Lumbar radiculopathy, often referred to as sciatica, occurs when the nerve roots in the lower spine become compressed or irritated, causing pain, numbness, and movement difficulties. At the Institute of Orthopedics, Spine, & Sports in Edison, NJ, we focus on non-surgical treatments, emphasizing injection therapies to provide pain relief and improve patients’ quality of life.
Our dedicated team of specialists is committed to understanding each patient’s unique needs and delivering top-notch care using advanced techniques, high-quality equipment, and extensive expertise. Reach out to us at (973) 922-9515 to schedule an appointment and experience our personalized approach to managing lumbar radiculopathy.
Understanding Lumbar Radiculopathy
Causes
Lumbar radiculopathy is primarily caused by conditions that lead to the compression or irritation of the nerve roots in the lumbar spine. The most common causes include:
- Herniated Disc: One of the leading causes of lumbar radiculopathy is a herniated disc. When the soft inner material of the spinal disc protrudes through a tear in the outer layer, it can press against the nerve roots, causing pain and inflammation.
- Spinal Stenosis: This condition involves the narrowing of the spinal canal, which can compress the nerve roots. Spinal stenosis often results from age-related changes in the spine, such as the thickening of ligaments, bone spurs, or disc degeneration.
- Degenerative Disc Disease: As we age, the spinal discs can lose their elasticity and height, leading to decreased space between the vertebrae. This degeneration can result in nerve root compression and lumbar radiculopathy.
- Spondylolisthesis: This condition occurs when one vertebra slips forward over the one below it, potentially compressing the nerve roots. Spondylolisthesis can result from degenerative changes, congenital abnormalities, or trauma.
- Trauma: Injuries from accidents or falls can cause acute damage to the lumbar spine, leading to nerve compression and radiculopathy.
Symptoms
The symptoms of lumbar radiculopathy can vary based on the severity and location of nerve compression. Common symptoms include radiating pain that starts in the lower back and extends down the leg, which can range from a mild ache to a sharp, burning sensation. Many affected individuals experience numbness, tingling, or a “pins and needles” sensation in the lower back, buttocks, legs, or feet. Muscle weakness in the leg or foot is another frequent symptom, potentially impacting the ability to perform everyday activities such as walking or standing.
Changes in reflexes, such as reduced or absent knee-jerk reflexes, may occur due to nerve compression. Additionally, symptoms often worsen with certain activities or positions, such as sitting, standing, or bending.
Diagnosis of Lumbar Radiculopathy
Accurate diagnosis of lumbar radiculopathy is crucial for effective treatment. At our clinic, we employ a comprehensive approach to diagnose this condition. This begins with taking a thorough medical history to understand the patient’s symptoms, lifestyle, and any previous injuries or conditions that may contribute to lumbar radiculopathy. A detailed physical examination is then conducted to assess pain patterns, muscle strength, reflexes, and range of motion.
Special tests, such as the straight leg raise test, can help identify nerve root irritation. Imaging techniques like MRI (Magnetic Resonance Imaging) and CT (Computed Tomography) scans provide detailed views of the spinal structures, allowing for the identification of herniated discs, spinal stenosis, or other abnormalities.
Additionally, electrodiagnostic studies, including electromyography (EMG) and nerve conduction studies, can assess the electrical activity of muscles and nerves, helping to pinpoint the exact location and extent of nerve damage.
Injection Therapies for Lumbar Radiculopathy
Injection therapies are a cornerstone of non-surgical treatment for lumbar radiculopathy at the Institute of Orthopedics, Spine, & Sports. These treatments aim to reduce inflammation, alleviate pain, and improve function. The main types of injection therapies include:
Epidural Steroid Injections (ESIs)
Epidural steroid injections are one of the most common and effective treatments for lumbar radiculopathy. This procedure involves injecting a corticosteroid medication directly into the epidural space around the spinal nerves, utilizing the anti-inflammatory properties of corticosteroids to reduce swelling and pain.
During the procedure, the patient is positioned comfortably, and the injection site is cleaned and numbed with a local anesthetic. Using fluoroscopic (X-ray) guidance, the physician inserts a needle into the epidural space and injects the corticosteroid medication. ESIs can provide significant pain relief, often within a few days of the procedure.
The effects can last from several weeks to months, allowing patients to participate in physical rehabilitation and other therapeutic activities. While the frequency of ESIs can vary, they are typically administered up to three times per year, depending on the patient’s response and the severity of symptoms.
Selective Nerve Root Blocks (SNRBs)
Selective nerve root blocks involve injecting a local anesthetic and corticosteroid medication near the affected nerve root. This targeted approach helps confirm the source of pain and provides relief by reducing inflammation around the nerve. During the procedure, the patient is positioned to allow access to the affected nerve root. Using fluoroscopic guidance, the physician inserts a needle near the nerve root and injects the medication. SNRBs provide both diagnostic and therapeutic benefits.
If the patient experiences significant pain relief, it confirms the specific nerve root as the source of pain. Additionally, the anti-inflammatory effects can provide lasting relief. Similar to ESIs, SNRBs can be repeated several times a year, depending on the patient’s needs and response to treatment.
Facet Joint Injections
Facet joint injections target the small joints between the vertebrae in the spine. These joints can become inflamed due to arthritis or injury, contributing to lumbar radiculopathy symptoms. Injecting a corticosteroid and anesthetic into the facet joint can reduce inflammation and pain. During the procedure, the patient is positioned to allow access to the affected facet joints. Using fluoroscopic guidance, the physician inserts a needle into the joint and injects the medication.
Facet joint injections can provide immediate pain relief, which can last for several weeks to months. This allows patients to engage in physical therapy and other treatments to address the underlying causes of pain. These injections can be administered several times a year, based on the patient’s symptoms and response to treatment.
Sacroiliac (SI) Joint Injections
The sacroiliac joints connect the spine to the pelvis and can become a source of pain in lumbar radiculopathy. SI joint injections involve injecting a corticosteroid and anesthetic into the joint to reduce inflammation and alleviate pain. During the procedure, the patient is positioned to allow access to the SI joints. Using fluoroscopic guidance, the physician inserts a needle into the joint and injects the medication. SI joint injections can provide significant pain relief, allowing patients to participate in other treatments to improve mobility and function. These injections can be repeated several times a year, depending on the patient’s needs and response to treatment.
Conclusion
Lumbar radiculopathy can significantly impact a person’s quality of life, but effective non-surgical treatments are available. At the Institute of Orthopedics, Spine, & Sports in Edison, NJ, we specialize in injection therapies that provide targeted relief from pain and inflammation. Our comprehensive approach to diagnosis and treatment ensures that each patient receives personalized care to address their specific needs. If you are experiencing symptoms of lumbar radiculopathy, contact us today at (973)-922-9515 to schedule a consultation and begin your journey toward recovery.