lx radiculopathy

Question 1

What is it?

Answer 1

Disorder that causes pain in the lower back and hip which radiates down the back of the thigh into the leg
Damage caused by the compression of nerve roots which exit spine - L1-S4
Compression results in tingling, radiating pain, numbness, paraesthesia and occasional shooting pain

Question 2

Anatomy

Answer 2

Since disc herniations occur posterolaterally, the root that gets compressed is the root that exits the foramen below the herniated disc
E.g. Disc protrusion at L4/L5 will compress the L5 root and a protrusion at L5/S1 will compress the S1 root.

Question 3

Epidemiology

Answer 3

Lumbar radiculopathy - 3 to 5 % incidence
5-10% of patients with lbp have sciatica

Question 4

Risk factors

Answer 4

Activities that place an excessive/repetitive load on the spine
Heavy labour/contact sports
Age (peak 45-64 years)
Smoking
Mental stress
Strenuous physical activity (frequent lifting)
Driving

Question 5

Clinical Presentation

Answer 5

Lesions of intervertebral discs and degenerative disease of the spine
Herniated disc with nerve root compression causes 90% of cases
Lumbar spinal stenosis
Scoliosis
Osteomyelitis

Question 6

Special tests

Answer 6

Straight leg raise test
Femoral nerve stretch test