Loss or decrease of sensory or motor function of a nerve root, causing symptoms such as pain, tingling and weakness, which radiate down the leg.
The most common cause is due to degenerative discs between vertebrae, whose function is to act as a cushion against the impact that vertebrae produce during movement. When losing part of their aqueous contents, discs lose their flexibility and have a higher chance of tearing or breaking. Another determining factor is a sedentary lifestyle and not exercising the muscles that give stability to the vertebral column.
The diagnosis is based on a correct clinical history and physical examination, requiring additional tests such as X-ray, CT or MRI to detect alterations in the spine, identifying the affected nerve and its cause. An EMG may also be performed to assess the presence of lesions that may affect the nerves and muscles.
For the treatment of acute pain, paracetamol, NSAIDs and even opiates are used. Cortisone may be used in some cases, either orally or through injections near where the nerve is pinched. In cases where the pain becomes chronic, the use of tricyclic antidepressants such as amitriptyline, antiepileptics such as gabapentin and pregabalin and treatment with physical therapy may be added as well. In the most severe cases, doctors may indicate surgery, mainly to decompress the affected nerve root.
At the level of the last lumbar vertebra and the sacrum, multiple nerve roots emerge from the spinal column, forming what is known as the cauda equina. They control the lower limbs and pelvic organs.
When they are affected, there is pain in the lower back, perineal region or lower limbs, associated with loss of sensation in the genitals and anus, in the skin of the perineum and thighs, as well as impotence, constipation, incontinence or the inability to urinate.
It is a medical emergency, which must be treated immediately, as some symptoms may become irreversible and the patient's condition may worsen in as little as 24 hours. It requires emergency surgical decompression to reduce or eliminate pressure on the nerve.
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