What is Lumbar Radiculopathy?
The human body contains an extensive system of nerves that facilitate communication between the cells. Nerves send and receive messages throughout the body. Without them, we wouldn’t have basic human functions, like movement, balance, and sleep, or sensations, like touch.
Unfortunately, just like the rest of the human body, nerves are susceptible to damage. Radiculopathy is one type of nerve damage that can severely impact one’s mobility and quality of life.
In this article, we’re going to discuss a specific form of this nerve condition: lumbar radiculopathy.
What is Lumbar Radiculopathy?
The vertebrae are the bones of the spine. An intervertebral disc is located in between each vertebra and acts as a cushion by absorbing impact.
If the vertebrae or the discs between them impinge on a nerve root in the spinal column, chronic nerve injuries may result. Radiculopathy is the general term for these injuries.
Radiculopathy most commonly occurs in the lower, or lumbar, region of the spine. This condition has been termed lumbar radiculopathy. Though less common, radiculopathy may also occur in the neck, or cervical region of the spine, which is known as cervical radiculopathy.
Symptoms of Lumbar Radiculopathy
Common symptoms of radiculopathy include radiating pain, numbness, tingling, and weakness. In some cases, a loss of motor function can result from lumbar radiculopathy. These symptoms may be felt all the way to the tips of the fingers or toes, even though the nerve injury is at the base of the spine.
Radiculopathy symptoms felt in the arms and hands are usually caused by cervical radiculopathy, while those in the back of the leg and the foot usually result from lumbar radiculopathy. The location of the nerve compression determines where radiculopathy symptoms are felt.
The severity of lumbar radiculopathy symptoms can vary from patient to patient. Some patients with radiculopathy experience severe, debilitating symptoms that significantly impact their day-to-day activities.
Causes of Lumbar Radiculopathy
There are several possible causes for lumbar radiculopathy, including:
- Degenerative disc disease
Degenerative disc disease is a normal part of the aging process. It occurs when the intervertebral discs weaken and dry out over time. As the discs become damaged, the nerves of the spine may become irritated, leading to radiculopathy symptoms.
- Repetitive motions involving the spine
Repetitive and high-impact motions can contribute to lumbar radiculopathy. This is more common among people with occupations that require repetitive motions or heavy lifting.
- Being overweight
Being overweight or in poor physical health can also contribute to radiculopathy. This is because added body weight puts extra stress on the nerves, which can lead to nerve damage.
Diabetes is associated with heightened blood glucose levels. This can cause the development of deposits within the blood vessels that decrease circulation throughout the body. As a result, high blood sugar can lead to nerve damage.
A genetic predisposition can also increase one’s risk of developing spinal radiculopathy.
- Spinal conditions
Various spinal conditions can cause nerve impingement and lead to radiculopathy. Examples of these conditions include herniated disc, spinal stenosis, osteoarthritis, spondylolisthesis, and scoliosis.
What Is The Difference Between Sciatica and Lumbar Radiculopathy?
Sciatica is a form of radiculopathy. In fact, it’s the most prevalent type of radiculopathy. It refers to pain that radiates throughout the sciatic nerve, meaning that it starts in the lower back and moves through the buttocks, down the legs, and to the feet.
The terms lumbar radiculopathy and sciatica are commonly used interchangeably. This is because nerve impingement in the lumbar spine typically involves the sciatic nerve. After all, the sciatic nerve is the largest nerve in the body.
Can Lumbar Radiculopathy Get Worse?
Lumbar radiculopathy has the potential to get worse. In some patients, the pain may come and go. But, in others, radiculopathy symptoms are persistent and gradually become worse over time.
If lumbar radiculopathy isn’t promptly addressed, various factors can exacerbate the condition by causing additional nerve damage. These factors include:
- Poor posture
Poor posture increases the amount of stress placed on the spinal nerves. In patients who lead a sedentary lifestyle, sitting at a desk with poor posture for hours on end may significantly worsen radiculopathy symptoms.
- Repetitive movements
Repeatedly twisting, bending, and straining the spine can further irritate the affected nerves, leading to worsened radiculopathy symptoms.
- High-impact activities
Weight-bearing physical activities can cause additional damage to the spinal nerves. Examples of these activities include football, wrestling, weightlifting, soccer, and hockey.
How Do You Treat Lumbar Radiculopathy?
Lumbar radiculopathy treatment methods may be non-surgical or surgical. Doctors begin with non-surgical treatment, and if the patient’s symptoms don’t improve after several months, consider surgery.
Non-Surgical Lumbar Radiculopathy Treatment
Physical therapy, medication, steroid injections, and relaxation are often prescribed successfully to treat lumbar radiculopathy.
- Physical therapy
Physical therapy is often recommended for lumbar radiculopathy. It involves exercises and therapies designed to improve spinal stability and alignment. This can help create more space for the spinal nerve roots.
Non-steroidal anti-inflammatory drugs, or NSAIDs, can help relieve inflammation and pain caused by lumbar radiculopathy. This can help make radiculopathy symptoms more manageable. However, these medications generally aren’t recommended for long-term use.
- Epidural steroid injections
Epidural steroid injections reduce the body’s inflammatory response at the injection site. For lumbar radiculopathy, this can help alleviate inflammation in the spinal nerves.
Doctors generally advise patients to receive no more than three to four epidural steroid injections per year. Since steroid injections hamper the immune system response, they can cause tissue damage when used in excess.
- Rest and relaxation
Rest and relaxation are recommended for patients with lumbar radiculopathy to give the spinal nerves time to heal.
Surgical Lumbar Radiculopathy Treatment
When non-surgical treatments fail to provide relief for radiculopathy of the lumbar region, surgical methods may be recommended. Generally, physicians don’t recommend surgery for lumbar radiculopathy unless the patient has undergone at least six months of conservative treatment.
Spinal decompression surgery is the main surgical lumbar radiculopathy treatment. This type of spine surgery involves removing spinal tissues to alleviate pressure on the affected nerves. Laminectomy, laminotomy, laminoplasty, foraminotomy, and discectomy are all common methods of spinal decompression.
Spinal Fusion and Spinal Decompression Surgery For Radiculopathy
Since spinal decompression surgery involves removing tissues from the spine, it can lead to spinal instability. To prevent this, spinal decompression surgery is often combined with spinal fusion back surgery. This combination of procedures has been a common treatment modality for lumbar radiculopathy patients who don’t respond to conservative treatments.
Spinal fusion permanently joins the affected vertebrae using bone graft material. This prevents all motion in the fused spinal segment. Unfortunately, while this counters instability, it also significantly decreases the patient’s range of motion.
Additionally, fusing two spinal vertebrae forces the adjacent vertebrae to bear additional impact with day-to-day motions. The added impact can cause the adjacent spinal segments to deteriorate at a quicker rate, potentially leading to back pain, stiffness, and neurological symptoms. This complication of spinal fusion is known as adjacent segment disease or ASD.
Alternative Options For Lumbar Radiculopathy Patients
The TOPS™ (Total Posterior Spine) System is a new advancement in spinal surgery that can be used as an alternative to spinal fusion. Unlike fusion, the TOPS™ System preserves the full natural range of motion of the individual vertebrae, which is lost when the bones are fused.
This spinal implant has also been shown to provide superior outcomes in clinical studies conducted across the globe. With TOPS™, lumbar radiculopathy patients can attain lasting relief for nerve pain without having to worry about complications from spinal fusion.
Advances like TOPS™ give individuals with back problems more options for effective treatments. So, if you’re suffering from persistent radiculopathy pain, speak with a spine specialist about the complete range of treatment solutions available today.