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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 the lower back to the feet.
Area Affected By Lumbar Radiculopathy
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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 the 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

You will be asked 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.
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, antibiotics will be prescribed.
Physical Therapy
Continue normal activities unless it causes pain. Staying active helps maintain muscle strength and flexibility.
A physical therapist can advise 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. A therapist can also provide back care education including proper posture and body mechanics.
Counseling
Counseling will help manage chronic pain through single or group therapy.

Surgery

If no other treatments work, surgery may be an option. 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 the chance of 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 Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116935/Chronic-low-back-pain. Updated June 30, 2017. Accessed September 7, 2017.
Lumbar disk herniation. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116077/Lumbar-disk-herniation. Updated September 6, 2017. Accessed September 7, 2017.
Lumbar radiculopathy. Advancing Neuromuscular, Musculoskeletal, and Electrodiagnostic Medicine website. Available at: http://www.aanem.org/Education/Patient-Resources/Disorders/Lumbar-Radiculopathy.aspx. Accessed September 7, 2017.
Lumbar radiculopathy. Spine Health website. Available at: http://www.spine-health.com/conditions/lower-back-pain/lumbar-radiculopathy. Updated April 25, 2012. Accessed September 7, 2017.
Lumbar spinal stenosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114133/Lumbar-spinal-stenosis. Updated September 6, 2017. Accessed September 7, 2017.
Physical therapist's guide to low back pain. Move Forward—American Physical Therapy Association website. Available at: http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=d0456c65-7906-4453-b334-d9780612bdd3#.Vfl8WZcTDOt. Updated June 2, 2015. Accessed September 7, 2017.

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