Nerve root inflammation

Definition

A Nerve root inflammation, also called radiculopathy, radiculitis or root neuritis, describes the damage and irritation of a person Nerve root on the spine.

Occurs between each vertebra Pair of nerve roots off: left and right a pair. At this exit point, the nerve root can be damaged. This can be an acute or chronic event. Nerve root inflammation often occurs in the Cervical and lumbar spine area on. Causes can include orthopedic but also infectious in nature.

causes

There are different possible causes for a nerve root inflammation.

One lies in the degenerative changes the bones and especially the vertebral bodies. When the bony tissue and cartilage wear and tear, the nerve root is irritated by friction. In addition, due to wear and tear, an inflammatory process takes place on the spine. This inflammation also affects the surrounding structures, such as the nerve roots.

Another option is one disc prolapsewhich, through pressure on the nerve root, leads to acute or chronic inflammation. Also should Space claims in and on the spine, e.g. Bruising (Hematomas) or Tumors.

Another group of triggering causes are Infectious diseases. Above all, that should be mentioned here Lyme disease (Infection transmitted by ticks) which can cause nerve root and cranial nerve inflammation. The reactivation of the Chickenpox Virus (Varicella zoster virus) in shingles.

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Symptoms

The affected patient often complains sensitive disorders in the area that is supplied by the corresponding inflamed nerve root. It's going over Tingling sensations, numbness and pain reported. Depending on the strength of the inflammation, not only the sensitivity but also the Motor skills fail. With motor skills, i.e. the ability to tense a muscle, the reflex of the corresponding muscle fail.

If not just one nerve root but several are affected, then the symptoms are not limited to one area, but to one larger area. The pain caused by nerve root inflammation should not be underestimated. They can be so extreme in their strength that the patient is no longer able to pursue his daily activities and needs strong pain relievers. Depending on which nerve roots are affected, can also basic body functions restricted be like breathing, for example. In these cases, action must be taken quickly and the patients receive intensive medical care.

In the case of nerve root inflammation due to the Herpes zoster (shingles) First a reddening and then vesicles can be found along the course of the nerve over several days, which dry up over time. Before that, patients often complain of fatigue and exhaustion.

diagnosis

https://www./?id=10226 Each nerve root can be assigned to a sensitive area, specific muscles and their reflexes. The examining doctor can use this Assignment recognize which nerve roots are affected and how severe the inflammation is. If necessary, a provocation carried out in which a conscious attempt is made to compress the nerve root and trigger the pain. This enables the diagnosis to be secured. It happens that the pain is caused by other structures (e.g. the Sciatic nerve (Sciatic nerve)) comes and unconsciously projected into the region of the nerve root becomes. A detailed survey and a precise description of the type and location of the pain is therefore of great relevance.

In the course of the diagnosis, new complaints should be reported CT or MRI (see: MRI of the spine) to rule out a herniated disc or tumor. At first one also helps roentgen the spine, since inflammatory and degenerative remodeling processes (arthrosisDisc damage) can be made visible on the vertebral bodies.

If one is suspected Neuroborreliosis (Infection of the nerves in lymph borreliosis) should be one CSF puncture (Puncture of the cerebral water) can be performed to provide evidence of inflammation of the cerebral water.

There should be vesicles along the course of the affected nerve that are attached to a Herpes zoster (shingles) are compatible, a Puncture the vesicles respectively. If the clinical picture is clear (i.e. the diagnosis is certain for the doctor due to the typical appearance of the infection), direct therapy can also be used.

therapy

The treatment of nerve root inflammation is highly dependent on its cause. If the cause is an infection (Borrelia or herpes), it is important that adequate antibiotic or antiviral therapy is carried out to kill the pathogens and prevent the inflammation from progressing. In the case of herpes inflammation, therapy with painkillers and neuroleptics may also be indicated to prevent chronic pain.

If a hematoma (bruise) or a tumor is the reason for the nerve root inflammation, then the therapy consists in removing them surgically if possible and necessary. If an operation cannot be performed, conservative means (physiotherapy, manual therapy, painkillers) should try to relieve the symptoms.

In the case of herniated discs, the type and severity of the discomfort or the incident determines whether it is operated on. If surgery is not indicated, the nerve root inflammation is treated with physiotherapy and pain relievers. Basically, it is important that the person concerned is adequately supplied with painkillers. For example, drugs from the group of non-steroidal anti-inflammatory drugs (ibuprofen, diclofenac or Voltaren) relieve pain and also have an effect against inflammation.

Read more on the subject at: Treatment of a herniated disc.

It is also possible to infiltrate the affected nerve root epidurally. This means that cortisone and / or local anesthetics (lidocaine) are injected locally onto the inflamed nerve root. However, this is not possible for every patient and also harbors dangers that should not be underestimated. Whether an infiltration is appropriate must be discussed individually with the treating doctor.

Read more on the subject at: Epidural Infiltration.

Nerve root inflammation of the cervical spine

Nerve root inflammation in the area of ​​the cervical spine is often very unpleasant and sometimes very severe Pain connected. Those affected have inflammation depending on the location Tension in the neck, the shoulder or between the shoulder blades. The tension can go so far that it is difficult and painful to move your head in different directions. Additionally can be strong Headache from tension in the neck arise. The headache can be in the back area, but also in the temples. Another problem are Numbness or paralysis in the arms and hands. These arise because the nerves that supply the arms and hands both sensibly and motorically, leave the cervical spine and, in the case of nerve root inflammation, the transmission of stimuli via these nerves is disturbed.

Since the cervical spine also has nerves for the sympathetic innervation of the Eye muscles can come off a so-called Horner syndrome occur. The Regulation of sweat secretion on the upper extremity via nerve fibers from the cervical spine. In the case of nerve root inflammation in the cervical spine, the secretion of sweat can and also be disturbed Sweats are possible.

Nerve root inflammation of the lumbar spine

In the lumbar spine (lumbar spine) go off the nerves that the lower extremity, i.e. the legs, motor and sensitive care. In the case of nerve root inflammation, disorders can occur in the muscles and skin areas that are supplied by the affected nerve branch, e.g. muscle weakness, abnormal sensations and paralysis. These often feel as if they extend from the lumbar spine down into the leg. In the lumbar spine, nerve root inflammations are often caused Herniated discs and degenerative changes conditionally.

In the lumbar spine different Testing to diagnose inflammation or irritation of nerve roots. E.g. the extended leg raised on the patient lying down (Laségue test) and additionally the foot pressed to the tibia (Bragard test). If these tests cause pain in the patient, it is a sign that there is a problem in the lumbar spine that should be investigated more closely, such as a nerve root inflammation or a herniated disc.

Duration of the nerve root inflammation

https://www./?id=7440 The duration of the inflammation and the symptoms can be very different. The acute phase of inflammation can last a few days to weeks. Adequate therapy with pain medication is very important during this time.

If the nerve root inflammation was caused by Lyme disease, the pain may persist and permanent nerve pain persists. If Lyme disease is suspected, treatment should therefore be given as early as possible in order to prevent long-term consequences.

With herpes zoster (shingles), the nerve pain heals after a few weeks with the right treatment. Here, however, persistent pain persists in around 10% of patients (so-called post-zoster neuralgia). In these patients, it may be necessary to use higher-dose morphine drugs and drugs from the class of antipsychotics (e.g. amitriptyline, gabapentin) to combat chronic pain.

Read more on the topic: Duration of an inflammation of the nerves - what you should be aware of!

After a herniated disc, the nerve complaints will ideally slowly regress with appropriate therapy. This usually takes several weeks and requires active involvement of the patient in physical therapy and muscle building. If the patient does not cooperate sufficiently, the pain can persist.

Read more on the subject at: How long does a herniated disc last?