Lumbar Radiculopathy

What is lumbar radiculopathy?

Lumbar radiculopathy is a condition in which pain is caused by irritated or pinched nerve roots in the lower back, that results in pain that starts in the back and shoots into the buttocks and legs. This is commonly known as sciatica since the sciatic nerve is often involved. However, “sciatica” describes the area and type of pain experienced and is not a diagnosis. Dr. Brenton Pennicooke, MD, lumbar radiculopathy specialist, treats patients in St. Louis, St, Peters, Creve Coeur and surrounding cities in St. Louis county and St. Charles county, Missouri, who are experiencing pain or a pinched nerve in their lower back.

What causes lumbar radiculopathy?

Lumbar radiculopathy is caused by anything that damages or inflames nerve roots in the back. Factors such as age, mobility, posture, and overall health can increase the likelihood of these injuries. Common causes of lumbar radiculopathy include:

• Herniated (slipped/bulging/ruptured) disc: A damaged disc may press on adjacent nerve roots.
• Degenerative disc: General wear and tear over time may cause the disc to become thinner, leading to a narrowed opening between the vertebra and pinching of the nerve roots.
• Trauma: Accidents or falls can cause injuries to the vertebra or discs in the spine and can irritate nerve roots, leading to low back pain.
• Spinal Deformity: Abnormal spinal curvature or slippage resulting in nerve compression.

Less commonly, diabetes, infection, bone spurs, or a tumor may cause lumbar radiculopathy.

What are the symptoms of lumbar radiculopathy?

The most common symptom of lumbar radiculopathy is low back pain with shooting pain into the buttocks and legs. A common pain pattern runs along the sciatic nerve down the back of the thigh to the calf and foot. Pain may also be accompanied by numbness, tingling, and muscle weakness. Patients may also experience muscle spasms and poor reflexes. Usually, symptoms are present on one side of the body, but they could be on both.

How is lumbar radiculopathy diagnosed?

To diagnose radiculopathy, a  CT or MRI is needed to evaluate for potential causes of nerve compression. Dr. Pennicooke will conduct a physical exam to determine the patient’s pain level, muscle strength, and nerve function. Imaging alone may not be enough for a diagnosis, so it is important to give an accurate medical history. After diagnosis, Dr. Pennicooke will determine an individualized treatment plan for each patient.

What is the treatment for lumbar radiculopathy?

Treatment for lumbar radiculopathy depends largely on the severity of the symptoms the patient is experiencing. Dr. Pennicooke will recommend the patient try the least invasive options first, which is typically non-surgical management.

Non-Surgical:

Non-surgical treatment for lumbar radiculopathy includes managing pain with prescription or over-the-counter painkillers, ice and heat, massage, and posture correcting. Patients may also find that stretching, yoga, and gentle exercise alleviate pain. Dr. Pennicooke may also recommend steroids (pills or injections) or a course of physical therapy to decrease inflammation and increase mobility.

Surgical:

If the patient does not experience pain relief and pain is restricting daily activities, Dr. Pennicooke may recommend surgery. The type of surgery will greatly depend on the type and severity of the injury. Some surgical options include:

• Microdiscectomy: Part of the irritated disc is removed to relieve pressure on the spinal cord or nerve roots.
• Laminectomy or Foraminotomy: Part or all of the vertebral bone (lamina) is removed to relieve pressure on the spinal cord or nerve roots.
• Lumbar Spinal Fusion: One or more of the vertebral bones are fused to prevent movement and create more space for the nerve roots.

Patients treated by Dr. Pennicooke should expect a recovery time of up to 2 to 3 months after surgery; however many patient’s recover in under 6 weeks. A back brace and physical therapy may also be recommended to promote healing. Dr. Pennicooke will assess each patient and create a treatment and recovery plan according to their needs.