Lumbar radiculopathy causes great discomfort and pain which is often located in the lower leg region compared to the back. Affected individuals suffer from sharp pain that radiates down to the foot, which may aggravate while coughing or sneezing. Many a times, there is associated abdominal pressure when the pain turns severe. This is accompanied by numbness and tingling sensation in the affected leg. Changes in sensation can occur along with loss of reflexes. Prolonged duration of sitting or standing is not possible for such individuals and they may have to frequently change their position in order to avoid pain [7].

• Pain

  Rather than focusing on the surgical procedure, ergonomics or lumbar biomechanics, perioperative pain neuroscience education teaches people about the underlying mechanisms of pain, including the pain they will feel following surgery. [ncbi.nlm.nih.gov]

  Lumbar radiculopathy is a condition, characterized by pain in the lower back region due to nerve compression. Individuals suffer from pain along with numbness in the buttocks and legs. [symptoma.com]

• Weakness

  An injury at the L3 level may result in thigh pain and knee and thigh weakness. Damage at the L4 level may cause pain from the lower back to the foot and also foot weakness. [theneuromedicalcenter.com]

  Over the following week, the patient reported progressive right lower extremity weakness, worsening sensory loss, and ambulatory dysfunction. Examination revealed mild L3/4 myotomal weakness, sensory changes, and areflexia at the right patella. [ncbi.nlm.nih.gov]

  Damage at the L2 level of the lumbar Pain in the thigh Weakness in the hip Damage at the L3 level of the lumbar Pain in the thigh Weakness in the knee and thigh Damage at the L4 level of the lumbar Pain in the lower back down to the knee and foot Weakness [orthoneuro.com]

• Disability

  Disability was measured using the Bournemouth Disability Questionnaire (BDQ) and pain using the Numerical Rating Scale for pain. Fear beliefs were measured with the Fear-Avoidance Beliefs Questionnaire (FABQ). Patients also self-rated improvement. [ncbi.nlm.nih.gov]

• Surgical Procedure

  This may involve, for example, explaining the surgical procedure or 'back school' (education that focuses on biomechanics of the lumbar spine and ergonomics). [ncbi.nlm.nih.gov]

  Here, you will find helpful, comprehensive, and interactive patient education videos on a variety of orthopedic conditions, orthopedic surgical procedures, and associated treatment options. [bhosc.com]

  The surgical procedure involves removing pressure on the spinal nerves by cutting or removing part of the lamina (the bony roof over the disc) or any disc material that is compressing the spinal nerve structures. [cpcmds.com]

  The surgical procedure involves removing pressure on the spinal nerves by cutting or removing part of the lamina (the bony roof over the disc) or any disc material that is compressing the spinal nerve structures. Other Conditions Procedures [laorthoexperts.com]

• Asymptomatic

  He remained asymptomatic at 4 weeks follow-up. We found two cases of postsurgical, retroperitoneal fluid collection that caused lumbar radiculopathy, but none associated with hydronephrosis. [ncbi.nlm.nih.gov]

  View Article PubMed Google Scholar Jarvik JG, Hollingworth W, Heagerty PJ, Haynor DR, Boyko EJ, Deyo RA: Three-year incidence of low back pain in an initially asymptomatic cohort: clinical and imaging risk factors. [bmcmusculoskeletdisord.biomedcentral.com]

• Sneezing

  In lumbar radiculopathy, it may increase along with abdominal pressure from sneezing, laughing, coughing, or going to the bathroom. The distribution of sensory symptoms may follow a discrete pattern specific for each nerve root involved. [uclahealth.org]

  The pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, sciatica can be accompanied by incontinence of the bladder and/or bowels. [medicinenet.com]

  (may include one or more): Stabbing pain in the buttock (sciatica) Dull non-localized ache Back pain going down one leg Leg cramping Numbness in the leg to the foot Burning pain down the back of the leg Symptoms worsening with sitting, coughing, or sneezing [spineoptions.com]

  Common symptoms of lumbar radiculopathy include: Numbness and tingling in the leg extending to the foot Weakness in the leg Increased nerve pain when moving the lower body Increased nerve pain when coughing or sneezing Bladder/bowel incontinence Diagnosis [bidmc.org]

• Vomiting

  It was severe over a period of time, to the point where it made me vomit, and ended up in an emergency room screaming. They contacted Dr. McLaughlin. He was immediately astute… Right Parietal Lobe Osteoma Dr. [princetonbrainandspine.com]

  Pain medicines can cause vomiting, upset stomach, constipation (large, hard bowel movements that are difficult to pass), or kidney or liver problems. Opioid medicine may be addictive (hard to quit taking once you start). [drugs.com]

• Skin Rash

  Therefore, it is important to inquire about the presence of a skin rash or blisters and inspect the patient’s skin from the back and buttock down the leg. [journals.lww.com]

• Low Back Pain

  A 24-year-old woman presented with low back pain and right sciatica lasting 5 months. There was no objective weakness. [ncbi.nlm.nih.gov]

  […] for the treatment of patients with low back pain and signs of radiculopathy. [health.utah.edu]

• Leg Pain

  Success at follow-up was ≤ 17.5 for visual analogue scale (VAS) leg pain, ≤ 22.5 for VAS back pain and ≤ 20 for Oswestry Disability Index (ODI). [ncbi.nlm.nih.gov]

  This type of surgery typically provides relief of radicular pain/leg pain for 85% to 90% of patients. [spine-health.com]

  Leg pain often referred to as Sciatica or Lumbar Radiculopathy is very common and is not always from a herniated disc. [youtube.com]

• Acute Low Back Pain

  Inferior vena cava thrombosis is a rare but important cause of acute low back pain and lumbar radiculopathy. Failure to diagnose and treat this condition could result in propagation of the thrombosis, resulting in fatal pulmonary embolism. [ncbi.nlm.nih.gov]

  The use of a classification approach to identify subgroups of patients with acute low back pain: Inter-rater reliability and short-term treatment outcomes. Spine 2000;25:106-14. [health.utah.edu]

• Hip Pain

  It is often diagnosed by history and symptoms, which include pain, burning, tingling or numbness that radiate from the lower back and buttock around the back of the thigh to cause low back pain, buttock pain, hip pain, or, most commonly, hip pain. [painmanagement.weillcornell.org]

  (front of a shinbone), great toe (extensor hallicus longus), and hip abductors (moves a leg outward from the hip) Pain down the side of the leg S1 Decreased Achilles reflex (heel) Sensory loss of the lateral (side) foot and the small toe Weakness of [spineuniverse.com]

  HIP FLEXORS L1-L2 HIP EXTENSORS L4-5 KNEE FLEXORS L5-S1 KNEE EXTENSORS L3-L4 DORSIFLEXION L4-L5 PLANTAR FLEXION S1-S2 GREAT TOE EXTENSION L5-S1 you have L4 radic. what do you find? LOWER BACK, HIP, POSTEROLATERAL THIGH, ANTERIOR LEG PAIN. [quizlet.com]

  This causes pain in your chest and torso. It’s uncommon and can be mistaken for shingles. Lumbar radiculopathy is pressure on one of the nerve roots in your lower back. It can cause hip pain and sciatica, or shooting pain in your leg. [healthline.com]

• Muscle Strain

  Physicians may also recommend use of medications to relieve pain and inflammation (anti-inflammatory drugs), and muscle strain (muscle relaxants). Steroid injections are used for acuterelief of severe pain. [cpcmds.com]

  Physicians may also recommend use of medications to relieve pain and inflammation (anti-inflammatory drugs), and muscle strain (muscle relaxants). Steroid injections are used for acute relief of severe pain. [laorthoexperts.com]

  In the case of muscle strain or ligament sprain, professional medical care can sometimes be delayed. [hedleyortho.com]

• Incontinence

  In more severe instances, sciatica can be accompanied by incontinence of the bladder and/or bowels. Increased radiating pain when the lower extremity is lifted supports the diagnosis of lumbar radiculopathy. [medicinenet.com]

  Common symptoms of lumbar radiculopathy include: Numbness and tingling in the leg extending to the foot Weakness in the leg Increased nerve pain when moving the lower body Increased nerve pain when coughing or sneezing Bladder/bowel incontinence Diagnosis [bidmc.org]

  Surgery may be necessary if the pain is unrelenting with severe impairment of function, or incontinence. Procedure performed depends on the overall status of the spine, and the age and health of the patient. [epainassist.com]

• Radiculopathy

  Of patients with single-level radiculopathy and multiple-level radiculopathy, 175 (80.3%) and 11 (78.6%) expressed an immediate response to transforaminal epidural steroid injection, respectively. [ncbi.nlm.nih.gov]

  Various methods are adopted for treating lumbar radiculopathy depending on the underlying etiology. [symptoma.com]

• Sciatica

  For others, however, sciatica can be severe and debilitating. [indypain.com]

• Tingling

  This is accompanied by numbness and tingling sensation in the affected leg. Changes in sensation can occur along with loss of reflexes. [symptoma.com]

  Lumbar radiculopathy symptoms may include pain, tingling, numbness, weakness, and reflex loss. Lumbar radiculopathy symptoms may present in the leg and foot. [shimspine.com]

  If you have leg pain, numbness and tingling or sciatica please call (281) 405-2611 or visit us online at www.AdvancedHoustonChiropractor.com for an appointment today. [youtube.com]

• Headache

  Side effects consisted of sedation/drowsiness (46%), gastrointestinal upset (23%), headache (19%), blurred vision (15%), weakness/fatigue (11%), and dyscoordination (11%). [ncbi.nlm.nih.gov]

  Neck pain and headaches near the back of your head are common with cervical radiculopathy. The back of your head is called the occiput, which is why headaches in this area are called occipital headaches. [depuysynthes.com]

  Steroid injections may be painful and can cause severe headaches, infections, allergic reactions, or nerve damage. [drugs.com]

  Pain Headache Rep. 2008. 12. 14-21. https://doi.org/10.1007/s11916-008-0004-7 15. Yakovlev A., Tamimi M.A., Liang H., Eristavi M. Outcomes of percutaneous disc decompression utilizing nucleoplasty for the treatment of chronic discogenic pain. [mif-ua.com]

• Radiculitis

  NOS Lumbar neuritis or radiculitis NOS Lumbosacral neuritis or radiculitis NOS Thoracic neuritis or radiculitis NOS Radiculitis NOS Type 1 Excludes neuralgia and neuritis NOS ( M79.2 ) radiculopathy with cervical disc disorder ( M50.1 ) radiculopathy [icd10data.com]

  2012 ICD-9-CM Diagnosis Code 724.4 Thoracic or lumbosacral neuritis or radiculitis, unspecified Short description: Lumbosacral neuritis NOS. [icd9data.com]

  Aetiology Narrowing of the intervertebral foramen, intervertebral disc prolapse, and radiculitis due to arteritis, infection, or inflammatory exudates. [pijn.com]

A preliminary physical and neurological examination is carried out. Physical examination would include determining the range of motion, through tests such as straight leg and cross straight leg test. The test would also provide sufficient information about the nature of symptoms. The gait and balance of the individual would also be analyzed. In addition, imaging studies such as CT scan and MRI would be done to analyze the root cause of the condition [8].

X-rays of the lower back region would be required in order to determine injury or infections in the spinal region. Electromyography is also required for measuring the electrical activity in the muscles and is useful for excluding other causes of sensory and motor disturbances [9].

Various methods are adopted for treating lumbar radiculopathy depending on the underlying etiology. The following methods would be employed:

• Medications: Medications such as non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants and opoids are given for effective management of symptoms of pain and tingling sensations. When these do not work or the pain is severe then oral steroids or steroids injection can be given in the lumbar region to reduce pain and swelling.
• Physical therapy: Exercises are advised to improve the posture and gait. Muscle strengthening exercises are also taught.
• Transcutaneous electrical nerve stimulation: This forms an important part of treatment regime. Mild intensity electrical currents are given to the affected area in order to reduce the pain and other associated symptoms [10].
• Surgery: This is usually the last resort and it is done when symptoms do not improve within 4 to 6 weeks of treatment. In this procedure, surgery is conducted to relieve the compressed nerve.

The prognosis of the condition is favorable with recovery occurring within few weeks to months after initiation of treatment. However, the underlying etiology in the causation of lumbar radiculopathy also needs to be considered. Individuals with herniated discs can do well without surgery; and there are significant chances of recurrence of radiculopathy even with treatment. With proper exercise and appropriate body weight, individuals can lead a quality life [6].

Several factors such as underlying diseases and or structural abnormalities can cause nerve compression in the spinal region. Herniated disc, physical trauma, injury, mechanical stretching or bone spur can also lead to lumbar radiculopathy. Damage to the discs can occur due to strenuous activity, injury or congenital defect in the spinal region. This causes the cushioning material contained in the disc to leak which in turn exerts pressure on the nerve root, compressing it. Such a type of phenomenon causes pain, and tingling sensation in the affected area [2].

Lumbar radiculopathy can also stem from infections or tumor. In such conditions, the space in the spinal canal is significantly reduced, which in turn exerts pressure on the nerves. Degeneration, which is a common phenomenon of ageing, is also a contributory factor for lumbar radiculopathy.

About 80% of individuals across the globe fall prey to low back pain. It is one of the main reasons why quality of life is greatly affected. In US, about 3 to 5% are affected by lumbar radiculopathy; with men and women being affected in equal number. However, men aged 40 years and above and women in the age group of 50 to 60 are affected the most. Such a type of trend speaks of the relationship between advancing age and incidence of lumbar radiculopathy [3].

Anatomically, the spine comprises of 33 vertebrae with 4 regions, namely cervical, lumbar, thoracic and sacrum. These vertebrae are separated by discs which are cushioning materials that provide support to the spine by absorbing shocks. These discs contain a tough ring in the outer layer, known as annulus fibrosus and an inner gel-like center which is known as nucleus pulposus [4].

Factors or conditions that cause damage to the discs, can favor development of lumbar radiculopathy. Development of bone spurs, which occurs due to weakening of discs can also lead to narrowing of the space in between vertebrae gradually leading to nerve compression [5].

It is not always possible to prevent all the causes of lumbar radiculopathy. Some are inevitable, while some can be prevented by taking necessary precautions. Maintaining good posture and an ideal body weight can prevent the spine and lumbar region from undue pressure. Individuals are also advised to follow the correct posture while lifting heavy objects from ground level. For example, while lifting heavy objects or picking something from floor, it is necessary to bend the knees and not the back. Such a practice would not strain the spine and prevent it from trauma or injuries.

Due to compression of a spinal nerve, the neighboring muscles, tendons, bones and tissues are gravely affected. Lumbar describes the lower back region and radiculopathy refers to the nerve in the spine region compressed and/or inflamed. Therefore, lumbar radiculopathy indicates the condition that causes pain in the lower back region and leg due to compression of nerves in the spine. Individuals in the age group of 30 – 50 years are more likely to get affected [1].

Definition: Lumbar radiculopathy is characterized by pain in the leg and lower back region due to compression of a nerve in the spine. Men and women are affected in equal numbers and advancing age is one of the major factors for onset of the condition.

Cause: Several factors such as herniated disc, bone spurs, physical injury or trauma to the spine, structural abnormalities, degeneration or disease conditions can cause the nerve root to get compressed, giving rise to lumbar radiculopathy.

Symptoms: Affected individuals suffer from pain in the lower back, which then radiates down the legs accompanied by feeling of numbness and tingling sensation. There is loss of sensation and reflexes in the affected area.

Diagnosis: Physical examination followed by a neurological examination is done in the preliminary level. The gait and balance of the individual is determined using various tests. Imaging studies are indicated for analyzing any injury or development of tumor in the spinal region.

Treatment: Non-surgical treatment methods include medications both steroidal and non steroidal and physical therapy for effective management of symptoms. Surgery is usually the last resort and employed when other methods are not effective in reducing pain and discomfort.

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3. Tarulli AW, Raynor EM. Lumbosacral radiculopathy. Neurol Clin. May 2007;25(2):387-405.
4. Hay MC. Anatomy of the lumbar spine. Med J Aust 1976; 1:874.
5. Brown HA, Pont ME. Disease of lumbar discs. Ten years of surgical treatment. J Neurosurg 1963; 20:410.
6. Levin KH. Radiculopathy. In: Comprehensive Clinical Neurophysiology, Levin KH, Lüders HO (Eds), WB Saunders, New York 2000. p.627.
7. Bogduk N. The lumbar disc and low back pain. Neurosurg Clin N Am 1991; 2:791.
8. Deyo RA, Rainville J, Kent DL. What can the history and physical examination tell us about low back pain? JAMA 1992; 268:760.
9. Nardin RA, Patel MR, Gudas TF, et al. Electromyography and magnetic resonance imaging in the evaluation of radiculopathy. Muscle Nerve 1999; 22:151.
10. Malanga GA, Nadler SF. Nonoperative treatment of low back pain. Mayo Clin Proc. Nov 1999;74(11):1135-48.