The word 'radiculopathy' describes the loss of function related to a nerve root. Lumbar radiculopathy (or 'lumbosacral radiculopathy') describes radiculopathy where it affects the hip, lower back and the legs – in some cases down to the foot. The other two types of radiculopathy that affect the spine are cervical radiculopathy which affects the neck area and much less common thoracic radiculopathy, which affected the middle section of the spine.
Radiculopathy in general terms is often described as a 'pinched' or 'compressed' nerve or as 'nerve entrapment' or 'nerve root impingement'.
Lumbar radiculopathy occurs when nerve roots which exit the spine between the vertebrae L1 and S4 are compressed.
The primary cause of lumbar radiculopathy is an irritation to one of these nerve roots where it connects to the spinal cord. This can in turn be caused for example by…
- Pressure on the nerve, often from an intervertebral disc bulging out from the spinal column (a 'herniated disc') or an 'osteophyte', which is a bony growth on the side of a verterbra.
- Swelling around the nerve root.
- Narrowing of the spinal column ('spinal stenosis').
- Degenerative disc disease ('spondylosis').
- Sideways curvature of the spine ('scoliosis').
- Scar tissue from previous surgery.
- Injury ('trauma').
In 90% of cases of lumbar radiculopathy, the primary cause is a herniated disc, and in many cases more than one of these causes is present.
Risk factors for developing lumbar radiculopathy include…
- Being aged 45-64.
- Driving a lot (this causes prolonged vibration in the body) .
- Frequent heavy lifting and other strenuous physical activities (including contact sports).
- Pain in the hips, lower back and / or legs, which may extend down the back of the leg to the foot.
- Sensations of numbness, tingling and muscle weakness in these areas.
- Pain when sitting down.
- Pain when coughing / sneezing.
- Loss of reflexes and / or hypersensitivity.
Tests / Diagnosis
When you visit the doctor, they will evaluate symptoms and conduct a physical examination and also a neurological examination, which will involve testing reflexes, sensation and muscle strength. Other tests may be recommended, such as imaging (x-ray, CT or MRI scans). Further tests may also be required, but rarely.