In human medicine, root compression syndrome is understood to mean irritation of the nerve roots in the vicinity of the spine. Such irritation is usually due to mechanical causes (e.g. pressure) and leads to considerable back pain, which can also radiate. In rare cases, root compression syndrome can also be congenital.
What is Root Compression Syndrome?
Root compression syndrome is used in medicine when the roots of the spinal nerves are irritated due to mechanical causes (e.g. sustained pressure). Spinal nerves are all nerves that arise directly from the spinal cord. For meaning of hornstein-knickenberg syndrome in English, please visit sportingology.com.
In the specialist literature, a distinction is made between different forms of root compression syndromes. A classification can be made both according to the time of origin and according to the localization of the stimulus. In the latter case, a distinction is made between cervical, thoracic and lumbar syndrome.
Cervical syndrome is directed to the neck. The thoracic syndrome belongs to the region of the chest arm (thorax). Finally, lumbar syndrome is located in the lumbar region. Lumbar syndrome is the most common form of root compression syndrome because stress is usually greatest in the lumbar vertebrae.
Special manifestations are sciatica. Based on the time of onset, the literature also distinguishes between congenital and acquired root compression syndrome.
Causes
Root compression syndrome can either be caused by external factors or be congenital. However, the congenital form is rare. It is caused by deformations of the spine, such as can occur in the context of scoliosis.
Acquired root compression syndromes have various causes. Fractures of the spine, tumors in the spine area, hematomas and various infections should be considered. However, the majority of diseases are due to degenerative factors.
The underlying cause is therefore increased wear, which leads to a reduction in functionality. Due to the progressive wear and tear, pathological changes occur in the bone tissue. The soft tissues surrounding the nerve roots can also be changed. These changes are then triggered by arthrosis of the facet joints ( facet syndrome ) , osteophytes or a herniated disc (prolapsed disc).
Symptoms, Ailments & Signs
Root compression syndrome causes particularly severe pain in the back area. The center of pain varies depending on the type of syndrome. Thus, in patients suffering from a lumbar form of the syndrome, there may be an increase in the lumbar region.
Similarly, a center may be in the posterior region of the thorax or the lower neck region. However, this is not mandatory. Since there is irritation or pinching of the nerves, there may also be a loss of sensitivity in the nerves. This manifests itself in a loss of feeling.
Various paraesthesias can also develop around the area supplied by the affected nerves. Paresthesia is a bodily sensation that is not elicited by adequate stimuli. It usually manifests itself as an unpleasant tingling sensation, coldness, warmth or numbness.
In particularly severe cases, paralysis often occurs. A characteristic of root compression syndrome pain is that it radiates. Pain or discomfort in the hip or leg area is nothing out of the ordinary.
Some sufferers also report functional disorders of the bladder and rectum. However, the exact form or intensity of the radiation depends on the individual case.
Diagnosis & course of disease
Root compression syndrome can only be diagnosed by a doctor. This will first localize the pain. He will also try to categorize the intensity, duration and nature of the pain by questioning the patient.
This can provide an opportunity to initiate further diagnostic measures. A reliable diagnosis cannot be made without technical aids. X-rays are usually taken at the beginning to rule out any fractures or tumors. However, an exact depiction of the nerves can only be achieved by means of magnetic resonance imaging (MRI) or computed tomography (CT).
A myelo-CT may also be considered. Sometimes a functional myelography is also used. A wide range of measures is therefore available for diagnosing a root compression syndrome.
When should you go to the doctor?
If the person concerned suffers from persistent or increasing pain in the back area, a doctor should be consulted. If there is an impairment of movement options and, in particular, a restriction of rotational movements in the area of the back, medical examinations are necessary to clarify the cause. Sensitivity disorders, pressure sensitivity or muscle complaints must be examined, as these are warning signals from the organism.
In the case of hypersensitivity to cold, heat or other perceptual stimuli, the observations should be discussed with a doctor. If physical performance drops and sports or professional activities can no longer be carried out, a medical examination is required. In the case of impairments in coping with everyday life, consultation with a doctor is also necessary. If there are behavioral problems, mood swings or other emotional peculiarities, the cause should be investigated.
A decrease in zest for life, general malaise and withdrawal from social life are considered worrying. In many cases there are physical irregularities that should be examined more closely by a doctor. If the back pain spreads to the hips or legs, there is a need for action. A tingling sensation in the back, buttocks or thighs should be discussed with a doctor. If there are functional disorders of the bladder, a doctor’s visit is required immediately.
Treatment & Therapy
The therapy of a root compression syndrome consists of general and special measures. Usually, the implementation of the general measures is started. The more special forms are only used if previous therapy attempts have been unsuccessful.
General therapies include surgical measures (e.g. decompression), physiotherapy, acupuncture and drug-based pain therapy. The scope and type of pain therapy depend on the frequency and intensity of the pain.
If these are acute or start suddenly, peripheral preparations are administered. These are those that act directly at the point where the pain occurs. These include antirheumatic drugs (e.g. parecoxib or etoricoxib ). Muscle relaxants are also administered. These are substances that cause the muscles to relax.
Baclofen (e.g. Lioresal®) is often used. In the case of particularly severe pain, preparations are used that act directly in the brain and prevent the pain stimuli from being transmitted there. Opioids (e.g. tramadol or tilidine ) are also prescribed. In these cases, however, there is a risk of dependency. The special therapeutic measures include further treatment concepts from pain clinics.
Prevention
A strengthened back musculature is suitable for prevention. In addition, activities that can lead to wear and tear in the spine area should be reduced.
Aftercare
In the case of a root compression syndrome, the options and measures for direct follow-up care are in most cases significantly limited. Therefore, those affected should ideally consult a doctor at an early stage and also initiate treatment to prevent the occurrence of other symptoms and complications. It is often not possible to heal on its own, so that those affected are always dependent on treatment by a doctor.
At the first signs, it is advisable to consult a doctor. In most cases, root compression syndrome can be relieved well with the help of physical therapy or physical therapy. The person concerned can also carry out many of the exercises at home in order to prevent the occurrence of other complaints and to speed up healing.
In some cases, this disease also requires the use of medication. Those affected should pay attention to the prescribed dosage and regular intake in order to alleviate the symptoms. If anything is unclear or if there are severe side effects, a doctor should be consulted. The syndrome does not usually reduce the life expectancy of the affected person.
You can do that yourself
This painful condition needs medical treatment. Depending on the type of complaint, the family doctor will coordinate the various therapeutic approaches such as pain therapy, acupuncture, physiotherapy or even surgery. The patient would do well to follow the doctor’s advice and take the medication regularly (“compliance”). This is especially true when root compression syndrome is caused by a disease such as a tumor.
If the symptoms limit the patient’s quality of life so much that he withdraws, psychotherapeutic crisis intervention is indicated. In order to support the body’s own immune system and thus ensure a better general condition, the patient is advised to lead a healthy lifestyle. This primarily includes avoiding stimulants such as nicotine and alcohol, because they unnecessarily weaken the body. A diet rich in vitamins and fiber, on the other hand, rebuilds the body. In addition, the patient should exercise as much as possible, such as going for regular walks, swimming or cycling. Adequate rest is also important.
The patient can also do a lot for better pain management. Learning and using relaxation techniques, for example, can take the edge off the pain in an acute case. Relaxation techniques can be breathing or meditation exercises, as taught in yoga, or Jacobson’s progressive muscle relaxation.