LUMBAR RADICULOPATHY

Question 1

Nerve supply the hamstrings? What movement do they do?

Answer 1

Sciatic nerve

knee flexion, hip extension

Question 2

What is radiculopathy?

Answer 2

Condition due to compressed nerve in spine. Causes pain, numbness, tingling, weakness along course of nerve

→ can occur in any part of spine, but most common lower back (lumbar) and neck (cervical)

Question 3

Lower back pain radiating to buttocks and back of thigh likely caused by what?

Answer 3

Compression of sciatic nerve at root (radiculopathy), commonly caused by herniated disc

Causes inflammation, pain and numbness in affected leg

Question 4

Most cases of sciatica are caused by radiculopathy rather than neuropathy. This is because the sciatic nerve is supplied by multiple roots (L4 - S3) and therefore a herniated disc will not knock out the entire nerve. What can cause a neuropathy of the sciatic nerve?

what kind of symptoms with this cause?

Answer 4

• Posterior dislocation of hip, or fracture
• Prolonged compression e.g. coma, bedrest
• Hip replacement surgery

if mild may only cause sensory problems. If severe can cause hamstring muscle weakness, loss of Dorsiflexion/foot drop, sensory loss in lower leg and foot

Question 5

Pain radiating down the back of the leg and weak planter flexion (difficulty standing on toes) plus lost ankle reflex indicates compression of which nerve root? Which nerve is involved?

Answer 5

S1 (L5/S1 disc)

tibial nerve

Question 6

What test can you perform if you suspect a lumbar radiculopathy?

Answer 6

Straight leg raise test

This will stretch the sciatic nerve and nerve roots and will elicit symptoms

Question 7

What is this condition? What can this due to the nerve?

Answer 7

Spondylolisthesis

Can compress nerve root and cause radiculopathy

Question 8

somebody who has signs of radiculopathy whose symptoms worsen when they are stood up straight and improve when they are bent over indicate the problem is caused by what? Explain this condition

Answer 8

Spinal stenosis: narrowing of spinal canal

Age related shrinkage of intervertebral discs narrows foramen through which nerve roots leave spine. Often exacerbated by facet joint arthritis causing bony spurs and ligamentum flavum hypertrophy

standing up straight and narrows the lumbar canal further

Question 9

People with spinal stenosis can experience what symptom in the legs that can mimic a vascular condition? How will you differentiate between the two?

Answer 9

(Neurogenic) Claudication: most common symptom of lumbar spinal stenosis

• Often persists with rest when standing
• Improves when stooped/flexed posture