Lumbar Radiculopathy

Lumbar radiculopathy (LR) is a form of nerve irritation that causes pain, numbness, weakness or tingling in the lower back, radiating down into the legs.

This condition is a result of injured vertebral discs irritating spinal nerves. One of those nerves, the sciatic nerve, is the source of the painful condition known as sciatica. Although this condition often causes sciatic nerve pain — and is frequently referred to as sciatica — LR is its own diagnosis.

lumbar radiculopathy

Causes of Lumbar Radiculopathy

Anything that injures discs in the lower spine can lead to lumbar radiculopathy. Injury, trauma and degeneration may damage the discs. Herniated discs are most often associated with LR.

Some of the most common causes of disc damage leading to LR are:

  • a job or frequent activity that requires heavy lifting
  • driving for a living
  • playing contact sports
  • living a sedentary lifestyle

Medical conditions that increase risk include:

  • osteoarthritis
  • bone spurs
  • spinal stenosis
  • age-related degeneration

Lumbar radiculopathy is most common in patients age 45 to 64. Other risk factors include smoking, obesity and high stress levels. In some patients, biomechanical deficiencies may also be to blame. Ballet dancers, golfers, football linemen and weightlifters are especially vulnerable to this condition.

Symptoms and Diagnosis of Lumbar Radiculopathy

The symptoms of LR vary significantly depending on the cause of the underlying spinal damage, as well as which nerves are affected.

The pain may be sharp or dull, shooting, burning, stabbing or throbbing. The sensation typically travels downward from the lower back through the hip area and beyond. For some patients, the pain may extend to the knees, ankles or feet.

For an LR diagnosis, the pain must be accompanied by neurological deficits, such as numbness, tingling or a loss of reflex.

Diagnosing lumbar radiculopathy requires establishing the specific areas of pain, which allows the doctor to understand which vertebrae, discs and nerves are involved. The doctor will take a detailed medical history, including information about your work, exercise, daily activities and any incidents of trauma that may relate to your condition.

The doctor will also conduct a physical examination to evaluate strength, reflexes and range of motion in the lower extremities. The doctor will likely also request X-rays, MRI, CT, NCV or EMG testing to further evaluate the musculoskeletal structures.

Lumbar Radiculopathy Treatment

With appropriate treatment, many patients will notice a significant improvement in about two weeks. Without treatment, the condition is unlikely to resolve on its own, especially if you continue with the activities that led to your condition.

A conservative approach to treatment is typically recommended to start, with the goal of reducing pain. Rest and nonsteroidal anti-inflammatory drugs can be effective, along with therapeutic exercises recommended by your doctor or physical therapist.

Depending on the underlying cause of your LR, a more aggressive approach may be necessary. Fortunately, most patients who don’t respond to conservative treatment have success with guided injections. Other potential treatments include ultrasound therapy and nerve stimulation.

Although some patients may require surgery to relieve LR, most do not. The focus is on getting rid of the pain by correcting the underlying cause. Too many patients live for years under pain management programs. By addressing the source of the problem, you will have a much better chance of returning to your normal, active life, free from lumbar radiculopathy symptoms.

 

Robert Engelen, DO
Dr. Engelen served as a Lieutenant in the Navy and operated as the medical officer for Marines in North Carolina and for a deployment to Afghanistan. He has served as a team physician for a high school and a Division II Collegiate athletic sports team in Pittsburgh, and currently serves as the team physician for West Jordan High School.

Dr. Engelen has a special interest in fluoroscopic procedures, diagnostic ultrasound and ultrasound guided procedures, regenerative medicine, biomechanical analysis, and treatment of all sports and spine injuries. His unique practice focuses on non-surgical treatments.