Diagnosis
The diagnosis of nerve root irritation is in many cases already a clinical diagnosis. This means that a physician can make it already by questioning the patient (anamnesis) and his typical symptoms. The reflexes of the affected area should also be checked routinely and additional tests should be carried out.
Only if this is not sufficient to confirm a clear finding, or if one suspects a rather rare cause, will one resort to the help of imaging techniques. Magnetic resonance imaging (MRI) is the method of choice for diagnosis. Under certain circumstances, computer tomography (CT) is also used.
MRI and/or CT images then show the intervertebral discs particularly clearly and, in addition to the diagnosis of nerve root irritation, often make it possible to identify the cause. Depending on the patient’s symptoms, in rare cases a conventional x-ray or a special MR myelography may also be considered, but a physician will decide and inform the patient individually. If there is suspicion of an acute inflammation in the spinal canal or in the brain as the cause of the nerve root irritation, a puncture of the cerebrospinal fluid (liquor cerebrospinalis) is also performed to confirm or exclude an inflammation.
Therapy
In the majority of cases, nerve root irritation is treated conservatively with drugs. Anti-inflammatory drugs (anti-inflammatory drugs), cortisone preparations, muscle tension-reducing agents (myotonolytics) or local painkillers (analgesics) are available. Pain that cannot be relieved, or only slightly, by these drugs is sometimes improved by taking certain antidepressants.
In addition, the patient should be accompanied by physiotherapy. In the case of large herniated discs or untypical causes, surgery can be another alternative to treatment. This is preferably – if at all – done by microsurgery.This means with the least possible injury and risk. There is no clear evidence in scientific studies for the use of acupuncture against nerve root irritation or the so-called TENS therapy, which suggests nerve stimulation for symptom relief. Nevertheless, some patients report extraordinary treatment success under these therapies.
