Lumbar radiculopathy is a condition in which a nerve in the lower back becomes compressed or irritated where it exits the spinal column. This nerve compression causes pain, numbness, tingling, or weakness that travels from the low back into the buttock, thigh, leg, or foot. The specific pattern of symptoms depends on which nerve root is affected. At our spine clinic serving Parker, Lone Tree, and the surrounding Denver metro area, lumbar radiculopathy is one of the most common conditions we evaluate and treat.
What Causes Lumbar Radiculopathy?
The most common causes are disc herniations and degenerative changes in the spine. A herniated disc occurs when the soft inner material of a spinal disc pushes outward and presses against a nearby nerve. This is sometimes called a pinched nerve or sciatica.
Degenerative changes, including bone spurs, thickened ligaments, and facet joint enlargement, can gradually narrow the space where nerves exit the spine. This narrowing is called foraminal stenosis. Degenerative spondylolisthesis, where one vertebra slips forward on another, can also contribute to nerve compression.
In younger patients, disc herniations are the more frequent cause. In patients over 50, degenerative changes become increasingly common.
Symptoms of Lumbar Radiculopathy
Symptoms typically affect one leg and follow a specific pattern based on the involved nerve root. Common presentations include:
Pain radiating from the low back or buttock into the thigh, calf, or foot. Many patients describe the pain as sharp, shooting, burning, or electric. This is often referred to as sciatica.
Numbness or tingling in specific areas of the leg or foot.
Weakness in certain muscles of the leg or foot. You may notice difficulty lifting your foot, rising from a chair, or walking on your heels or toes.
Symptoms often worsen with prolonged sitting, bending forward, or activities that increase pressure on the disc such as coughing or sneezing.
How Lumbar Radiculopathy Is Diagnosed
Diagnosis begins with a thorough history and physical examination. Your provider will assess your lumbar range of motion, test the strength and sensation in your legs, check your reflexes, and perform specific maneuvers such as the straight leg raise test to reproduce your symptoms.
MRI of the lumbar spine is the imaging study of choice for evaluating lumbar radiculopathy. It provides detailed images of the discs, nerves, and surrounding structures and can identify the location and cause of nerve compression.
In some cases, electrodiagnostic studies such as EMG and nerve conduction studies may be ordered to evaluate nerve function and confirm which nerve root is affected.
Treatment Options
Most patients with lumbar radiculopathy improve with conservative treatment. The initial approach typically includes activity modification, anti-inflammatory medications, and physical therapy focused on core stabilization, lumbar mechanics, and nerve mobility.
If symptoms persist despite conservative care, lumbar epidural steroid injections may be recommended. These injections deliver anti-inflammatory medication directly to the area of nerve irritation and can provide significant relief. [Internal link: Learn more about epidural steroid injections]
Surgery is considered when symptoms are severe, progressive, or fail to respond to nonsurgical treatment. The most common surgical procedure for lumbar radiculopathy caused by a disc herniation is microdiscectomy, which removes the portion of disc compressing the nerve through a minimally invasive approach. [Internal link: Learn more about lumbar microdiscectomy]
What to Expect
The majority of patients with lumbar radiculopathy experience meaningful improvement within six to twelve weeks of starting treatment. Recovery time varies depending on the severity and duration of nerve compression before treatment begins. Some patients have residual numbness or mild symptoms even after successful treatment, particularly if the nerve was compressed for an extended period before diagnosis.
Schedule a Consultation
If you are experiencing low back pain with leg symptoms, our spine specialists can help determine the cause and develop a treatment plan tailored to your needs. Contact our office to schedule an evaluation.