Nerve Root Compression: Causes, Symptoms, Treatment

As stated, Nerve Root Compression is a condition in which the nerve roots get compressed usually due to a disc herniation causing pain and paresthesias in the muscles innervated by the nerve roots. To diagnose Nerve Root Compression comprehensive tests like detailed neuroimaging, EMG and NCV testing is done. The treatment of Nerve Root Compression is dependent on the severity of the compression and may vary from just pain medications, steroid administration and close observation to even surgical decompression of the nerve.

Some of the Causes of Nerve Root Compression Include:

• Disc herniation
• Bony changes due to conditions like rheumatoid arthritis or osteoarthritis of the cervical or lumbar spine which can also cause nerve root compression
• Some of the rare causes of Nerve Root Compression are medical conditions like meningitis, epidural abscesses, tumors, meningiomas which can also cause Nerve Root Compression.

The characteristic symptom of a Nerve Root Compression is pain along with neurologic abnormalities in the affected region. The muscles in these regions become weak and atrophied. The muscles also get flaccid and have fasciculations. If the sensory roots are involved then there will be sensory abnormalities in a dermatomal distribution. There may be accompanying hyporeflexia. The pain experienced will be exacerbated by any movement which puts pressure on the nerves like coughing, sneezing, or with Valsalva maneuvers.

• Abrupt change in sensation across the spine
• Paraparesis
• Hyporeflexia below the site of compression
• Sphincter dysfunction.

In order to diagnose a Nerve Root Compression, the best way is to perform neuroimaging and electrodiagnostic tests. An MRI or CT scan can also identify a compressed nerve. EMG is done to localize the nerve root affected. In case if the above tests are inconclusive then a CSF analysis is done to find the cause of Nerve Root Compression.

Some of the measures to treat Nerve Root Compression are as follows:

• Pain medications like acetaminophen and NSAIDs for pain relief.
• Muscle relaxants and topical treatments can also be beneficial at times though not always.
• Steroid administration in case pain medications are not effective
• Tricyclic antidepressants have also shown to be beneficial for pain relief in some cases
• Other alternative forms of treatment like electric nerve stimulation, acupuncture, chiropractic treatments are also beneficial.
• If all conservative treatments fail to relieve pressure on the nerve roots then a surgical procedure called spinal decompression surgery is done, although it has shown to be effective in only about 75% of cases.