Overview
What is Lumbar Radiculopathy?
Lumbar refers to the low back region. Nerve roots exit the back to enter the legs. Nerve roots branch out from the spinal cord and carry messages to and from the brain and the lower extremities and pelvis. If one of these roots is sick or injured in the area where it leaves the spine, it is called a radiculopathy. Symptoms usually arise in people between the ages of 30 and 50 and may follow an injury or occur with no warning. Sciatica is pain that radiates from the back down the back of the leg, and is a common manifestation of lumbar radiculopathy. Other common symptoms are numbness and tingling of the leg or foot, weakness, and muscle spasms. 80% to 90% of patients with sciatica recover without surgery.
Anatomy
The spine is comprised of 24 vertebrae (bones stacked on top of each other in a "building-block" fashion) that have 4 distinct regions: Cervical, Thoracic, Lumbar, and Sacral. Discs, cushion-like tissues separate most vertebrae and act as the spine's shock absorbing system. The disc has a tough outer ring of fibers called the Annulus Fibrosus and a soft gel-like center called the Nucleus Pulposus.
There are seven flexible cervical (neck) vertebrae that support the head. There are twelve thoracic (chest) vertebrae, which attach to ribs. The five lumbar vertebrae are large and carry the majority of the body weight. The sacral region helps distribute the body weight to the pelvis and hips.
The spinal cord is housed within the protective spinal column. Spinal nerves come from the spinal cord and travel through a tunnel or foramen. The nerves provide sensory (allowing you to touch and feel) and motor information (allowing the muscles to function) to the entire body.
What Causes Lumbar Radiculopathy?
Many disease states can cause lumbar radiculopathy, but most often it is a structural problem like a herniated disc, bone spur, or mechanical stretching or traumatic event. Discs may be damaged from strenuous activity, a congenital defect, or by injury. When the disc is damaged, material in the disc leaks and squeezes the nerve root. This can cause the numbness, tingling, pain, and weakness.
How is Lumbar Radiculopathy Diagnosed?
After the initial examination, the diagnosis of lumbar radiculopathy can be supported by electrodiagnosis, MRI, CT scans, and/or contrast myelography. Treatment of lumbar radiculopathy will vary depending on the actual cause of the radiculopathy. These treatments can include the use of back supports, medication, physical therapy, steroid injection in the spine, and even surgery.
Symptoms of Lumbar Radiculopathy
Lumbar radiculopathy is a classic syndrome of lower lumbar nerve root compression. Symptoms include:
- Low back pain - that may or may not have been associated with some sort of trauma and is commonly antecedent to the onset of leg pain by days to a few weeks.
- Motor weakness - is also seen, but can be missed if dynamic testing is not done.
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