Definition
Nerve root compression describes the mechanical irritation of the root of a spinal nerve in the area of the spine. The clinical picture described in medicine as “root compression syndrome” is characterized by its typical back pain, as well as the radiation of the pain into the body region supplied by the nerves. However, it can also lead to muscle weakness and paralysis.
Causes
Root compression syndrome can have various causes. For example, fractures of the vertebral body or fractures of the vertebral arch, but also bleeding (haematomas) or infectious processes can lead to pinching of spinal nerve roots. In very rare cases, a tumor, for example of the spinal cord skin, can also cause root compression.
By far the most nerve root compressions, however, are caused by degenerative processes, i.e. wear and age-related. Both changes in the bony structures of the spinal column and its soft tissues can be subject to these changes. For example, arthrosis of the small vertebral joints can lead to a narrowing of the intervertebral hole through which a spinal nerve emerges, either directly or through the resulting new bone formation.
More often, however, herniated discs can be identified as the cause of nerve root irritation. Here, the outer fibrous ring of an intervertebral disc can no longer stabilize the centrally located gelatinous core, so that it bulges and exerts pressure on nerve structures. Understandably, the pressure on the structures of the spinal column increases steadily with increasing distance from the head (at least when standing and sitting) until it reaches its maximum at the level of the lumbar spine. The spinal column has partially adapted to this load, so that the diameter of vertebrae and intervertebral discs increases steadily towards the legs. Nevertheless, the majority of nerve root compression occurs in the lumbar region.
Symptoms
The main symptom of compression of spinal nerve roots is primarily their characteristic pain. In the case of already advanced damage to the nerve root, further symptoms include sensitivity disorders in the respective dermatome. These are the skin areas that are supplied by a spinal nerve.
These sensory disturbances include numbness, tingling or temperature sensation disorders. Severe nerve root compression also leads to damage of the motor fibers located in the center of the nerve. This results in a weakness of the muscles it supplies, whereby the leg muscles are usually affected.
At the same time, this results in a weakening of the muscle reflexes. Very severe forms of root compression syndrome can even lead to paralysis. Depending on the level of nerve root compression in the spine, advanced nerve damage can also result in urinary or fecal incontinence.
Both incontinence and paralysis are medical emergencies and require the fastest possible treatment! The symptoms of nerve root compression can be very similar to those of nerve root inflammation. Therefore, inflammation of the nerve root is an important diagnosis, which cannot always be clearly distinguished from compression.
The nerve root compression syndrome is mainly characterized by its characteristic back pain. It is triggered by inflammatory processes during compression of the nerve tracts and is usually described as burning or pulling. In addition, it typically radiates into the skin areas (dermatomes) that are sensitively supplied by the affected spinal nerve.
Since most root irritations occur at the level of the lumbar spine, in the majority of cases this means pain in the leg area for the patient. This is because these are innervated by the spinal nerves exiting here. In addition, unaccustomed movements usually make the pain worse. Sneezing, coughing or abdominal pressing can also typically provoke or intensify them. This increases the pressure within the abdominal cavity and thus also on the structures of the spinal column, thus increasing the compression of the nerve root.
