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Lumbar Radiculopathy

Definition

Lumbar radiculopathy occurs when the spinal nerve roots in the lower back are compressed or inflamed. This can lead to pain, numbness, or weakness in any area from your lower back to your feet.
Area Affected By Lumbar Radiculopathy
IMAGE
Copyright © Nucleus Medical Media, Inc.

Causes

Lumbar radiculopathy may be the result of a herniated disc, spinal stenosis, bone spur, or injury affecting the nerve. This causes inflammation or compression of a spinal nerve.

Risk Factors

Factors that may increase your risk of lumbar radiculopathy include:
  • Birth defects in the structure of the disc
  • Strenuous activity, especially heavy lifting
  • Overstretching
  • Overweight
  • Injury
  • Diabetes
  • Previous spinal surgery

Symptoms

Lumbar radiculopathy may cause:
  • Tingling
  • Pain
  • Numbness
  • Weakness
  • Muscle spasms

Diagnosis

Your doctor will ask you about your symptoms and medical history. A physical exam will be done.
Tests may include:
  • Physical mobility tests
  • Pain sensation tests
  • Reflex tests
  • Electrodiagnostics to test nerve conduction speed
Imaging tests evaluate the spine and other structures. Imaging test may include:

Treatment

In most cases, lumbar radiculopathy goes away when the cause of the symptoms improves. If problems persist, symptoms can be managed.
Talk with your doctor about the best treatment plan for you. Options include one or more of the following:

Non-surgical Treatments

Corsets and back braces support posture and may reduce pain.
Spinal decompression, or traction, relieves pressure around pinched nerves in the spinal column. Spinal discs are slowly pulled apart allowing for blood and nutrients to heal the spine.
Medications
Medications used to treat lumbar radiculopathy include:
  • Over-the-counter pain relievers, such as ibuprofen or acetaminophen
  • Prescription pain relievers
  • Antidepressants
  • Muscle relaxers
  • Corticosteroid injections into the spine
If the lumbar radiculopathy is caused by a bacterial infection, your doctor will prescribe antibiotics.
Physical Therapy
Continue normal activities unless it causes pain. Staying active helps maintain muscle strength and flexibility.
Your doctor will refer you to a physical therapist for specific exercises. Exercises also improve range of motion. Physical therapy may also include other techniques such as massage, manual therapy, heating, cooling or ultrasound treatments. Your therapist can also provide back care education including proper posture and body mechanics.
Counseling
Your doctor may refer you to counseling. Counseling will help you manage chronic pain through single or group therapy.

Surgery

If no other treatments work, surgery may be an option for you. The goal of surgery is to relieve nerve compression and reduce pain. Surgical procedures may include:
  • Laminectomy—an open procedure to remove a portion of the bony arch of the spine
  • Microdiscectomy—a portion of the herniated disc is removed with instruments or a laser

Prevention

To help reduce your chance of some developing some causes of lumbar radiculopathy:
  • Maintain proper weight with a healthy diet and regular exercise
  • Learn how to properly lift heavy items
  • Exercise your back to keep muscles strong and flexible
  • Use proper technique when playing sports to avoid back injury
  • Avoid excess straining or stretching of your neck and back

RESOURCES

American Chronic Pain Association http://www.theacpa.org

Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org

CANADIAN RESOURCES

Canadian Orthopaedic Foundation http://www.canorth.org

Canadian Pain Society http://www.canadianpainsociety.ca

References

Chronic low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 18, 2014. Accessed August 15, 2014.

Lumbar disc herniation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 17, 2014. Accessed August 15, 2014.

Lumbar radiculopathy. Advancing Neuromuscular, Musculoskeletal, and Electrodiagnostic Medicine website. Available at: http://www.aanem.org/Education/Patient-Resources/Disorders/Lumbar-Radiculopathy.aspx. Accessed August 15, 2014.

Lumbar radiculopathy. Spine Health website. Available at: http://www.spine-health.com/conditions/lower-back-pain/lumbar-radiculopathy. Accessed August 15, 2014.

Lumbar spinal stenosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 20, 2014. Accessed August 15, 2014.

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