Radiculopathy — commonly referred to as a “pinched nerve” — occurs when a spinal nerve root is compressed or irritated, producing pain, altered sensation, or weakness that radiates along its distribution. Accurate diagnosis requires identifying the specific nerve root and structural cause. Dr. Andrew Bishara evaluates and manages cervical and lumbar radiculopathy in Sugar Land, TX, serving Fort Bend County.
Radiculopathy occurs when a spinal nerve root is compressed, stretched, or irritated — most commonly by a herniated disc, osteophyte (bone spur), foraminal stenosis, or degenerative disc disease. The symptoms appear not at the compression site, but along the path of the affected nerve.
Cervical radiculopathy affects the neck and produces symptoms into the shoulder, arm, or hand. The specific pattern of pain, numbness, and weakness corresponds to the compressed nerve root level (C5, C6, C7, C8).
Lumbar radiculopathy affects the lower back and produces symptoms into the buttock, thigh, calf, and foot. The most common levels are L4, L5, and S1 — with L5–S1 disc herniation being a frequent cause of classic sciatic nerve symptoms.
Sharp, burning, electric, or shooting pain that travels from the spine into the arm or leg along the path of the compressed nerve root.
Loss of sensation, pins and needles, or tingling in a specific region of the arm or leg corresponding to a dermatome.
Weakness in specific muscles innervated by the compressed nerve root — such as grip weakness (C8), shoulder abduction weakness (C5), or foot drop (L4/L5).
Reduced or absent deep tendon reflexes — biceps (C5), brachioradialis (C6), triceps (C7), patellar (L4), or Achilles (S1) — indicating nerve root compromise.
Cervical radiculopathy often worsens with neck extension and ipsilateral rotation; lumbar radiculopathy worsens with sitting, bending, or sustained loading.
Nocturnal pain or inability to find a comfortable sleeping position is common in moderate to severe radiculopathy.
Radiculopathy diagnosis requires identifying the specific nerve root level, severity, and structural cause — which requires systematic clinical examination combined with imaging when indicated.
Spurling’s compression test (cervical), Kemp’s test (lumbar), straight leg raise, femoral nerve stretch, and other provocation tests help identify the specific nerve root involved and reproduce radicular symptoms.
A complete neurological examination maps the dermatomal sensation pattern, tests each myotome for weakness, and assesses deep tendon reflexes — building a precise clinical picture of nerve root involvement.
MRI is the primary imaging modality for radiculopathy — identifying disc herniation, foraminal narrowing, or other structural compression. X-rays provide bony detail and alignment assessment. NCV/EMG may be coordinated to objectively quantify nerve root function.
Nerve conduction velocity and electromyography studies can confirm radiculopathy, determine chronicity, and quantify the degree of nerve injury — particularly valuable when clinical and imaging findings are inconsistent.
Treatment targets the specific vertebral level and structural cause identified through examination and imaging — not generic protocols.
Chiropractic adjustments, manual therapy, and targeted rehabilitative care aimed at reducing nerve root irritation and restoring function.
Neurological status is reassessed at each visit. Any worsening of deficits prompts immediate escalation — conservative care is never continued when neurological compromise is progressing.
When conservative management fails or neurological deficits are significant, referral to pain management for epidural steroid injection, or to spine surgery for decompression, is coordinated without delay.
Radiculopathy requires accurate diagnosis before treatment. Dr. Bishara performs neurological evaluation for nerve root conditions in Sugar Land, TX.
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