Lumbar Radiculopathy — Causes, Symptoms, and Treatment

Lumbar radiculopathy is a common problem we see in our physical therapy clinic located in Durham, NC. Traditionally, lumbar radiculopathy will cause sciatica symptoms in the leg. These symptoms are tingling, numbness, or burning into the buttock, back of the thigh, back of the calf, or foot. In today’s article, we want to discuss the symptoms and treatment for lumbar radiculopathy. 

What Causes Lumbar Radiculopathy

Traditionally, lumbar radiculopathy will be caused by a pinched nerve root in the lower spine. This pinched nerve can be a result of a number of causes. 

A herniated or bulging disc is the most common cause of lumbar radiculopathy. However, many people who have a herniated or bulging disc do NOT present with symptoms. 

In other words, just because one is diagnosed with a herniated disc or bulging disc does NOT mean it’s the cause of their lumbar radiculopathy symptoms. See treatment below…

Degenerative disc disease is another common cause of lumbar radiculopathy. This diagnosis can cause a pinched nerve as a result of the narrowing or shortening of the discs between the vertebrae. When the discs become smaller they cause a narrowing for the canal in which the nerve root exits the spine. A narrowing of the canal means a smaller hole for the nerve which can lead to a pinched nerve and lumbar radiculopathy. 

However, just because someone is diagnosed with degenerative disc disease does NOT mean it’s the cause of their lumbar radiculopathy symptoms.

Spinal stenosis is the final (traditional) cause of lumbar radiculopathy and essentially means there is a narrowing of the spinal canal. This can be caused by a herniated disc or degenerative disc disease. 

Just because someone is diagnosed with spinal stenosis does NOT mean it’s the cause of their lumbar radiculopathy symptoms.

What are Lumbar Radiculopathy Symptoms

Lumbar radiculopathy often causes sciatica symptoms. This can be tingling, numbness, or burning into the buttock, back of the thigh, or back of the calf and the foot. Many people report different areas of nerve pain. For example, some will only have nerve pain in the buttock while others will feel it in the entire leg and foot. Both are considered lumbar radiculopathy and should be treated as such.

The Science Behind Herniated Discs, Degenerative Disc Disease, and Spinal Stenosis

One thing most people don’t realize is that just because someone has a herniated disc, degenerative disc disease, or spinal stenosis does NOT mean it’s the cause of pain. If we take a look at the literature there are plenty of well-known studies showing people with these diagnoses who complain of NO pain. 

  • For example, a study in 2014 found that 80% of people over the age of 50 had degenerative disc disease, yet NONE of them reported any pain.
  • Furthermore, this same study found 36% of people had a herniated disc, and again, NO pain.

Treatment for Lumbar Radiculopathy

From our experience, many people will be offered steroid injections and some will be told they need surgery. But what we’ve learned is that this is rarely necessary. Pain is not always a result of damage. It’s much more complex than that. Here’s what should be looked at fro lumbar radiculopathy and degenerative disc disease treatment:

Simple Movement Tests for Herniated Disc and/or Degenerative Disc Disease/Stenosis

For someone who has been diagnosed with a herniated or bulging disc, there are some predictable movements at the spine which should cause increased symptoms. Specifically, spinal flexion should lead to an increase in symptoms. This occurs because the pressure becomes increased on the disc when in flexion.

Degenerative disc disease and spinal stenosis are opposite. In other words, symptoms should be worse with spinal extension. This occurs because in extension the canal where the nerve root exits the spine becomes smaller. 

Note: Degenerative disc disease and spinal stenosis should lead to symptoms occurring in BOTH legs, not just one. If you don’t have pain in BOTH legs it’s extremely likely that your problem isn’t either of these diagnoses, even if you were told it is. This is because at each spinal level there are two nerve roots that exit the spine (left and right). Therefore, a problem at any one spinal level should affect both nerves at that level.

Treatment for Lumbar Radiculopathy

Surgery, pain meds, and steroid injections are one option, albeit most don’t want to go in this direction. Here’s what we’ve found to work for pain relief:

Spine mobility: From our experience, most people with lumbar radiculopathy will be limited in spine mobility, specifically spinal extension. However, identifying and fixing any problems with spinal movement should be addressed and can be the root cause of the pain.

Hip mobility: From our experience, most people with lumbar radiculopathy will also be limited in hip rotation. This occurs because the nerve often times becomes pinched in the tight muscles in the buttock region. A stiff hip is a sign that this could be the root cause. 

Spine and/or hip weakness: From our experience, there is likely a combination of spine and hip weakness that is causing the pain. Furthermore, a balance deficit can also lead to lumbar radiculopathy symptoms. Many times the area which hurts is in pain because of a problem that is occurring somewhere else (i.e. compensation).

Rule out piriformis syndrome as the probable cause.

Creating a long-term solution to lumbar radiculopathy (and pain in general) requires taking an in-depth look at the entire body. Many people will be told their pain is due to a diagnosis seen on an MRI or X-ray. However, pain isn’t that simple. It’s much more complex than what you likely believe. And this is the reason why we should consider the entire person and not just a diagnosis. 

Physical Therapy for Lumbar Radiculopathy

Our physical therapy clinic in Durham, NC can likely help you get out of pain and avoid pain meds, injections, and surgery. If you’re seeking help we invite you to schedule a complimentary phone call with our physical therapy clinic. This phone call is designed for us to ask you more questions about your problem so we can learn if our therapy seems like the best fit. If it does we’ll invite you in for a treatment visit.

Medical Disclaimer:

All information on this website is intended for instruction and informational purposes only. The authors are not responsible for any harm or injury that may result. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied on this website.