Q. Are complaints of radiculopathy consistent with the ability to ride a bicycle to and from work? The MRI clearly reflects a bulging disk and it appears well documented that alcohol consumption is occurring in order to cope with pain caused by bicycle riding. I question whether the consumption of alcohol in a low enough amount to permit employment as a dishwasher, would sufficiently alleviate pain caused by bicycle riding, is possible with a true complaint of lower extremity radiculitus. Are there any objective tests to confirm radiculopathy with a person who provides the right answers to the standard tests or might this scenario be consistent with a related diagnosis such as myelopathy?

A. Lumbar radiculopathy refers to compression of one or more nerve roots that exit the lower spinal canal. These nerves distribute principally to the lower extremities. Causes include trauma, herniated discs, Arthritis amongst others. Symptoms usually include pain, tingling or numbness and possibly weakness of part of the leg often felt as back pain with radiation down the leg. It is still possible that one who has a mild radiculopathy could be quite functional including able to ride a bike. Certainly, alcohol could cover up some of the pain, but would not be the treatment of choice! An electromyelogram (EMG) is a test that can diagnose the nerve root involved and to some extent the severity of nerve conduction impairment. The MRI would have shown if there is a myelopathy (compression of the spinal cord), although if there are upper extremity symptoms also, an MRI of the cervical cord may be reasonable. Typical treatment usually includes anti-inflammatory meds such as Motrin, avoiding strenuous activity, using heat, muscle relaxants, physical therapy and sometimes epidural steroid injections. Sometimes surgery is needed to decompress the nerve.

Ref: http://medpmr.ucdavis.edu/RRTC/ResearchReports/Dxtests.html

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