Lumbar Radiculopathy (Sciatica): Causes, Symptoms, & Treatment

By Zina Semenovskaya, MD
Medically reviewed checkmarkMedically reviewed
December 2, 2019

Many people are unfortunately familiar with lower back pain. In fact, 80% of adults experience lower back pain at some point in their lives. To understand why this is so common, let’s take a closer look at our spine.  It’s made up of numerous small bones (33, to be exact), called vertebrae. These bones, along with ligaments, discs, and muscles, protect our spinal cord from injury. That’s important since our spinal cord lets us stand up straight, bend, and twist.

However, despite all the protection around our spine, sometimes we still manage to move in the wrong way, or sustain an injury or trauma that results in back pain. The culprit is a pinched nerve in the spine, called radiculopathy. This condition can lead to discomfort, pain, weakness, or numbness. When we get a pinched nerve specifically in our lower back or lumbar region, it’s called lumbar radiculopathy. Here, we’ll focus on the causes and symptoms of lumbar radiculopathy, as well as how it’s diagnosed, most effectively treated, and ways to prevent it.

What Is Lumbar Radiculopathy (Sciatica)?

As we mentioned, when a pinched nerve occurs in our lower back, also called the lumbar spine, it’s called lumbar radiculopathy. To get a better understanding of what this means, let’s take another look at our spine. First, it helps to know that the spine is divided into regions, each with a different name:

  • Cervical spine: Neck region
  • Thoracic spine: Mid back
  • Lumbar spine: Lower back, also called the radiculopathy lumbar region
  • Sacrum: Area where the spine connects to the hips
  • Coccyx: Tail bone

Our spinal cord runs the entire length of our interlocking vertebrae, passing through the center of them. Along the whole length of the spinal cord there are nerve roots that extend out, reaching between each vertebra as well as into other areas of the body. The nerve roots that extend out from the lumbar spine are (fittingly) named the lumbar spinal nerve roots. When these particular nerve roots get pinched, irritated or damaged, lumbar radiculopathy occurs, also known as lumbar root nerve disorder. What may follow is steady pain in the lower back, among other lumbar radiculopathy symptoms that we’ll describe below.

Along the lumbar spine, the fifth lumbar vertebra, also known as the L5, is the largest of the vertebrae in this region. When there is nerve root compression in the L5 nerve roots, L5 radiculopathy occurs.

Lumbar radiculopathy is also referred to as sciatica. This is because spinal nerve roots that compose the sciatic nerve often play a role. The sciatic nerve is the body’s longest and widest nerve, which extends from the top of the leg and down to the foot. Medical terms aside, with lumbar radiculopathy or sciatica, you may feel pain, numbness, or weakness in one side of the buttock and leg.

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Causes of Lumbar Radiculopathy

Lumbar radiculopathy is a result of a pinched nerve and resulting nerve pain in the radiculopathy lumbar region. But how do the lumbar spinal nerve roots get pinched to begin with? Each of the vertebrae is separated from its neighbor by a type of protective cushion called an intervertebral disc. This disc cushions each of the vertebrae to prevent them from rubbing against each other. However, during an injury, these intervertebral discs can become damaged or protrude, which can cause compression or irritation of a nearby nerve root.

When a disc protrudes from the lumbar spine, it is referred to as a lumbar herniated disc with nerve compression. With this condition, the lumbar spinal nerve root extending out from the lumbar spine gets pinched or damaged. This spinal disc herniation is the most common cause of lumbosacral radiculopathy and can also result in sciatica.

There are additional conditions or injuries that can also lead to lumbar radiculopathy. These include:

Risk Factors for Lumbar Radiculopathy

Some risk factors for developing lumbar radiculopathy include:

  • Aging
  • Poor posture
  • Being overweight
  • Improper lifting technique
  • History of car accident or fall
  • Family history of degenerative bone conditions

While those aged 30-50 years old are most likely to experience lumbar radiculopathy, younger people, especially those involved in physical sports or car accidents, can also be affected.

Lumbar Radiculopathy Symptoms

When lumbar radiculopathy is associated with spinal nerve root compression, inflammation and swelling of the nerve roots can occur. This can result in unpleasant symptoms centered around the lower back, leg, and foot. These symptoms may include sharp pain, numbness, tingling, or weakness. Some people go for years without flare ups of symptoms, while others experience them frequently. You should see your doctor if you experience any of these symptoms If they are severe and frequent enough you may be referred to a spine specialist.

How Is Lumbar Radiculopathy Diagnosed?

So, your lower back pain has brought you to the doctor’s office. Your doctor will review your medical history and symptoms. They will then perform a physical exam to look for any of the following signs and symptoms that may suggest nerve involvement:

  • Numbness or weakness
  • Loss of reflexes

Your doctor may also diagnose lumbar radiculopathy by using the following:

  • Imaging tests such as X-rays, CT scan, or MRI
  • Electrical impulse testing to evaluate nerve function

Lumbar Radiculopathy Treatment

Lumbar radiculopathy treatment often depends on what has caused the condition and its level of severity. Nonsurgical treatments are usually recommended initially, but surgical treatment may ultimately be required if these are unsuccessful.

Non-surgical lumbar radiculopathy treatment

  • Medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help reduce pain and swelling. Additional medications, including a short course of narcotic pain medications or muscle relaxants may also be prescribed to relieve severe pain and help manage the symptoms.
  • Steroid injections or oral corticosteroids may reduce inflammation and relieve acute pain from sciatica.
  • Physical therapy can help stabilize the spine and improve its flexibility by strengthening the muscles around it.
  • Weight control strategies may help reduce pressure in the lumbar area, and even a small amount of weight loss can make a big difference.
  • Additional treatments may include applications of heat and ice as well as massage, yoga, and gentle stretching.

Surgical lumbar radiculopathy treatment

Surgery is sometimes the best option to minimize the pressure on the lumbar spinal nerve root. Surgeons can widen the area where the nerve roots extend out from the spine by extracting all or parts of a vertebra or disc. One example of this type of surgery is cervical posterior foraminotomy, which is minimally invasive.

  • Other surgical procedures may include:
  • Surgery to repair a herniated disc
  • Surgery to remove bone spurs
  • Surgery to fuse bones
  • Other surgical procedures to decompress the nerve or stabilize the spine.

Each surgical treatment option depends on your specific cause of lumbar radiculopathy, your overall health, and other factors.

While the lower back is the area most frequently affected by radiculopathy, a pinched nerve can occur in other areas along the spine as well.

Cervical radiculopathy

Cervical radiculopathy occurs when you have a pinched nerve in your neck or upper back. The symptoms associated with cervical radiculopathy include:

  • Pain in the neck, shoulder, upper back, or arm
  • Weakness or numbness, typically experienced on one side

Thoracic radiculopathy

Thoracic radiculopathy occurs when you have a pinched nerve in your upper or mid-back region, resulting in pain in the chest and torso.

Thoracic radiculopathy is an uncommon condition that may be misdiagnosed as heart, gallbladder or abdominal complications, or shingles.

Thoracic radiculopathy symptoms include:

  • Shooting pain or burning sensation in the side, rib, or abdomen
  • Numbness and tingling

Myelopathy/spinal cord compression

In some cases, radiculopathy can progress to myelopathy. With this condition, you experience compression of the actual spinal cord. This happens when herniated or bulging discs press on the spinal cord in addition to the nerve roots. When there’s compression of the spinal cord itself, the symptoms can be more severe, including:

  • Difficulty walking
  • Paralysis
  • Inability to urinate or incontinence of stool or urine

If you experience any of these symptoms, you need to go to the emergency room immediately for evaluation and treatment.

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Preventing Lumbar Radiculopathy

While lumbar radiculopathy can’t always be prevented, there are ways to help reduce your risk from developing the condition. Incorporating the following strategies into your daily lifestyle may help prevent injury to your lumbar spine, and the potential lumbar spinal nerve root compression, inflammation, and lower back pain that go with it.

  • Stay physically fit by regularly performing stretching, aerobic and weight-bearing exercises, as well as by developing your core strength
  • Maintain a healthy weight by eating a balanced diet and exercising
  • Maintain good posture while sitting, driving, playing sports, and exercising, which will help prevent injuries.
  • Use proper lifting techniques by lifting with your legs rather than with your back, especially when picking up heavy objects.

When to See a Doctor

It’s important to see your doctor when you start having lower back and/or leg pain. This pain can be a symptom of lumbar radiculopathy, caused by spinal nerve root compression, inflammation, or injury. The faster your doctor can accurately determine the cause, the faster they can treat– and relieve–your lower back pain. Go to the ER immediately if you develop any symptoms concerning spinal cord compression, as outlined above.

How K Health Can Help

K Health’s virtual diagnosis tool can help you quickly determine whether the symptoms you are experiencing may be caused by lumbar radiculopathy. Our doctors are also available to help you learn how you can prevent any future lumbar spine injury.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Zina Semenovskaya, MD

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.