Lumbar radiculopathy

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What is lumbar radiculopathy?

Lumbar radiculopathy is pain, numbness or tingling that originates in the lumbar spine (lower back) and radiates down the leg. It results from any condition that irritates or compresses the nerve roots in the lower back. Lumbar radiculopathy often manifests itself as sciatica: pain, numbness or burning that travels down the large sciatic nerve in the back of the leg.

How does lumbar radiculopathy occur?

Lumbar radiculopathy can occur as the result of any condition that compresses the lower spine. Common causes include:

  • Lumbar disc herniation – a painful rupture of the outer cartilage of a lumbar disc
  • Spinal stenosis – a narrowing of the spinal canal in the lower back
  • Spondylolisthesis – a condition in which a vertebra in the lower back slips forward over another
  • Traumatic injury
  • Other degenerative spine disorders

What are the symptoms?

Lumbar radiculopathy usually affects only one side of the body. Often, symptoms extend from the lower back through the back of the thigh and down the leg. Depending on what part of the nerveroot is affected, the symptoms may also extend to the foot or toes.

Typical symptoms include:

  • Pain in the buttocks, thigh or leg that is worse when sitting
  • Burning or tingling down the leg
  • Weakness, numbness, or difficulty moving the leg or foot
  • A constant pain on one side of the buttocks
  • A shooting pain that makes it difficult to stand up

For some people, these symptoms may be severe and debilitating. For others, symptoms may be infrequent and irritating, but have the potential to get worse.

If symptoms impair function in the lower body or cause loss of bladder or bowel control, this could be a sign of a potentially life-threatening condition that requires immediate medical attention. Call your doctor right away.

What is the treatment?

Many patients improve with conservative treatment that includes rest, non-steroidal anti-inflammatory medications, weight loss or physical therapy.

If these measures fail to alleviate symptoms, epidural steroid injections (ESI) may be an effective treatment. This targeted procedure deposits a long-lasting steroid directly into the epidural space surrounding the spine. Your doctor will use fluoroscopic guidance and contrast dye to enhance visualization and improve accuracy. A specific type of ESI – a transforaminal approach – can be used to localize a specific nerve root that is the source of pain.

ESI are simple and safe. Performed in an outpatient surgery center, they can be administered up to three times in six months. Most patients see a significant improvement and return to full, pain-free function and activity.