Most everyone has experienced lower back pain at some point in their lives. This is because there can be a lot of sources of that pain, and everything from hormonal fluctuations to a minor injury could be a contributing factor.
When this pain is also accompanied by sciatica (pain that shoots down the legs) and other indications of nerve irritation, radiculopathy is usually involved.
Radiculopathy is the result of nerve irritation caused by damage between the vertebrae. This damage can occur when there is a traumatic injury or when there is just simple wear and tear. Causes of this type of damage might include:
- A herniated disc with nerve compression
- Bone spurs
- Nerve root injuries
- Previous spinal surgeries
- Normal degeneration
- Tumor or infection
Other risk factors can include working a heavy labor job or playing contact sports, as well as having a family history of radiculopathy or other spine disorders.
Symptoms of lower back pain are generally very clear: your lower back hurts. When radiculopathy is involved, symptoms may include:
- Sciatica (pain in the nerve extending from your lower back down each leg)
- Muscle weakness
- Loss of reflexes
When you go to your doctor with back pain, your physician will typically conduct a physical examination that involves trying to determine where your pain is radiating from. If radiculopathy is involved, this can help them to pinpoint the nerve responsible for that pain.
Imaging studies meant to confirm diagnosis are typically ordered from there. These might include:
- Magnetic resonance imaging (MRI)
- Computed tomography (CT)
- Electromyogram (EMG)
Most people respond well to nonsurgical treatment options within three months (usually seeing improvement within six weeks). These treatments may include:
- Physical therapy
- Cortisone injections
- Chiropractic treatment
- Patient education regarding how to avoid further strains
If there is no improvement after three months, your physician may need to explore surgical options in order to remove the herniated disc. These options include:
- Laminotomy: Removing ligaments and a small portion of the bone that forms the backside of your spinal cord
- Laminectomy: Removing ligaments and the entire bony wall that surrounds your affected disc
- Percutaneous Discectomy: Complete removal or destruction of your disc
- Chemonucleolysis: A nonsurgical treatment that involves injecting your disc with an enzyme meant to dissolve it
The type of procedure used will be determined based on the extent of damage involved. In many cases, interventional neuroradiology can be used to perform these procedures in a minimally invasive way, using catheter-guided technology to avoid the need for physical cuts and reducing your recovery time.