Radiculopathy discogenic (banal radiculitis) – diseases caused by damage to the roots of the spinal cord.
The reasons
The most common cause of peripheral nerve damage is spinal osteochondrosis.
Osteochondrosis is associated with impaired microcirculation, metabolism (vitamins, mineral components), leading to premature ossification of the ligamentous apparatus, muscles and intervertebral discs. Contributing factors for the onset of the disease are professional features of labor associated with heavy physical exertion, cooling, intoxication, and vascular pathology. Of no small importance is the genetically determined inferiority of the spine due to insufficient adaptation to holding the human body in an upright position.
Symptoms
Characterized by pain and stiffness in the corresponding part of the spine, fatigue of the back muscles.
Depending on the localization of the pathological process in the spine, the clinical picture is dominated by cervical, thoracic or lumbosacral syndromes.
Neck level of the lesion. Reflex syndromes: cervicalology, carniaology, cervicalobrachiology, vegetative-vascular and neurodystrophic manifestations. Radicular syndrome: cervical sciatica.
Thoracic level of the lesion . Reflex syndromes: thoracalgia with muscular-tonic, vegetative-visceral, neurodystrophic manifestations. Radicular syndrome: thoracic sciatica.
Lumbosacral level of the lesion. Reflex syndrome: lumbago, lumbalgia, lumboischalgia with muscular-tonic, vegetative-vascular, non-irodystrophic manifestations. Radicular syndrome: discogenic lesion (sciatica) of roots with sensitive motor disorders.
Diagnosis
X-ray examination of the spine with radiculitis traditionally detects osteochondrosis, but due to the high frequency of such findings in the population, their significance is small. A spondylogram cannot reliably verify the discogenic nature of the disease; it is necessary mainly to exclude destructive processes in the spine.
A lumbar puncture in patients with sciatica often reveals a moderate increase in protein content. With a long-term history in the form of repeated exacerbations of sciatica, the diagnosis of the discogenic nature of the disease is obvious. The diagnostic role of antalgic scoliosis (scoliotic sciatica) is very great, which does not occur in other forms of radiculopathies.
Differential diagnosis is carried out primarily with tuberculous spondylitis, Bechterew’s disease, tumors of the spine and spinal cord, spondylolisthesis.
Treatment
Immobilization of the spine (bed with a hard mattress), heat, analgesics – the main triad of therapeutic techniques that in many cases can stop the exacerbation of pain. Local irritating agents are shown – rubbing. Manual therapy. Traction, massage, physiotherapy exercises, physiotherapeutic procedures, blockades are widely used.
Spa treatment plays an important role in aftercare and prevention of exacerbation.
In the case of prolonged intense pain, despite full-fledged conservative therapy (3-4 months), the patient should be offered surgery – removal of a herniated disc. Absolute indications for surgery appear with paralyzing sciatica caused by compression of the cauda equina by a prolapsed disc.