal nerve root is impacted, it is called “polyradiculopathy”.
There are many medical conditions that can lead to radiculopathy, including “degenerative disc disease, osteoarthritis, facet joint degeneration/hypertrophy, ligamentous hypertrophy, spondylolisthesis, or a combination”. There are other, rare, conditions that lead to radiculopathy as well. The majority of radiculopathy is in the cervical spine, but injuries could also cause the condition, such as improperly lifting and car accidents, or (infrequently) tumors and diabetes. Tumors could compress local nerve roots. Diabetes may lead to “ischemia or lack of blood flow to nerves”.
Low back pain with radiculopathy is possible. Lumbar radiculopathy is more common in the US than cervical radiculopathy. Diagnostic tests for radiculopathy can be performed by primary healthcare professionals. They can examine the patient physically or with imaging and “electrodiagnostic” testing tools.1
What is Radiculitis?
There is some difference between radiculopathy vs. radiculitis and lumbosacral neuritis or radiculitis. So what is Radiculitis? Radiculitis refers to an “inflammation of the spinal nerve root”.2 This may lead to pain in similar regions to lumbosacral neuritis (lower back), which results from bulging disks, nerve compression, osteoarthritis, or tumors, for example. It also triggers pain, such as radicular pain, tingling, numbness, and muscle weakness.3
The basic difference in terminology is that neuritis involves “inflammation of a nerve”, whereas radiculitis is the “inflammation of the spinal nerve” on “its ‘path’ of travel”. Radiculopathy, by contrast, is a state of “disease, such as compression of a nerve and its ‘path’ of travel”. Inflammation terminology uses “itis” in the suffix, and disease terms use the suffix “pathy”.4
Radiculitis is a result of the spinal disc pressing on the nerves that are connecting to the spinal cord. Cervical radiculitis is “the compression of nerve roots in the upper part of the spine” while lumbar radiculitis is “the compression of nerve roots in the lower part of the spine”.
There is also a thoracic radiculitis, which refers to a situation in which the compressed nerve roots are located in the thoracic spine, between the cervical and lumbar regions. The pain radiating from the cervical area influences the arms, shoulders, neck, chest, and fingers. The thoracic region pain might cause the chest to have a tight feeling. Lumbar pain affects the gluteal muscles, lower back, legs, and feet. Typically, this is caused by “nerve root compression from a lumbar disc herniation or bone spurs”.5
As noted before, at each level of the spine the nerves exit, and these are called radicular nerves or nerve roots. The ones from the cervical spine impact the arms through the fingers. The nerves from the lumbar spine affect the legs through the feet.
Sciatica is a condition in which a radiculopathy occurs, resulting in leg or foot pain. Lower back problems can lead to lumbar nerve root issues. Any issues in the lumbosacral region, even serious conditions (low back fracture, large disc herniation), will not cause a spinal cord injury such as paralysis or paraplegia, however, because “there is no spinal cord in the lumbar spine”. There may still be lumbar nerve root troubles.
Sciatica is one of these types of problems, and the nerve root (radicular nerve) pain then radiates down the leg. This can be caused by a prolapsed or herniated disc. The common term for “radiculopathy in the low back is sciatica”.6
Sciatica symptoms include numbness, tingling, weakness, and leg pain “that originate in the lower back and travel through the buttock and down the large sciatic nerve in the back of the leg”. This is not a true medical diagnosis, though, as sciatica is really a symptom of another condition, such as spinal stenosis, degenerative disc disease, or a lumbar herniated disc. The sciatic nerve becomes compressed and irritated, as a result.
Sciatica generally affects one side of the body, with pain worsened upon sitting, buttocks pain, tingling, burning, or aching leg pain, leg or foot weakness, and sometimes sharp pains that make it difficult to walk or stand. The discomfort may be irritating or incapacitating. While debilitating, it is unlikely that permanent tissue damage will occur. If both legs are affected, or if bowel or bladder dysfunction occurs, it is crucial to seek immediate medical attention, because the disorder may actually be a serious condition called cauda equina syndrome.7
Some patients will end up with surgery for pinched nerves. Surgeries carry risks. This may still be necessary for some patients, though, such as those with “large cervical disk bulges”. Typical surgical procedures include “foraminotomy, laminotomy, or discectomy”. Treating the underlying cause with conservative methods is “ideal” for most cases of radiculopathy, though.
Effective treatment is designed to “resolve the underlying cause and restores the nerve root to normal function”. Conservative methods include pain control, physical therapy, and chiropractic care. Spinal manipulation has been found to be “effective for the treatment of acute lumbar radiculopathy and cervical radiculopathy”. Some patients may treat cervical radiculopathy with physical therapy. Regardless, treatment will likely involve therapeutic exercises. Patients need customized exercises.
It is important to keep the cervicothoracic region stabilized so that the patient experiences less pain and is not injured further. A neck brace may be needed to stabilize the neck. Cervical traction could also be part of the treatment. The goal, at first, is to achieve “a pain free full range of motion which can be accomplished through stretching exercises” followed by “a strengthening exercise program” to restore musculature. Later, isometric exercises could be included.8
For sciatica, patients have many non-surgical options, such as regular exercises. Heat and ice can alleviate the leg pain. Some patients may need to alternate ice and heat. There are prescription and over-the-counter NSAID medications (naproxen, ibuprofen, and COX-2 inhibitors) that could provide relief. Oral or epidural steroids might also be used to reduce inflammation.
Alternative Treatment Options
Alternative therapies, such as chiropractic, massage, and acupuncture, have been found to provide relief to those who suffer from sciatica. Spinal adjustments and manipulation realign the spine, which can reduce irritation on the nerves. Acupuncture is meant to open the flow of energy pathways, and it is FDA-approved as a back pain treatment. The National Institute of Health has also “recognized acupuncture as effective in relieving back pain, including sciatica”.
Massage therapy is designed to relax muscles, increase circulation, and release endorphins.9 Lower back pain treatment, for lumbar radiculopathy, includes many non-surgical options, “such as physical therapy, medications, and selective spinal injections” and other alternatives. If there is no pain alleviation after a couple of months, surgery may be recommended.
Surgery for leg pain, however, “is much more reliable than the same surgery for relief of low back pain”. Surgery is not advised “if definitive nerve compression cannot be documented on an MRI or CT-myelogram”.10
Learn more about cervical radiculopathy.