Radiculopathy is a condition in which one or more nerves become aggravated by abnormal pressure. When nerves become irritated or pinched they begin to operate ineffectively and information being relayed from the brain to the body becomes disrupted.
Lumbar radiculopathy, commonly referred to as “sciatica” occurs when a nerve in the lower back is compressed by a damaged spinal disc. Inflammation and irritation put pressure on the nerve root where the nerve branches away from the spinal cord causing pain to radiate down the back of the leg. Sciatica is the term commonly used to describe radicular pain along the sciatic nerve. The term sciatica describes where the pain is felt, but it is not an actual diagnosis.
Causes of Lumbar Radiculopathy
Lumbar radiculopathy is caused by compression of a spinal nerve root in the lower back that can be the result of degenerative changes to the bone, arthritis, ruptured discs, or acute injuries.
- Herniated discs can compress and disrupt nerve roots when the jelly-like center (nucleus) pushes through the outer ring (annulus) of the disc and puts pressure on sensitive nerve roots, causing pain and weakness.
- As we age, “wear and tear” degenerative changes cause spinal discs to lose height, causing them to bulge or even collapse. The body responds to the loss of height by forming more bone, called bone spurs, which can compression the nerve branches in the spinal cord.
- Foraminal stenosis, or the narrowing of the disc space where spinal nerves exits the spinal cord due to bone spurs or arthritis.
- Acute injuries
The most common symptom of lumbar radiculopathy is sciatica, or pain that radiates along the sciatic nerve and travels down the back of the thigh and calf into the foot. Other symptoms include:
- Localized lower back pain
- Deep and steady pain that can usually be reproduced with certain activities and movements
- Tingling and numbness
- Muscle weakness and loss of specific reflexes
For the majority of patients, lumbar radiculopathy gets better over time with conservative treatment options.Nonsurgical treatment options include:
- Physical therapy can strengthen muscles, reduce pain, and improve range of motion
- Over-the-counter anti-inflammatory medications can relive pain and swelling
- Oral corticosteroids can help reduce swelling and inflammation around the nerve root
- Steroid injections can help reduce swelling and inflammation around the nerve root
If nonsurgical treatment fails to alleviate the pain, decompression surgery may be recommended.
- Laminectomy: a procedure used to create more space for the spinal nerves by removing the lamina of the affected vertebrae. The lamina is the portion of the vertebral arch that forms the “roof” of the spinal canal.
- Microdiscectomy: involves removing the herniated portion of the disc and any fragments that are applying pressure to the spinal nerve.