Radicular syndrome

Description:

Radicular syndrome — quite frequent neuralgic syndrome which includes the complex of symptoms resulting from squeezing (compression) of spinal roots (spinal nerves). The radicular syndrome can be shown in the form of pains in absolutely different places: in a neck, extremities, a waist and even in internals, for example, in heart or a stomach.

Symptoms of the Radicular syndrome:

The radicular syndrome arises not at once, as a rule, to it conducts long degenerative process in intervertebral disks which comes to an end with herniation. In turn hernia, expanding and, being displaced, can damage a spinal root and a ganglion that leads to its squeezing and development of inflammatory reaction, the radiculopathy, a radicular syndrome as a result develops.

Standard tool diagnostic method of a radicular syndrome include a backbone X-ray analysis in front and side projections. For today the most sensitive and informative diagnostic method of pathology of a backbone is the magnetic and resonant tomography. However at installation of the diagnosis a radicular syndrome an important role is played by clinical symptoms.

The first and most characteristic sign of a radicular syndrome is pain on the course of the interested nerve. So, process in cervical department of a backbone causes neck and hand pains, in chest — in a back, sometimes there are feelings of characteristic heartaches or in a stomach (such pains pass only after treatment of a radicular syndrome), in lumbar — in a waist, buttocks and the lower extremities and so on. At the movement or rise in weight of pain amplify. Sometimes pain happens in the form of the lumbago giving to different parts of a body according to an arrangement of the corresponding nerve, in a waist such lumbago is called a lumbago. Pain can be also a constant, but it all the same amplifies at any careless movement (for example, a lyumbalgiya — pain in a waist). Attacks of pain can be provoked by physical or emotional pressure, overcooling. Sometimes pains arise at night or during sleep, are followed by reddening and a cutaneous dropsy, the increased perspiration.

Other sign of a radicular syndrome is disturbance of sensitivity in a zone of an innervation of this nerve: at an easy pricking the needle in this zone notes sharp decrease in sensitivity in comparison with similar area on the opposite side.

The third sign of a radicular syndrome — disturbance of movements which appear at changes in the muscles arising against the background of damage of the innervating their nerves. Muscles dry out (atrophy), become weak, sometimes it is visible even approximately, especially, when comparing two extremities.

Pain is localized in the field of a prelum of a root and in those bodies which are innervated by the injured spinal nerve. For example, at defeat of a root at the level of 5 of a lumbar vertebra (L5) pain is determined in lumbar area (lyumbalgiya), when walking — in an upper outside quadrant of a buttock, irradiirushchy by the outside surface of a hip and shin to the II—IV fingers of foot (lyumboishalgiya). At damage of a root of L4 pain extends from a buttock through the front surface of a hip and the anteriointernal surface of a shin to an internal part of foot.

As motive shoots of neuron and sensitive nerve fibrils are a part of a spinal root, at a radicular syndrome there can be a disturbance (decrease) in sensitivity of fabric. For example, at a radicular syndrome of L5 sensitivity of skin (hypesthesia) in the field of the outside surface of a hip, a shin decreases.

Reasons of the Radicular syndrome:

Osteochondrosis is the main reason for development of a radicular syndrome. However this syndrome can develop because of spinal hernia, a spondylarthrosis, a compression fracture of vertebras (at osteoporosis), spondylolistheses, development of a tumor (neurinoma), laterposition of bodies of vertebrae, squeezing of a root side osteofitamiya, and also infectious damage of vertebras (osteomyelitis, tuberculosis).

Treatment of the Radicular syndrome:

The basic principles of treatment of a radicular syndrome include a high bed rest on a firm surface, reception of the anesthetizing drugs (Baralgin, Ketorol), non-steroidal anti-inflammatory drugs (the Nurofen, Diclofenac, Ketonal, Movalis) and local irritants (ointment Finalgon, ointment Kapsikam, ointment of Nikofleks, a pepper plaster). At the expressed spasm of a muscle apply muscle relaxants — Mydocalmum, Sirdalud, Pentoksifillin. Carrying out epidural blockade using anesthetics (anesthetics) is possible. Purpose of antikonvulsant and antidepressants — according to indications.

As the radicular syndrome is followed not only the acute, but also chronic aching pains, at treatment of this disease it is necessary to consider duration of course purpose of NPVS and analgetics. As a rule, medicines of this group have a number of the side effects increasing at prolonged use therefore at therapy of chronic pain it is necessary to apply more sparing methods — reflexotherapy, manual influence, physical therapy (an electrophoresis, фонофорез), massage, the remedial gymnastics, a diet (directed to weight reduction and removal of salts).

Medicamentous measures consist in purpose of vitamins of group B (B6, B12, B1, a complex of Neyromultivit, Magne-B6), hondroprotektor (Struktum, Hondroksid (таб.), Hondrotek, Terafleks, Artra), NPVS for external use (Mataren plus cream, Ketonal cream, Fastum-gel).

Sometimes the patients suffering from a radicular syndrome accept muscle relaxants in hope that drugs will kill muscular spasms and pains accompanying them. However it is necessary to remember that muscle relaxants can be applied only on doctor's orders, otherwise medicine can do more harm, than advantage.

In some cases for treatment of a radicular syndrome surgical intervention is shown.

Measures of prevention of development of a radicular syndrome include primary prevention of degenerative processes in a backbone, strengthening of a muscular framework of a back by means of LFK and massage, and also normalization of weight.