Lumbar radiculopathy

Abstract

Low back pain is one of the most common musculoskeletal complaints in clinical practice. The differential diagnosis of low back pain is broad and should include lumbosacral radiculopathy. Radiculopathy is a term that covers sensory and motor deficits and paresthetic complaints resulting from the pathology of the nerve roots. Lumbar radicular pain is neuropathic pain caused by disc compression of the lumbar spinal nerve root, resulting in radiating pain in a dermatomal pattern. The most common causes of radicular pain are intervertebral disc herniation and lumbar spinal stenosis. Diseases such as neoplasms affecting the nerve roots, epidural abscesses, Herpes zoster, and Lyme disease can also cause radicular pain. The diagnosis of lumbar radicular pain due to disc compression/stenosis can be made by a history and physical examination. However, imaging and electrodiagnostic studies should be performed to exclude other possible causes of radicular symptoms. Urgent imaging and rapid intervention are important if 'red flag' symptoms or signs such as cauda equina syndrome, malignancy, vertebral fracture, vertebral osteomyelitis, and epidural abscess are present. Conservative treatment is the first-line treatment for radicular pain. However, in the presence of progressive neurologic deficit or cauda equina syndrome following radicular pain, surgical planning should be made according to the etiology and the current condition of the patient.