Lumbar Radiculopathy (Sciatica)

Radiculopathy is a condition caused by inflammation or pressure on a nerve as it leaves the spine. The pain can be in any part of your spine, but it is most common in the low back (lumbar) or neck (cervical). Lumbar radiculopathy is pain that radiates down into your legs, and it is often referred to as sciatica.

Causes

The most common cause of lumbar radiculopathy is due to compression on a spinal nerve, which causes inflammation. This can be caused by different spinal conditions including disc herniation, stenosis, spondylolisthesis or other degenerative changes in the spine.

Lumbar radiculopathy can also be the result of a spinal injury.

Symptoms

Symptoms of lumbar radiculopathy are described as pain that worsens with activity or positions, such as walking or prolonged sitting. The inflamed nerve can cause sharp pain, radiating pain, weakness, numbness and tingling.

Diagnosis

The diagnosis of lumbar radiculopathy is made by a good medical history, a physical exam, and lumbar spine imaging such as x-rays and an MRI. On imaging, you may see a nerve being compressed by a lumbar disc herniation or from spinal stenosis, a narrowing of the canal where it travels.

Treatment

Treatment will vary, depending on the severity of symptoms and pathology on imaging.

Nonsurgical Treatment

Treatment starts with medication such as anti-inflammatories, or NSAIDs. Physical therapy is also a first-line recommendation to help with strengthening and stretching of your lumbar spine. Injections would be another option; this would target the inflammation surrounding the nerve to help lessen the irritation and thus pain.

Surgical Treatment

Finally, if symptoms do not improve with conservative care and time, surgery may be a last resort. Two common surgeries used for lumbar radiculopathy are microdiscectomy and laminectomy.