Radiculopathy Rapid Review: Cervical and Lumbar Patterns

Radiculopathy Rapid Review: Cervical and Lumbar Patterns

Typically impinges nerve below disc (ie: L4-L5 herniation causes L5 radiculopathy)

Cervical radiculopathy:

Cervical Radiculopathy

Spurling’s test: This test is typically done by having the patient bend the head to the side where symptoms have occurred (closing down the intervertebral foramen), and then gently apply pressure to the top of the head.

C5 - bicep reflex

  • C5 radiculopathy can cause pain and/or weakness in the shoulders and lateral upper arms. It especially may cause discomfort around the shoulder blades but rarely causes numbness or tingling.

C6 - brachioradialis reflex

  • C6 radiculopathy (one of the most common) causes pain and/or weakness along the lateral forearm, including the biceps (the muscles in front of the upper arms), wrists, and the thumb and index finger.

C7 - triceps reflex

  • C7 radiculopathy (the most common) causes pain and/or weakness from the neck to the hand and can include the triceps (the muscles on the back of the upper arms) and the middle finger.

Lumbar radiculopathy:

Lumbar radiculopathy L4 L5 and S1 Nerve Roots

L4 - patellar reflex

  • Anterior sciatica: pain which radiates along the anterior aspect of the thigh into the anterior leg is due to L4 or L3 radiculopathy. L2 pain is antero-medial in the thigh. Pain in the groin usually arises from an L1 lesion.

L5 - Achilles reflex  Pain top of foot/big toe. Weakness- ankle dorsiflexion, inversion and eversion and great toe

  • Posterior sciatica pain due to L5 radiculopathy may radiate to the dorsum (top) of the foot and to the large toe

S1- Achilles reflex Pain lateral foot/sole

  • Posterior sciatica when caused by S1 irritation it may proceed to the lateral aspect of the foot

Map of lower extremity dermatomes

Lower extremity radicular pattern