Radiculopathy: When a Disc Pinches a Nerve Root — Pain, Numbness, and Weakness Explained

Radiculopathy occurs when a spinal nerve root — emerging from the spinal cord between vertebrae — is compressed or irritated, usually by a herniated disc or osteophyte (bone spur from cervical or lumbar spondylosis). The result is a distinctive pattern of symptoms: pain, numbness, tingling, and weakness that follow the specific dermatomal and myotomal distribution of the compressed root — radiating down the arm (cervical radiculopathy) or leg (lumbar radiculopathy) in a predictable pattern that a trained clinician can map to the affected level.

Cervical Radiculopathy (Neck Disc)

C6 radiculopathy (C5-6 disc — the most common cervical level): Pain and tingling radiating from the neck into the shoulder, outer forearm, thumb, and index finger; weakness of biceps and wrist extension; diminished brachioradialis reflex. C7 radiculopathy (C6-7 disc — second most common): Pain into the posterior arm, middle finger; weakness of triceps; diminished triceps reflex. Typically worsened by extending and rotating the neck toward the affected side (Spurling's manoeuvre) — which narrows the neural foramen.

Lumbar Radiculopathy (Back Disc)

L4 radiculopathy: Pain down the front of the thigh and medial leg; weakness of knee extension (quadriceps); diminished knee jerk. L5 radiculopathy (L4-5 disc — the most common lumbar level): Pain down the lateral leg to the big toe and dorsum of foot; foot drop; no reflex change. S1 radiculopathy (L5-S1 disc — second most common): Pain down the back of the thigh and leg to the small toe; weakness of plantar flexion (calf); diminished ankle jerk.

Treatment

Most radiculopathies (80–85%) resolve with conservative management within 6–12 weeks: rest modification (not complete bed rest); NSAIDs; physiotherapy including nerve mobilisation and traction; short course of oral steroids for severe acute pain. Red flags requiring urgent imaging and possible surgery: progressive weakness, bladder/bowel dysfunction, bilateral symptoms. MRI spine is the investigation of choice. Sri Anand CNC, Chanda Nagar, Hyderabad. Call +91 90633 66983.