Lumbar Radiculopathy (“Sciatica”) and Herniated Disc

 


Lumbar radiculopathy (also known as “sciatica”) is term used to describe radiating leg pain, numbness, or weakness caused by inflammation or pinching of a spinal nerve in the lower back. Lumbar radiculopathy can result from a herniated disc, degenerative disc disease, or stenosis (narrowing) of the lumbar spine.

Radiculopathy

  • Radiating leg pain or numbness from an inflamed or pinched spinal nerve
  • Also called “sciatica”
  • Can be caused by stenosis, disc degeneration, or disc herniation

Herniated Disc

  • Tear in the outer wall (annulus) of the disc allows the inner gel (nucleus) to protrude into the spinal canal

Natural History (“Doing Nothing”)

  • Not all disc herniations cause symptoms
  • Symptoms may resolve without treatment
  • Herniated material may dissolve over time

“Cauda Equina Syndrome”

  • Rare
  • Loss of bowel and bladder function due to pressure an all of the nerves running through the spinal canal
  • Caused by large herniated disc
  • Surgical treatment needed urgently

Three Phases of Treatment for Lumbar Disc Herniation:

  • Phase I – Non-Invasive Treatments
  • Phase II – Spinal Injections
  • Phase III – Surgery
  • Goals of Each Phase:
  • Relieve Pain
  • Improve Function

Treatment Options for Lumbar Disc Herniation: Phase I

  • Oral Medications
  • Steroids
  • Non-Steroid Anti-Inflammatories (NSAIDs)
  • Pain relievers
  • Physical Therapy and Home Exercise
  • Ice and Heat

Treatment Options for Lumbar Disc Herniation: Phase II

  • Epidural Steroid Injections
  • Outpatient procedure
  • Done with x-ray guidance
  • 1-3 injections may be needed

Treatment Options for Lumbar Disc Herniation: Phase III – Surgery