Nerve root pain

Nerve root pain originates from nerves that have been damaged or are compressed in the spine. Nerves carry information that control body movements and sensations to the brain. When a nerve in the spine is damaged it can cause pain, increased sensitivity, numbness and muscle weakness. Pain can originate from multiple nerve roots. Radicular pain refers to pain that comes from one single nerve root.

Types of nerve root pain include: 

• Lumbar nerve pain (sciatica): Lumbar nerve pain can be a combination of back and leg pain, with pain worse in the leg below the knee. Usually caused by a slipped disk.
• Brachial neuralgia: Brachial neuralgia originates in the nerves of the neck, causing pain in the arm or radiating down the arm into the hands and fingers.

Nerve root pain is often described as burning or sharp, stemming from the back and traveling to other parts of the body connected to the damaged nerve.

Nerve root pain symptoms may include:

• Tingling or numbness
• Weakness of muscles
• Increased sensitivity
• Pain in the back, neck, and limbs

Nerve root pain is often caused by other underlying conditions that have caused compression or damage to the nerve root.

Causes of nerve root pain may include:

• Arthritis
• Bone spurs
• Inflammatory disease
• Degenerative spinal conditions, such as spinal stenosis
• Herniated discs
• Spondylosis
• Abnormalities, such as tumors, cysts, hernias, and hematomas
• Spinal injury or infection

A careful physical exam and a review of your medical history is the first step in diagnosing nerve root pain. Your physician will check for any numbness or loss of feeling you may be experiencing, muscle reflexes, muscle strength and posture.

Other diagnostic tests your doctor may recommend include:

• Spine MRI scan to determine soft tissue damage to the ligaments and discs, and assess spinal cord injury
• X-rays to show the alignment of the bones along your neck and determine any narrowing or damage to the discs

Nerve root pain can be easily treated with medication or physical therapy. In some cases, the symptoms get better over time and do not require treatment. At Penn, physicians begin with conservative, non-surgical approaches to treat nerve root pain. When non-surgical treatments do not work and an individual's condition does not improve, surgery may be the next best step to treat underlying conditions causing nerve root pain.

Non-surgical treatment for nerve root pain may include:

• Taking non-steroidal anti-inflammatory drugs (NSAIDs)
• Interventional techniques such as nerve blocks (spinal injections)
• Epidural injections in the lumbar and cervical spine
• Nerve killing procedures such as radiofrequency ablation
• Engaging in exercise and physical therapy
• Activity modification

Surgery to treat conditions causing nerve root pain may include:

• Spinal decompression surgery
• Spinal Fusion
• Foraminotomy
• Disc replacement surgery