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Lumbar Radiculopathy—Symptoms, Causes, and Treatments

Figure 1:Spinal nerves provide sensation to predictable areas of the skin. View Larger

Definition of Lumbar Radiculopathy

Radiculopathy is one clinical name for pain that radiates from a nerve root in the lumbar spine down into your legs in a dermatomal pattern.

 

The term radiculopathy originates from two Latin words:

  • radix = the roots of a tree
  • pathos = disease

At every level of vertebra, nerve roots branch out of each side of the spinal cord to a specific area of your body. A “dermatome” is an area of skin where the sensory nerves all come from a single spinal nerve root.

 

Nerves affect the dermatome in two ways:

  • Sensory aspects: physical sensation
  • Motor aspects: the ability to move

Radicular pain is radiated along the dermatome (sensory distribution) of a nerve. Pain or loss of sensation in a particular dermatome tells doctors where the pinched nerve is occurring.

Symptoms of Lumbar Radiculopathy

The symptoms of lumbar radiculopathy are often described as follows:

  • Radiating pain
  • Tingling or "pins and needles"
  • Difficulty with control or movement of the leg
  • Muscle weakness

Radiculopathy and Sciatica

Sciatica is one of the conditions associated with lumbar radiculopathy. It’s often used as a catch-all term for any type of leg pain that radiates from the lower back, but in actuality, it refers to a very specific condition.

 

Sciatica occurs when a disc protrudes into the vertebral column, pinching or causing irritation to the sciatic nerve in particular, which results in radicular pain.

Causes of Lumbar Radiculopathy

Radiculopathy is primarily caused by pressure from herniated disc or degenerative changes in the lumbar spine. The causes of lumbar radiculopathy can include the following:

Lumbar Radiculopathy and Spinal Stenosis

Lumbar spinal stenosis is common cause of radiculopathy. In a recent clinical trial, 79% of patients diagnosed with lumbar spinal stenosis experienced dermatomal pain radiation.1

 

People often associate radiculopathy and spinal stenosis with herniated discs, but herniated discs are not always present in cases of lumbar spinal stenosis and radiculopathy. For example, in the same trial, only 15% of patients diagnosed with lumbar spinal stenosis had a herniated disc.1

Nonsurgical Lumbar Radiculopathy Treatment

As a first line of treatment, your doctor may prescribe any of the following:

  • Physical therapy can help strengthen the area and improve motion.
  • Medications like, non-steroidal anti-inflammatory drugs, help relieve pain and reduce inflammation.
  • Epidural steroid injections can reduce inflammation and relieve the pain. The steroid medication injected into the back.

Learn more about nonsurgical treatment for radiculopathy caused by lumbar spinal stenosis

Surgical Lumbar Radiculopathy Treatment

If numbness or weakness worsens, or other treatment options don't relieve the pain, your doctor may recommend spinal surgery to address the underlying cause of the pinched nerves.

 

For example, when lumbar spinal stenosis is present, surgery may help create more space for the nerves, which may alleviate pain. Learn more about surgeries for lumbar spinal stenosis.

Learn more:

References:

  1. Weinstein JN, Tosteson TD, Lurie JD, et al, for the SPORT Investigators. Surgical versus nonsurgical therapy for lumbar spinal stenosis. NEJM. 2008;358:794-810.