Neuro - radiculopathy (cervical and lumbar)

Question 1

radiculopathy

Answer 1

conduction is limited or blocked along a spinal nerve or its roots

Question 2

radicular pain causes

Answer 2

compression of nerve root
cervical disc herniation
degenerative spondylotic changes

Question 3

what is cervical radiculopathy?

Answer 3

pain and weakness +/- numbness in one or both arms corresponding to dermatome of involved cervical root

Question 4

age prevalence

Answer 4

50-54 years

more common in men

Question 5

assessment

Answer 5

exclude red flags
ask about symptoms
examine for signs

Question 6

what % improve within 4 weeks with no operation?

Answer 6

88

Question 7

what tests can be done?

Answer 7

spurling test
arm squeeze test
axial traction

Question 8

management

Answer 8

reassurance, info, advice
oral analgesics
offer amitriptyline, gabapentin
muscle relaxant/physio

Question 9

cervical radiculopathy >4-6 weeks

Answer 9

MRI

Question 10

red flags

Answer 10

fever 
neck stiffness 
LN
Nausea and vomiting 
pain disturbs sleep 
skin erythema
neurological problems 
LHermitte's

Question 11

sciatica

Answer 11

pain, tingling and numbness arising from nerve root compression in lumbosacral spine

Question 12

cause of sciatica

Answer 12

herniated IV disc - 90%
spinal stenosis
spondylolisthesis

Question 13

risk factors - sciatica

Answer 13

heavy lifting, strenuous activity

whole body vibration eg driving

Question 14

complications of sciatica

Answer 14

permanent nerve damage

loss of employment

Question 15

what test is positive in sciatica?

Answer 15

straight leg raising test

Question 16

differential diagnosis - sciatica

Answer 16

OA
ankylosing spondylitis 
trochanteric bursitis 
peroneal palsy 
myelopathy

Question 17

sciatica risk stratfication tool

Answer 17

STarT Back - modifiable risk factors for back pain disability