Why does it occur?

Lumbar Radiculopathy is low back pain that radiates or travels from the low back and into the gluts, hips, legs, and even into the toes. These radicular symptoms occur because the nerves emanating from your spinal cord are becoming compressed, often secondary to arthritis or a Herniated Disc.  Once the nerve is compressed, you may feel symptoms along the nerve’s pathway anywhere from your low back to your toes.  The most common causes of lumbar radiculopathy are a Herniated Disc or degenerative Arthritis (Spondylosis) that compresses the nerve.

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Lumbar Radiculopathy is very common.  As many as 80% of people in their lifetime will experience low back pain.  Luckily, the majority of these cases resolve within weeks to months and few require surgical intervention.

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Symptoms:

Patients often present with low back pain that shoots into the hips or down the legs.  Pain may be sharp and include numbness, tingling, and even weakness in more severe cases. Pain associated with a herniated disc may be made worse by coughing, sneezing, or bearing down with bowel movements.  Long periods of sitting, bending at the waist, lifting, or twisting often lead to increased pain as well.

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Diagnostic Testing:

An X-ray may be advised during your office visit with Dr. Lee.  The X-ray is a valuable tool to assess the bones in your spine.  Dr. Lee will assess for any mal-alignment, arthritis spur formation, disc or joint space narrowing, or other bony pathology.  Dr. Lee may also order an MRI if your symptoms are significant, failing to improve over time, or if you have any signs of weakness.

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An EMG (nerve study) may also be considered, especially in a patient that is suspected to have multiple sites of compression.

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Treatment Options:

Treatment options will vary depending on the severity of symptoms. If weakness is found on examination or perceived by the patient, Dr. Lee will need to evaluate and treat the nerve more urgently.  Physical Therapy is a very important aspect of treatment to strengthen the surrounding musculature of the spine, help alleviate muscle spasms, and decrease pain.  NSAIDs such as Advil or Aleve (if not contraindicated) may be advised to reduce inflammation in the area. If your pain is acute and severe, stronger medications may be discussed to address the pain. Injections such as an Epidural Steroid Injections (ESI) can be useful to patients with severe pain, significant radicular symptoms, or symptoms that did not improve with Physical Therapy, activity modifications, and/or NSAID use.

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Surgical Treatment:

 

The majority of lumbar radiculopathy pain is treated successfully without the need for surgery.  However, surgery will be advised in those patients with progressive neurologic compromise and especially weakness of the muscles.  Surgery can also be performed for those patients with severe pain that is unable to be controlled via nonoperative means, a decision the patient gets to determine.

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The type of surgery performed will be related to the pathology causing the problem.  This may be anywhere from simply removing a herniated disk, to removing bone spurs, to performing fusions of the joint.  If surgery for this problem is necessary, Dr. Steven Lee will refer you to one of his surgical spine specialists.

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*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables. It is provided as an educational service and is not intended to serve as medical advice.  Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.

 

*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.