Ask Dr. Wills: How Do I Know If I Have Lumbar Radiculopathy?
Radiculopathy is a spinal nerve root condition caused by nerve compression, inflammation, or injury that can trigger back and leg pain. When this injury is located in the lower part of the spine, it is called lumbar radiculopathy. Spine surgeon Dr. Wills explains how lumbar radiculopathy is diagnosed.
“Lower back pain tells us that something is wrong, but pain is a symptom, not a diagnosis,” explains spine surgeon Dr. Nicholas Wills. “Our job is to identify and treat the source of the problem. At Summit, we take the patient’s medical history, do a physical examination, order imaging tests as appropriate to confirm our diagnosis, and then develop a treatment plan focused on treating the source of patient back pain.” This article explains specifically the condition lumbar radiculopathy.
Understanding the terms: Lumbar radiculopathy and sciatica
“Lumbar radiculopathy and sciatica are terms that are often used interchangeably to describe the compression or inflammation of a spinal nerve in the lower back,” says Dr. Wills. “Pain as a symptom can provide us with clues about the source or cause of the problem, but our approach to diagnosis is focused on understanding the underlying issue that is causing the pain. Radiculopathy is our term for the actual nerve dysfunction caused by compression.”
Coming to a diagnosis
At Summit, a clinical diagnosis is reached by taking the patient’s history, including a description of the pain, conducting a physical exam, and using imaging studies to identify the impingement on the nerve root in the lumbar spine and confirm the diagnosis.
“Hearing about the pain from the patient helps us narrow in on a diagnosis,” explains Dr. Wills. “Radicular pain—often called sciatica—has some distinct characteristics. This type of pain radiates down the back of the leg to the calf or foot, following the path of the sciatic nerve. Patients often describe it as a deep, steady pain felt especially during walking or sitting. It is usually much worse in the legs than in the lower back. Radicular pain is often accompanied by numbness, prickly sensations, and muscle weakness.”
Benefits of discussing medical history
The patient’s medical history provides additional clues. “Certain patient conditions increase the likelihood of radiculopathy,” Dr. Wills explains. “We want to know if the patient has a herniated disc; one of the most common causes of nerve compression. If the patient is elderly and has arthritis, we check for indications of stenosis, a narrowing of the tunnel that houses the spinal nerve—usually caused by arthritis. Other conditions—including diabetes, nerve root injuries, and scar tissue from previous spinal surgery—can also cause radiculopathy.”
Lumbar radiculopathy treatment options
Summit Orthopedics is home to the area’s top spine specialists for lumbar radiculopathy treatment. When lumbar radiculopathy is diagnosed, conservative, nonsurgical treatment is usually the first step. If there is no improvement after six to eight weeks, a surgery to decompress the nerve may be considered. In rare cases when a patient is experiencing severe leg pain and progressive muscle weakness, surgery may be considered sooner.
“Our spine team offers comprehensive expertise with an emphasis on conservative care,” says Dr. Wills. “We know that 90 percent of patients suffering from sciatic pain recover without surgery, and we use conservative treatments first whenever appropriate. When patients do require surgical treatment, Summit is committed to providing the most advanced and proven spine surgical techniques available, and delivering the best possible outcome for every patient.”
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