What is Lumbosacral Radiculopathy

Lumbosacral radiculopathy is a condition that involves the spinal nerves and nerve roots in the low back and bottom of the spine. The condition develops when these nerves and nerve roots move out of place or become inflamed and cause symptoms.

What are the causes?

This condition may be caused by:

• Pressure from a disk that bulges out of place (herniated disk). A disk is a plate of soft cartilage that separates bones in the spine.
• Disk changes that occur with age (disk degeneration).
• A narrowing of the bones of the lower back (spinal stenosis).
• A tumor.
• An infection.
• An injury that places sudden pressure on the disks that cushion the bones of your lower spine.

What increases the risk?

You are more likely to develop this condition if:

• You are a male who is 30–50 years old.
• You are a female who is 50–60 years old.
• You use improper technique when lifting things.
• You are overweight or live a sedentary lifestyle.
• Your work requires frequent lifting.
• You smoke.
• You do repetitive activities that strain the spine.

What are the signs or symptoms?

Symptoms of this condition include:

• Pain that goes down from your back into your legs (sciatica), usually on one side of the body. This is the most common symptom. The pain may be worse with sitting, coughing, or sneezing.
• Pain and numbness in your legs.
• Muscle weakness.
• Tingling.
• Loss of bladder control or bowel control.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history.
• A physical exam.

If the pain is lasting, you may have tests, such as:

• MRI scan.
• X-ray.
• CT scan.
• A type of X-ray used to examine the spinal canal after injecting a dye into your spine (myelogram).
• A test to measure how electrical impulses move through a nerve (nerve conduction study).

How is this treated?

Treatment may depend on the cause of the condition and may include:

• Working with a physical therapist.
• Taking pain medicine.
• Applying heat and ice to affected areas.
• Doing stretches to improve flexibility.
• Doing exercises to strengthen back muscles.
• Having chiropractic spinal manipulation.
• Using transcutaneous electrical nerve stimulation (TENS) therapy.
• Getting a steroid injection in the spine.

In some cases, no treatment is needed. If the condition is long-lasting (chronic), or if symptoms are severe, treatment may involve surgery or lifestyle changes, such as following a weight-loss plan.

Follow these instructions at home:

Activity

• Avoid bending and other activities that make the problem worse.
• Maintain a proper position when standing or sitting:
  • When standing, keep your upper back and neck straight, with your shoulders pulled back. Avoid slouching.
  • When sitting, keep your back straight and relax your shoulders. Do not round your shoulders or pull them backward.
• Do not sit or stand in one place for long periods of time.
• Take brief periods of rest throughout the day. This will reduce your pain. It is usually better to rest by lying down or standing, not sitting.
• When you are resting for longer periods, mix in some mild activity or stretching between periods of rest. This will help to prevent stiffness and pain.
• Get regular exercise. Ask your health care provider what activities are safe for you. If you were shown how to do any exercises or stretches, do them as directed by your health care provider.
• Do not lift anything that is heavier than 10 lb (4.5 kg) or the limit that you are told by your health care provider. Always use proper lifting technique, which includes:
  • Bending your knees.
  • Keeping the load close to your body.
  • Avoiding twisting.

Managing pain

• If directed, put ice on the affected area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• If directed, apply heat to the affected area as often as told by your health care provider. Use the heat source that your health care provider recommends, such as a moist heat pack or a heating pad.
  • Place a towel between your skin and the heat source.
  • Leave the heat on for 20–30 minutes.
  • Remove the heat if your skin turns bright red. This is especially important if you are unable to feel pain, heat, or cold. You may have a greater risk of getting burned.
• Take over-the-counter and prescription medicines only as told by your health care provider.

General instructions

• Sleep on a firm mattress in a comfortable position. Try lying on your side with your knees slightly bent. If you lie on your back, put a pillow under your knees.
• Do not drive or use heavy machinery while taking prescription pain medicine.
• If your health care provider prescribed a diet or exercise program, follow it as directed.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your pain does not improve over time, even when taking pain medicines.

Get help right away if:

• You develop severe pain.
• Your pain suddenly gets worse.
• You develop increasing weakness in your legs.
• You lose the ability to control your bladder or bowel.
• You have difficulty walking or balancing.
• You have a fever.

Summary

• Lumbosacral radiculopathy is a condition that occurs when the spinal nerves and nerve roots in the lower part of the spine move out of place or become inflamed and cause symptoms.
• Symptoms include pain, numbness, and tingling that go down from your back into your legs (sciatica), muscle weakness, and loss of bladder control or bowel control.
• If directed, apply ice or heat to the affected area as told by your health care provider.
• Follow instructions about activity, rest, and proper lifting technique.