Lumbar radiculitis, lumbosacral radiculitis symptoms and treatment in the multidisciplinary clinic CELT.

Lumbar radiculitis is a complex of symptoms, the appearance of which is caused by damage to the spinal cord roots in the lumbar spine. It involves severe pain that spreads along the nerves, the roots of which are subject to compression, and is found everywhere.

The frequent diagnosis of lumbosacral radiculitis is due to the fact that it is this section that is subject to the greatest load more than others, “wears out” faster and leads to radiculitis. You can undergo a course of treatment for lumbar radiculitis at the CELT multidisciplinary clinic. In order to become our patient and save yourself from pain, you do not have to have a residence permit in the capital!

At CELT you can get advice from a neurosurgeon.

Initial consultation – 3,000
Repeated consultation – 2,000

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Causes

The reasons leading to the appearance of symptoms of lumbar radiculitis are a number of diseases, which are characterized by pinched nerve roots:

intervertebral disc herniation;
prolapse or protrusion of the intervertebral disc;
spinal canal stenosis;
cysts of intervertebral joints (synoviomas)
osteochondrosis in advanced stages;
spondylosis;
piriformis syndrome.
inflammation of the nerves of an infectious nature (herpes)

Another factor in the occurrence of symptoms of lumbosacral radiculitis is spinal trauma, in which displacement of the vertebrae is observed.

Similarities and differences in pathogenesis

Many doctors consider radiculitis as a complication of osteochondrosis. After 40 years, degenerative-dystrophic changes in the intervertebral discs and vertebrae begin to develop. The older a person gets, the more pronounced the destruction of cartilage and bone tissue. The situation is aggravated by a decrease in collagen production and a gradual decline in regenerative processes in the spine. Doctors even put forward versions that osteochondrosis is not a disease, but only a sign of natural aging of the body. Therefore, osteochondrosis should be considered a pathology only with its corresponding manifestations. The most pronounced of them is radiculitis.

In order for this disease to complicate the course of osteochondrosis, the body must be affected by several provoking factors at once. These are heredity, heavy physical activity, an autoimmune disorder, a pathological condition of the spinal cord roots, significant damage to bone and (or) cartilaginous structures.

When asked by patients how radiculitis differs from osteochondrosis, doctors find it difficult to answer in a few words. The difference lies in pathogenesis, etiology, clinical pictures, even prognosis for recovery.

Osteochondrosis

Cervical, thoracic, lumbar osteochondrosis occurs due to the gradual destruction of intervertebral discs. These cartilaginous structures do not have their own blood supply. Tissues receive oxygen, fluid, nutrients, and bioactive substances through diffuse exchange with the surrounding tissues. When muscle fibers contract, a certain amount of fluid, saturated with beneficial compounds, is released into the intercellular space. It is absorbed by cartilage, releasing in response unspent water in which carbon dioxide is dissolved, toxic metabolic products.

When this coordinated work is disrupted, a state of dehydration occurs in the cartilage tissues. They become brittle, inelastic, and lose their shock-absorbing properties.

To stabilize the vertebrae and discs during movement, the body begins the process of forming bone growths, or osteophytes. They compress blood, lymphatic vessels, and nerve endings. This causes the appearance of neurological, traumatic symptoms.

Radiculitis

Radiculitis is a pathology that affects the roots of the spinal cord. It is characterized by the occurrence of a combination of motor, autonomic, and pain disorders. The cause of the development of radiculitis is destructive and degenerative changes in various parts of the spinal column. The disease is diagnosed with osteochondrosis, deforming spondylosis, anomalies in the development of vertebral segments:

sacralization;
spondylolisthesis;
accessory ribs;
vertebral aplasia.

The trigger for the occurrence of the inflammatory process can be hypothermia, spinal injury, respiratory, urogenital pathologies, neuroviral diseases complicated by radicular syndrome, for example, tick-borne encephalitis. Painful sensations appear when lifting heavy objects, awkward movements, infections, colds, due to stretching or rupture of the fibrous disc ring. The gelatinous disc is displaced, which provokes the formation of an intervertebral hernia. An extended disc and bone growths put pressure not only on the spinal roots, but also on nearby tissues.

Classification

It is customary to distinguish two forms of radiculitis:

acute - characterized by intense pain symptoms and lightning-fast development;
chronic - characterized by exacerbations due to sudden movements or hypothermia, arising as a result of the lack of treatment for the acute form of the disease.

Depending on the location of the lesion, the following types of lumbar radiculitis are distinguished:

lumbar - characterized by pain symptoms in the lumbar region, accompanied by pain and stiffness of movement;
lumbosacral - accompanied by pain symptoms in the sacral area, which intensifies with walking and bending and radiates to the buttock, lower leg and heel.

Depending on the etiology of lumbar radiculitis, there are:

primary - occurs as a result of inflammatory processes of the spinal root;
secondary - occurs as a result of compression of the spinal root.

What complications can there be?

Spinal cord ischemia can lead to disability.
Radiculitis is rarely accompanied by negative consequences. Complications are caused by untimely consultation with a doctor, late start of therapy, prolonged compression of the nerve roots, impaired nutrition of the nerves and blood circulation in the spinal column. Against this background, it joins:

heart attack, ischemia of the spinal substance;
inflammatory process in the meninges (epiduritis, arachnoiditis);
hemiparesis, paraparesis;
atrophic paralysis.

There is no need to assume that self-medication of radiculopathy will help get rid of the pathology. The clinical picture requires an integrated approach and qualified assistance.

Clinical manifestations

Symptoms of lumbar radiculitis appear as follows:

Severe pain in the lumbar region, which has an aching, burning character and radiates to the buttocks, thigh, and lower leg, intensifying with changes in body position and movements;
pronounced, intense, “stripe-like” pain in the leg, often along the back or outer surface of the thigh and lower leg.
increased pain in the leg when changing body position;
weakness in the leg, foot; determined when trying to walk on tiptoes or heels;
decreased sensitivity in the leg, feeling of numbness, frozenness in the leg;
lameness in the leg caused by the desire not to put stress on the affected area.
curvature in the lumbar spine.
discomfort or pain when the body is in a sitting or standing position;
reduction of pain in the position of lying on the side with the sore leg tucked to the stomach;
thinning, drying, hypotrophy of the muscles of the thigh, buttocks, legs;
limited mobility in the lower back;

Prevention of radiculopathy

You need to avoid lifting weights or do it correctly.
In order not to waste money on medications and not to consult a doctor to determine the cause and methods of treating pain, it is recommended to take timely care to prevent radiculopathy.

First of all, these are courses of physiotherapeutic procedures, daily contrast showers, vibroacoustic massage using special devices. In the latter case, the level of exposure is easy to dose yourself, so you can carry out the procedure at home.

To eliminate the risk of developing provoking diseases, it is necessary to eliminate a sedentary lifestyle, avoid injury to the spinal column and rationally distribute physical activity. It is recommended to sit with a straight back, do not slouch; it is better to purchase a chair or a chair with a high orthopedic back for work.

In the morning you need to do exercises that last at least 10-15 minutes. This will allow you to develop your spine and prepare your muscles and bone structures for physical activity throughout the day.

If your job requires you to sit most of the day, you need to take breaks from time to time, during which you can bend, twist your body, and do other simple movements.

Diagnostics

Diagnosis of lumbar radiculitis is carried out in different ways. When conducting an examination by a neurologist, special attention is paid to the following:

MRI of the spine

Cost: 16,000 rub.

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to the “drawing” of pain in the leg along the distribution of the nerve, the root in the form of a strip, a stripe from the lower back, the buttock along the thigh, the lower leg to the foot; the pain is persistent and debilitating, disrupts the ability to work and the normal course of life, and leads to physical and mental suffering.
to reduce or suppress tendon reflexes on the legs: knee, Achilles;
decreased strength in the leg: difficulty or inability to walk on toes or heels, instability in the knee.
to reduce sensitivity in the foot, leg, thigh;
increased pain in the lower back, buttock, thigh, lower leg when changing body position or moving;
for curvature, scoliosis in the lumbar spine;
the inability to walk due to pain and forced position in bed with legs bent to the stomach;
the disappearance of the natural deflection, lordosis in the lumbar spine, the lower back becomes flat or even arches at the back;
the inability to raise a straight leg up to 90 degrees to the horizontal while lying on your back, this provokes and increases pain in the leg and back;

Magnetic resonance imaging and computed tomography make it possible to accurately determine the changes that have occurred in the spine and visualize the cause of compression of the roots, most often it is a herniated disc or spinal canal stenosis.

Radiculitis

This is more likely not a diagnosis, but a symptom of previous diseases. He rarely appears on his own. In this condition, the nerve roots become inflamed. And the reason may be their compression by an intervertebral hernia or growths. With radiculitis, there is acute pain that is felt along the entire nerve. Sharp attacks occur - “lumbago”. But the sensations are not constant and may disappear when changing body position. The pain is sometimes accompanied by dizziness, nausea, and numbness of the limbs.

If osteochondrosis is left untreated for a long time, the cause of an attack of radiculitis may be:

excessive load on the damaged part of the spine;
injury (bruise, sprain);
hypothermia, which results in a narrowing of the capillaries and, as a result, the intervertebral disc loses its shock-absorbing properties and the radicular nerve is injured;
stress factors and emotional overstrain - the hormone cortisol enters the blood, the capillaries narrow and the nutrition of the disc is disrupted, as a result an inflammatory process develops;
bad habits (smoking, alcohol);
overweight.

All these conditions require mandatory treatment, without which it will be very difficult to cope with them. To determine the causes and signs of pathology, a visual examination is not enough. Magnetic resonance imaging and radiography will help make an accurate diagnosis. These examinations will show the condition of the spine, the location and size of the hernia or processes.

Reviews of doctors providing the service – Lumbar radiculitis

In 2000, Andrei Arkadyevich performed spinal surgery on me.
Four days in the clinic and I have been living a full life for 20 years without restrictions on movement and I remember with gratitude Dr. A.A. Khodnevich. God bless him. And in 2000 he could walk no more than 10 meters. Read full review Viktor Alexandrovich

20.05.2020

Low bow to Alexander Semenovich Bronstein and Andrei Arkadyevich Khodnevich. I arrived at CELT on July 2, 2021 with extreme pain that I endured for 10 days. Hernia C6-C-7. I was given two blockades in Ivanovo, about 9 complex IVs, I lost 6 kg in a week and was in a panic, I didn’t see a way out and nothing happened to me... Read full review

Elena Nikolaevna L.

20.10.2019

Treatment

Treatment of radiculitis by CELT specialists is successfully carried out using conservative and surgical methods. They can not only eliminate pain, but also reduce inflammation, relieve muscle spasms and free the roots from compression. The following methods are used for this:

Methodology	Description
Treatment with medications	intramuscular injections of “Dolobene” for 5 days and switching to “Diklak” tablets (5 times a day, 100 mg for 10 days); intramuscular injections of "Tolperil" 2 times for 10 days and switching to tablets (2 times a day, 100 mg for 30 days); intramuscular injections of Neurobion for 10 days; intramuscular injections of “Mukosat” every other day, a total of 20 injections, followed by taking “Chondroethin sulfate” tablets for 3 to 6 months; patch with diclofenac on the lower back for 5 to 7 days.
Limitation of physical activity	wearing an orthopedic corset
Manual therapy	therapeutic massages
Physiotherapeutic treatment	electrophoresis; acupuncture; exercise therapy; healing magnets.
Surgical techniques	spinal root decompression

A procedure such as a blockade, which is a special injection into the source of pain using local anesthetics and anti-inflammatory drugs, allows for an almost instantaneous effect that can last up to one year. It is achieved by introducing the drug into the affected area. In this case, the patient can go home on the same day and live a normal life.

Similarities and differences between treatment methods

The treatment methods for osteochondrosis and radiculitis are quite similar. One of the differences is the need for antiviral treatment, antibiotic therapy, and detoxification measures for radiculitis of toxic or infectious etiology. In other cases, patients are advised to take drugs with anti-inflammatory, analgesic, and anti-edematous effects:

nonsteroidal anti-inflammatory drugs (NSAIDs) - Ketoprofen, Nimesulide, Diclofenac, Ibuprofen, Celecoxib;

muscle relaxants - Sirdalud, Baclofen, Mydocalm.

Drug blockades are usually indicated for the relief of acute pain in osteochondrosis. Glucocorticosteroids (Triamcinolone, Diprospan, Dexamethasone) are used in combination with anesthetics (Lidocaine, Novocaine). To eliminate acute painful attacks of radiculitis, intravenous or intramuscular administration of analgesics is practiced.

After reducing the intensity of the painful sensation, patients are recommended to use local remedies. These are gels with NSAIDs (Fastum, Voltaren, Nise, Ketorol) and ointments with a warming effect (Capsicam, Finalgon, Apizartron, Viprosal, Nayatox).

The pepper patch has proven itself well in the treatment of radiculitis and osteochondrosis of any location. The transdermal agent relieves pain within a few hours after application due to its local irritating effect.

Physiotherapeutic procedures are actively used in the treatment of pathologies - UHF therapy, laser therapy, magnetic therapy, applications with ozokerite, paraffin, baths with mud or mineral waters.

Laser therapy is part of the treatment of spinal pathologies.

For osteochondrosis of 3, 4, and sometimes 2 degrees of severity, patients undergo surgery. Surgical intervention is also indicated for radiculitis complicated by paralyzing sciatica caused by compression of the cauda equina and the development of dysfunction of the pelvic organs.

Surgical intervention

Operations for diseases of the spine

Cost: 100,000 - 250,000 rubles.
Duration: 40-60 minutes
Hospitalization: 2-3 days in hospital

More details

Surgical intervention is carried out exclusively according to indications:

lack of effect from conservative treatment;
inhibition of tendon reflexes;
feeling of weakness in the lower limb;
decreased sensitivity of the lower limb.

Neurosurgeons at the CELT multidisciplinary clinic perform gentle operations through micro-incisions or punctures while preserving all supporting structures of the spine. Three-dimensional modeling of the operation and planning of each stage are carried out in advance. The process uses microsurgical and endoscopic techniques, laser and ultrasound, which allows our patients to quickly recover and return to work within two to three weeks after surgery.