CERVICAL OR LUMBAR RADICULOPATHY IN ADULTS NICE GUIDELINES LANICE. SUSPECTED NEUROLOGICAL CONDITIONS: RECOGNITION AND REFERRAL. NICE GUIDELINE NG127. PUBLISHED MAY 2019, LAST UPDATED OCTOBER 2023 WWW.PHYSIOTHERAPYONLINE.NET
SENSORY SYMPTOMS Symptoms: Tingling or numbness Sudden onset unilateral numbness ➡️ Assess for stroke/TIA Refer Immediately If: Rapidly progressive, symmetrical numbness/weakness (within hours to days).
SENSORY DISTURBANCES Urgent Referral Required For: Brief, recurrent sensory disturbances (< 2 minutes). Persistent altered sensation with brisk reflexes. Suspect Conditions: Possible brain or spine disease Peripheral neuropathy
MIGRAINE WITH AURA Key Signs: Fully reversible sensory symptoms Develop gradually (≥5 minutes) Last 5–60 minutes
FUNCTIONAL NEUROLOGICAL DISORDER Key Advice: Numbness and tingling may fluctuate. No need for re-referral if diagnosed unless new symptoms arise.
CARPAL TUNNEL SYNDROME Referral Guidance: Severe or persistent symptoms after initial treatment.
LATERAL THIGH SYMPTOMS Meralgia Paraesthetica: Reassure: benign condition, may resolve spontaneously. Refer for pain management only if symptoms are severe.
CERVICAL OR LUMBAR RADICULOPATHY Referral Not Needed Unless: Symptoms persist >6 weeks and are disabling or uncontrolled. Presence of: Gait disturbance Weak hands/legs Bowel/bladder dysfunction
ON WAKING TINGLING Do Not Refer If: Tingling lasts <10 minutes after waking.
REFERENCE Summary derived from NICE guideline NG127
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