Radiculopathy
Radiculopathy is a clinical condition that occurs when a nerve root is compressed, pinched, or irritated as it exits the spinal column. Because the nerve root serves as the gateway between the spine and the rest of the body, symptoms typically radiate along the pathways of the peripheral nervous system. Rather than staying in the back or neck, symptoms often travel into the arms or legs as sharp pain or described as a burning or shooting pain.
At Rivercity Brain & Spine, patients are cared for by Dr Joseph Garcia Redmond, who has specialised training in minimally invasive spine surgery. For patients experiencing severe symptoms of nerve root compression that have not resolved with conservative care, a specialist assessment can help identify the underlying cause and determine a suitable clinical pathway to support long-term function and relief.
Types of Nerve Compression
Radiculopathy is categorised based on where the compressed nerve root is located in the spine. The location dictates the affected nerve and where a patient will feel symptoms:
Cervical Radiculopathy
Cervical radiculopathy happens when a nerve root in the cervical spine (the neck) is compressed. It is typically caused by structural changes in the neck and often leads to neck pain accompanied by radiating arm pain, numbness, or weakness in the upper extremity.
Thoracic Radiculopathy
This involves compression in the mid-back. It is the least common form and may cause pain that radiates around the chest or abdomen.
Lumbar Radiculopathy
Affecting the lower back, this form of radiculopathy occurs when a lumbar nerve root in the lumbar spine is compressed. Often referred to as lumbosacral radiculopathy or sciatica, it frequently affects the nerve roots that form the sciatic nerve, causing radiating pain down the buttock and leg.
Radiculopathy Symptoms, Causes and Risk Factors
The specific radiculopathy symptoms a patient experiences depend on the severity of the root compression. Alongside pain, patients may also experience tingling (pins and needles), numbness, or progressive muscle weakness in the affected limb.
Patients may develop radiculopathy due to a variety of anatomical changes within the spine. Common risk factors and underlying causes include:
Herniated Disc: When the soft inner disc material pushes through a tear in the outer layer of the intervertebral disc, protruding into the spinal canal and compressing the adjacent nerve.
Degenerative Disc Disease: Natural wear and tear where a degenerated disc loses height, narrowing the disc space and reducing the room available for nerves.
Foraminal Stenosis: A narrowing of the bony openings where nerve roots exit the spine.
Bone Spurs: Extra bone growth, often forming on the facet joints, or in the neck, or, in the neck, the uncovertebral joints, in response to joint instability or wear.
Individuals with a history of heavy physical labour, spinal trauma, or a family history of spinal degeneration may be at a higher risk of developing these conditions.
How We Diagnose a Compressed Nerve Root
During your assessment for radiculopathy, Dr Garcia Redmond will conduct a comprehensive clinical evaluation to map your symptoms to the specific affected nerve root.
Physical Examination: A detailed physical exam involves assessing muscle strength, reflexes, and sensory changes. Dr Garcia Redmond may also use provocative tests (specific movements designed to reproduce symptoms) to confirm nerve compression.
Imaging Tests: High-resolution MRI scans are typically used to visualise soft tissues, nerves, and discs. X-rays, including flexion and extension views, can help assess spinal alignment, while CT scans provide detailed images of bony structures.
Electrodiagnostic Studies: Tests such as Electromyography (EMG) or nerve conduction studies may be ordered to measure nerve electrical activity. These are particularly useful to distinguish spinal radiculopathy from peripheral neuropathy or nerve compression elsewhere in the limb, such as carpal tunnel syndrome.
How to Treat Radiculopathy
The goal when we treat radiculopathy is to alleviate pressure on the nerve and manage symptoms. This is achieved through a carefully considered, staged approach.
Conservative Treatments
In many cases, mild nerve irritation from bulging discs will see symptoms improve naturally. It is common to see radiculopathy improve over a few weeks to months with targeted non-surgical treatments.
First-line conservative treatments typically include:
Physiotherapy and targeted exercises to strengthen the paraspinal muscles supporting the spine.
Activity modification and maintaining a healthy weight.
Medications such as non-steroidal anti-inflammatory drugs (NSAIDs) or short courses of oral steroids to manage flare-ups, while avoiding heavy reliance on opioid pain medications.
Targeted steroid injections mixed with a local anaesthetic to directly reduce inflammation around the nerve root.
Surgical Decompression Options
If a patient experiences persistent symptoms that disrupt daily life despite conservative care, or if they present with progressive muscle weakness, surgical treatment may be evaluated. Surgical decompression aims to physically create more room for the nerve.
Depending on individual anatomy, other symptoms, and any prior surgery, options may include:
Endoscopic Spine Surgery: A minimally invasive (keyhole surgery) technique that uses a high-definition camera and specialised micro-instruments to access and decompress the nerve root through a very small incision.
Microdiscectomy: A minimally invasive surgery to remove herniated disc material. This often utilises a muscle-splitting approach rather than wide tissue cutting.
Foraminotomy: Enlarging the lateral edge of the neural foramen (where the nerve exits) by removing bone spurs or other tissue narrowing the opening.
Anterior Cervical Discectomy and Fusion (ACDF): Removing the damaged disc through an anterior approach (from the front of the neck) and fusing the vertebrae to stabilise the segment, relieving compression in the cervical spine.
Surgical Risks
It is important to note that while surgery is designed to help manage pain and limit the risk of further neurological decline, all spinal surgeries carry inherent risks.
Potential complications include:
Infection
Bleeding
Dural tears
Nerve injury
Incomplete symptom relief
The need for further surgery
These risks are carefully discussed during your consultation.
When to Seek Immediate Medical Attention
While many cases of radiculopathy are managed routinely, certain symptoms require urgent medical assessment. Seek emergency medical care immediately if you experience:
A sudden loss of bladder or bowel control
Numbness in the "saddle" area (groin and inner thighs)
Severe weakness in both legs, or rapidly progressive weakness in any limb
Symptoms of spinal cord compression, such as difficulty walking, hand clumsiness, or sudden balance problems
These "red flag" symptoms can indicate a severe level of compression (such as Cauda Equina Syndrome) that may require urgent surgical intervention.
Why Choose Rivercity Brain & Spine
Dr Garcia Redmond has specialised training in minimally invasive spine surgery and treats a wide range of spinal and peripheral nerve conditions. The practice focuses on an evidence-based, multidisciplinary approach – emphasising non-surgical treatment when appropriate, and reserving advanced, minimally invasive surgical techniques for cases where clinical indications demonstrate clear potential benefit.
Patient-centred decision-making ensures you understand all options, risks, and expected recovery timelines before proceeding with any treatment.
SCHEDULE A CONSULTATION
Radiculopathy Treatment in Brisbane
If you are experiencing persistent radiating pain, numbness, or weakness that has not improved with conservative therapies, a specialist assessment can help determine the underlying cause. You may request a consultation with a referral from your general practitioner to discuss your clinical indications and treatment options with Dr Garcia Redmond.