Nerve root irritation
definition
From one Nerve root irritation one speaks as soon as it becomes one Irritation in the area of the central nerve roots comes. The so-called central nerves are those that start from the brain in the spinal cord run and that brain directly including his nerves. The latter are actually less affected by nerve root irritation. The nerve root irritation can have various causes. For example a Compression of the root after a disc prolapse or one inflammation.
Read more about the topic here: Nerve root compression
causes
As mentioned earlier, many different causes can be the triggering factor Nerve root irritation be. In most cases it is supported by a disc prolapse (Disc prolapse) or a Intervertebral disc bulge (Disc protrusion). Due to the Advancement of the intervertebral disc in the event of an incident or protrusion, it penetrates the Spinal canal one in which usually only the nerve roots have their place. The intervertebral disc compresses the nerves due to the limited space.
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From this compression The affected nerve root quickly becomes irritated and, over a longer period of time, possibly also local inflammation. The mechanical stress on sections of the spine can result in a so-called Nerve root inflammation arise. Following a similar pattern - via the narrowing of the nerve root in the spinal canal - can also Spinal stenosis, Vertebral fractures, Space claims (for example tumors or bony outgrowths), chronic inflammation or chronic degenerative changes cause typical nerve root irritation. More rarely found Nerve root irritationthat on a pure Blockage of mobility with permanent bad posture, Circulatory disorders in the area of the spine or Cysts near the vertebral joints.
Read more about the topic here Causes of back pain.
Symptoms
Sharp, stabbing, sometimes electrifying pains are typical for the presence of nerve root irritation. The pain often follows the “normal”, ie anatomically correct, nerve path. More symptoms can be Sensory disturbances and a uncomfortable tingling sensation be. As a rule, however, there is no pure nerve root irritation Numbness or a recognizable Loss of strength in muscles. These things are more likely to suggest a major nerve root injury, or at least one strong and lasting compression. Usually there is a pain in addition to the characteristic pain reflex tension of the back muscles to this, which in turn causes pain again - A vicious circle!
diagnosis
The diagnosis of nerve root irritation is already one in many cases clinical diagnosis. That means a doctor can already help you with the Questioning the patient (anamnese) and its typical complaints put. The Reflexes The affected area is checked and additional tests are carried out. Only if that is not enough to confirm a clear finding, or if you suspect a rather rare cause, you turn to the help of imaging procedures back. The means of choice for diagnosis is here Magnetic resonance imaging (MRI). There may also be one Computed Tomography (CT) are used.
MRT and / or CT images then show the particularly clearly Band washers and allow next to the Diagnosis of nerve root irritation often to name the cause. Depending on the patient's symptoms, in rare cases a conventional x-ray or a special one MR myelography come into question, about which a doctor decides and informs individually. Is there any suspicion of a acute inflammation In the spinal canal or in the brain as the cause of the nerve root irritation, there is also a Puncture of the nerve water (Cerebrospinal fluid) to confirm or rule out inflammation.
therapy
The Therapy of nerve root irritation occurs in the majority of cases conservative with medication. There are anti-inflammatory drugs (Anti-inflammatory drugs), Cortisone preparations, Muscle tension-reducing agents (Myotonolytics) or also local pain relievers (Analgesics) to disposal. Pain that cannot be alleviated or only marginally alleviated, sometimes improves with the use of certain Antidepressants. In addition, the patient should use physiotherapy (physical therapy) to be accompanied. In the case of large herniated discs or atypical causes, a surgery be another alternative to treatment. This is preferred - if at all microsurgical. That means with the least possible injury and the lowest possible risk. This is not clearly proven in scientific studies Use of acupuncture against nerve root irritation or the so-called TENS therapywho suggests nerve stimulation to relieve symptoms. Nonetheless, some patients report exceptional ones Treatment successes under these therapies.
Read more about the topic here: Treatment of a herniated disc
Duration
The acute case of a nerve root inflammation usually lasts between a week and six months, depending on the severity and severity. The pain should improve rapidly with adequate therapy. Persistent irritation or other impairment of the nerve root can become chronic and result in pain that is difficult to treat. These can then possibly accompany patients for life.
You might also be interested in: Duration of a pinched nerve
Nerve root irritation of the cervical spine
It occurs less often than lumbar spine complaints, but much more frequently than thoracic spine complaints Nerve root irritation of the cervical spine (Cervical spine). The relatively small cervical vertebrae with their associated intervertebral discs are solely due to their nature and Size more sensitive against irritation. Nonetheless, of course, they wear much less weight than, for example, the lumbar spine and are therefore subject to less stress. In the case of nerve root irritation of the cervical spine, the irritation occurs depending on the exact location Tingling sensations and deafness in the poor and / or in the field of hands. This Sensory disturbances can be one-sided, but also at the same time if there is great irritation on both sides become noticeable. Here too you can Reflex failures and Functional weaknesses give clinical indications of the location of the nerve lesion or irritation of certain key muscles.
You might also be interested in: Symptoms of cervical spine syndrome.
Nerve root irritation of the thoracic spine
As the middle section of the spine are the Thoracic vertebrae Slipped discs or bruises are much less likely than the lumbar spine. In those cases in which this nevertheless occurs, the picture usually presents itself Intercostal neuralgia. It is understood as belt-like pain in the area of the upper body with sudden radiation of pain along the ribs. There may also be other symptoms. Sensory disturbances in the case of nerve root irritation in the thoracic spine, analogous to the corresponding pain, usually also run in a belt or ring shape around the chest.
Not infrequently it happens that one acute herniated disc the thoracic spine because of these symptoms at first for you Heart attack is held. Unlike a heart attack the pain increases a nerve root irritation, however, classically when inhaling deeply or the Rotation of the upper body left and right. Rotary movements in particular irritate the already sensitive nerve roots, so that all symptoms are significantly increased. Diagnosing a Intercostal neuralgia can usually be asked by asking the patient. Imaging and further examinations should only be used in the case of atypical or long-lasting pain.
Read more about the topic here: Intercostal neuralgia
Nerve root irritation of the lumbar spine
The Lumbar spine, often abbreviated as LWS, is the most common place nerve root irritation. Because this is where most of the herniated discs occur. The intervertebral discs between the vertebral bodies are particularly at risk L4 (i.e. the fourth lumbar vertebra) and L5 as well as between L5 and the first sacral vertebral body (S1). The reason for this lies in the biomechanically conditioned higher load of the lower back. The lumbar spine carries a large part of the body weight, enables upright stand and performs at its best when lifting heavy objects.
The best known nerve root irritation of the lumbar spine is the - popularly called Sciatic pain - Lumboischalgia in a herniated disc in the lumbar spine. She goes with very characteristic burning or stabbing back pain in the area of the lumbar spine, which can possibly be carried to the leg of the affected side, as well as sensory disturbances and paralysis.
Nerve root irritation L5
The so-called Identification muscles the nerve root L5 is the Extensor hallucis longus muscleresponsible for pulling the toes towards the nose (= dorsiflexion of the foot). An identification muscle marks a certain nerve because it is supplied by this nerve and receives its commands. Can he Identification muscle its actual function can no longer perform sufficiently while the surrounding muscles are completely unaffected, the suspicion that it is a Problem of nerve could act.
The same applies to certain reflexes, which is why the Tibialis posterior reflex in the case of nerve root irritation in the L5 area carefully and in side comparison should be tested. This reflex can be triggered by a targeted blow on the Tibialis posterior muscle trigger, whereupon the inner edge of the foot should react with a lift. Next Muscle weakness and Reflex disorders can it to Sensory disturbances on the outside of the knee, over the outside of the lower leg and the back of the foot to the back of the big toe.
Nerve root irritation S1
A key muscle can also be tested in the event of nerve root irritation of nerve root S1; this is the gastrocnemius muscle, i.e. the calf muscle. The large gluteal muscle (gluteus maximus) can also be affected. In addition, the Achilles tendon reflex is important, which lets the tip of the foot flap downwards as soon as you tap the Achilles tendon. Sensory disturbances occur in the case of nerve root irritation in area S1, especially on the outer rear side of the entire leg as well as over the heel and on the lower outer edge of the foot.
You might also be interested in this topic: S1 syndrome
