Lumbar Radiculopathy (Sciatica)

Pain in spine radiating down right leg.

What is lumbar radiculopathy?

Sciatic nerve pain is one of the most common causes in the United States of low back and leg pain. This condition is defined as inflammation of the sciatic nerve which typically causes pain that starts on one side of the low back or in the buttock, and then radiates down the back, side or front of the leg. Depending on the underlying cause, lumbar radiculopathy can require a multimodal or multidisciplinary approach to best relieve the pain.

What are the symptoms of lumbar radiculopathy?

  • Back pain

  • Leg pain

  • “Shooting” or “electric” type pain running down the leg

  • Numbness, tingling or weakness

  • Bowel or bladder dysfunction

  • Pain increases when walking, sitting or standing for extended periods

  • Worsened pain with raising the leg

What are the causes of lumbar radiculopathy?

While there are many possible causes of, most cases of sciatica are the result of spinal discs pushing out of their normal alignment and contacting the lumbar or sacral nerve roots. This can cause compression of nerve roots, inflammation, and radiating pain that is classic with this condition. Other causes of sciatica are compression of the spinal cord (spinal canal stenosis), piriformis syndrome, pregnancy, cancer, infection, or trauma. It is important to be evaluated by a medical professional especially if the pain persists, or serious symptoms develop such as numbness, tingling, weakness, or bowel or bladder dysfunction.

What is the treatment of sciatica?

First, you should consult with a physician to determine the source of your sciatic pain as the treatment can vary depending on the underlying cause. In addition to performing a history and physical exam, your physician may order imaging such as a MRI or CT scan. This will help identify where nerve compression could be occurring.

Fortunately, most cases of acute sciatic pain they tend to get better with only mild therapies such as rest, ice and time. This is because most causes of lumbar radiculopathy are from “slipped” or herniated low back discs which tend to get reabsorbed by the body over time. However, a sizable portion of patients continue to have low back and leg pain despite conservative measures. In this case, other therapies should be considered to improve quality of life and alleviate the pain. These treatments include:

  • Physical therapy and core strengthening exercises

  • Procedures such as epidural steroid injections to target the area of nerve compression and inflammation with steroid and local anesthetic

  • Multimodal medications

  • Alternative therapies such as chiropractic care or acupuncture

  • Surgery to relieve severe cases of nerve compression

  • Spinal cord stimulation

While the pain from lumbar radiculopathy can be overwhelming, there is hope. With continued treatment, even refractory low back pain can improve greatly. Schedule an appointment with Cahaba Pain to work on reversing your sciatic pain and getting your life back today!