Radiculitis(redirected from Radicular pain)
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the most common disease of the peripheral nervous system in man, resulting from inflammation of the root of a spinal nerve. The disease is caused by traumas and metabolic disturbances and, in the case of multiple inflammations (polyradiculitis), by intoxications.
Depending on the level at which the roots are affected, a distinction is made between cervical, cervicobrachial, thoracic, and lumbosacral radiculitis; all may be acute or chronic. In cervical radiculitis, which involves the upper cervical roots, pain is localized in the region of the occiput and neck and intensifies when the person turns the head or coughs; a protective reflex position develops in which the head is tilted back. When cervical radiculitis develops from osteochondrosis or spondylosis, the root pains may be combined with dizziness, disturbance of hearing, staggering gait, and other symptoms of insufficient blood supply to the brain. With cervicobrachial radiculitis, in which the lower cervical and upper thoracic roots are affected, the intense, often shooting, pain is localized in the region of the neck and shoulder girdle and in the arms. The pain intensifies sharply when the person moves his arms, coughs, or turns or bends his head. With thoracic radiculitis, in which the middle and lower thoracic roots are affected, the paroxysmal girdle pain along the intercostal nerves intensifies with movement or deep inhalation. Neurological examination reveals characteristic symptoms that depend on the level of affection.
Lumbosacral radiculitis, which involves the lumbar and sacral roots, is the most common form of the disease. It often results from such degenerative processes of the intervertebral disks, ligaments, and joints of the spinal column as osteochondrosis or herniated disk. The course tends to be chronic, with recurrences. Various types of pain are localized in the lumbosacral region and along the sciatic nerve. The pain intensifies when the person moves, walks, or bends. Pain in the paravertebral areas of the spinal column’s lumbosacral region and symptoms of tension of the roots and the sciatic nerve are indicators of the disease. Also common are deviation of the spine (scoliosis—a reflex posture to avoid pain), reduction of the knee reflex, absence of the Achilles tendon reflex, and disturbances in sensitivity.
Treatment depends on the disease’s cause and the stage to which it has progressed. Radiculitis is treated by analgesics, Novocain blockades, such irritants as bee or snake venom, B-complex vitamins, such biogenic stimulants as aloe and vitreous body, and anticholinesterases. When radiculitis is caused by dystrophic changes in the spine, it is treated by various forms of traction and such physiotherapeutic procedures as ultraviolet radiation, diadynamic currents, ultrasound, electrophoresis with drugs, inductothermy, and radon and mud baths. Other methods include exercise therapy, massage, acupuncture, and sanatorium and health resort treatment. Radiculitis caused by the slipping of an intervertebral disk requires surgical treatment (removal of the herniated disk) if conservative measures are ineffectual or if there is an increase in symptoms of pressure on the roots and other complications.
REFERENCESMnogotomnoe rukovodstvopo nevrologii, vol. 3, book 1. Moscow, 1962.
Kanareikin, K. F. Poiasnichno-kresttsovye boli. Moscow, 1972.
V. B. GEL’FAND