Lumbar Radiculopathy
THE CLINICAL SYNDROME
 Lumbar radiculopathy is a constellation of symptoms consisting of neurogenic back and lower extremity pain emanating form the lumbar nerve roots. In addition to the pain, the patient with lumbar radiculopathy may experience associated numbness, weakness, and loss of reflexes. The causes of lumbar radiculopathy include herniated disc, foraminal stenosis, tumor, osteophyte formation, and rarely infection. Many patients and their physicians will refer to the constellation of symptoms that compromise lumbar radiculopathy as sciatica.
The patient suffering from lumbar radiculopathy will often assume an unnatural posture in an attempt to take pressure off the affected nerve root and relieve pain.
| Clinical Features of Lumbar Radiculopathy |
| Lumbar Root |
Pain |
Sensory Changes |
Weakness |
Reflex Changes |
| L4 |
Back, shin, thigh, and leg |
Skin numbness |
Ankel dorsiflexors |
Knee jerk |
| L5 |
Back, posterior thigh, and leg |
Numbness of top of foot and first web space |
Extensor hallucis longus |
None |
| S1 |
Back, posterior calf, and leg |
Numbness of lateral foot |
Gastrocnemeus and soleus |
Ankle jerk |
TREATMENT
Lumbar radiculopathy is best treated with a multimodality approach. Physical therapy, including heat modalities and deep sedative massage, combined with nonsteroidal anti-inflammatory drugs and skeletal muscle relaxants represent a reasonable starting point. The addition of caudal or lumbar steroid epidural nerve blocks is a reasonable next step. Caudal or lumbar epidural blocks with local anesthetic and steroid have been shown to be extremely effective in the treatment of lumbar radiculopathy. Underlying sleep disturbance and depression are best treated with a tricylic antidepressant compound such as nortriptyline, which can be started at a single bedtime dose of 25 mg.
AAAAAAAAA. Patients with C-7 radiculopathy will often place the hand of the affected extremity on the head to obtain relief. AAAAA
Low intensity laser therapy as well as a coordinated wellness program is also effective in treating this disorder.
Low Intensity Laser Therapy (LILT)
The low intensity Laser (LILT) sends photons (light) into the injured tissues and can penetrate two to three inches to treat affected areas. It uses a natural enhancement of the cellular machinery that can and has been dynamically measured in published studies to promote healing without burning affected tissue .Once the photons find the injured tissues, they stimulate and energize the cells to repair and strengthen at a remarkable rate. The treatment does not hurt, takes about 30 minutes and is very cost advantageous.
Wellness Program
A wellness program whichindividualizes treatment for age, performance and function has been shown in pilot studies to improve the overall health and well being of the individuals evaluated. A well conceived dietary and supplementary regimen based on scientific age–related decline in certain necessary compounds can improve quality of life, correct the ravages of hormone imbalance, balance critical neurotransmitter function without resorting to powerful drugs for depression that often have unfavorable side-effect profiles and restore vitality and youth in daily exercise routines. Furthermore, when wellness products are utilized with success, individuals often seek less costly interventions including unnecessary surgeries and narcotic options to treat pain. For more information go to www.drpwellness.com.
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