Lumbar Radiculopathy

What is lumbar radiculopathy?

Lumbar Radiculopathy Care Guide

Lumbar radiculopathy is a painful condition that happens when a nerve in your lumbar spine (lower back) is pinched or irritated. Nerves control feeling and movement in your body.

What causes lumbar radiculopathy?

You may get a pinched nerve in your lumbar spine if you have disc damage. Discs are natural, spongy cushions between your vertebrae (back bones) that allow your spine to move. Your discs may move out of place and pinch the nerve in your spine. Your risk for a pinched nerve and lumbar radiculopathy increases if:

  • You smoke.

  • You have diabetes, a spinal infection, or a growth in your spine.

  • You are overweight.

  • You are male.

  • You are elderly.

What are the signs and symptoms of lumbar radiculopathy?

You may have any of the following:

  • Pain that moves from your lower back to your buttocks, groin, and the back of your leg. The pain is often felt below your knee. Your pain may worsen when you cough, sneeze, stand, or sit.

  • Numbness, weakness, or tingling in your back or legs.

How is lumbar radiculopathy diagnosed?

Your caregiver will examine you and ask about your family history of back and leg pain. He may also test you for weakness, numbness, or tingling in your back, buttocks, and legs. Your caregiver may ask you to lie on your back and lift your leg to locate your pain. You may have any of the following:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Magnetic resonance imaging (MRI): An MRI machine is used to take a picture of your lower back. Your caregiver will use this picture to check for problems and changes in your back bones, nerves, and discs. You will need to lie still during this test. The MRI machine contains a very powerful magnet. Never enter the MRI room with any metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

  • X-ray: An x-ray is a picture of your lower back. A lumbar x-ray may show signs of infection or other problems with your spine.

  • Electromyography: This is also called an EMG. An EMG is done to test the function of your muscles and the nerves that control them. Electrodes (wires) are placed on the area of muscle being tested. Needles that enter your skin may be attached to the electrodes. The electrical activity of your muscles and nerves is measured by a machine attached to the electrodes. Your muscles are tested at rest and with activity.

  • Computed tomography (CT) scan: A special x-ray machine uses a computer to take pictures of your lower back. It may be used to look at your bones, discs, and nerves. You may be given dye in your IV to help improve the pictures. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes.

How is lumbar radiculopathy treated?

Treatment of lumbar radiculopathy may reduce pain and swelling, and improve your ability to walk and do your normal activities. Ask your caregiver for more information about these and other treatments for lumbar radiculopathy:

  • Medicines:

    • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your primary healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.

    • Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.

    • Opioids: This is a strong medicine given to reduce severe pain. It is also called narcotic pain medicine. Take this medicine exactly as directed by your caregiver.

    • Oral steroids: Steroids may be given to reduce swelling and pain.

    • Steroid injections: Caregivers may give you steroid medicine through a needle (shot) into your lumbar spine. This may help decrease your nerve pain and swelling. You may need more than 1 injection if your symptoms do not improve after the first treatment.

  • Physical therapy: Your caregiver may suggest physical therapy. Your physical therapist may teach you certain exercises to improve posture (the way you stand and sit), flexibility, and strength in your lower back. He may also teach you how to remain safely active and avoid further injury. Follow the exercise plan given to you by your physical therapist.

  • Transcutaneous electrical nerve stimulation: This treatment, called TENS, stimulates your nerves and may decrease your pain. Wires are attached to pads. The pads are attached to your skin. The wires send a mild current through your nerves.

  • Surgery: You may need surgery to relieve your pinched nerve if your condition has not improved within 4 to 6 weeks. You may also need it if you have lumbar radiculopathy more than once.

What are the risks of treatment for lumbar radiculopathy?

  • Without treatment, your pain may worsen. The pinched and swollen nerve may lead to problems when you walk or move. In severe cases, you may lose control of your urine or bowel movements. Bedrest can make your symptoms worse.

  • Pain medicines can cause vomiting, upset stomach, constipation (large, hard bowel movements that are difficult to pass), or kidney or liver problems. Opioid medicine may be addictive (hard to quit taking once you start). Oral steroids and steroid injections may have side effects, such as facial redness, fluid retention (water weight gain), and mood changes. Steroid injections may be painful and can cause severe headaches, infections, allergic reactions, or nerve damage. Surgery risks include delayed problems with healing, spinal or bladder infection, damage to the spinal cord or other nerves, and ongoing pain. In rare cases, you could become paralyzed (not able to move your arms or legs).

How can I care for myself when I have lumbar radiculopathy?

  • Stay active: It is best to be active when you have lumbar radiculopathy. Your caregiver may tell you to take walks to ease yourself back into your daily routine. Avoid long periods of bed rest. Bed rest could worsen your symptoms. Do not move in ways that increase your pain. Ask your caregiver for more information about the best ways to stay active.

  • Use ice or heat packs: Use ice or heat packs on the sore area of your body to decrease the pain and swelling. Put ice in a plastic bag covered with a towel on your low back. Cover heated items with a towel to avoid burns. Use ice and heat as directed.

  • Avoid heavy lifting: Your condition may worsen if you lift heavy things. Avoid lifting if possible.

  • Maintain a healthy weight: Excess body weight may strain your back. Talk with your caregiver about ways to lose excess weight if you are overweight.

When should I contact my caregiver?

Contact your caregiver if:

  • Your pain does not improve within 1 to 3 weeks after treatment.

  • Your pain and weakness keep you from your normal activities at work, home, or school.

  • You lose more than 10 pounds in 6 months without trying.

  • You become depressed or sad because of the pain.

  • You have questions or concerns about your condition or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • You have a fever greater than 100.4°F for longer than 2 days.

  • You have new, severe back or leg pain, or your pain spreads to both legs.

  • You have any new signs of numbness or weakness, especially in your lower back, legs, arms, or genital area.

  • You have new trouble controlling your urine and bowel movements.

  • You do not feel like your bladder empties when you urinate.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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