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Lumbar Radiculopathy Treatment in New Jersey

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Commonly caused by a pinched nerve, radiculopathy is a radiating pain that can affect patients of all ages and backgrounds. While radiculopathy is most common in the lower back, it also can develop in the neck (cervical spine) or upper back (thoracic spine). Often a normal result of the aging process, radiculopathy can develop because of arthritis, disc degeneration, motor vehicle accidents, sports injury, injury at work, or other degenerative changes to the spine.

With a comprehensive team of neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, certified physical therapists, and support staff, Centers for Neurosurgery, Spine & Orthopedics (CNSO) in northern New Jersey offers cutting-edge treatments for a wide range of back and spine conditions. The medical team at CNSO is experienced in treating all forms of radiculopathy and uses a conservative approach to help patients live pain-free without surgery if possible. But if surgery is necessary, the CNSO spine surgeons are the most qualified and skilled in the Northeast. Learn more about the causes and symptoms of lumbar radiculopathy, as well as diagnosis and treatment options.

What Is Lumbar Radiculopathy?

Radiculopathy is a type of pain caused by compression of a spinal nerve root. Patients may experience radiculopathy in the neck, upper back, or lower back. When nerve root pain originates in the lower back, it is known as lumbar radiculopathy.

Causes and Risk Factors

The lumbar spine is the part of the back that is affected by radiculopathy most frequently.

Lumbar radiculopathy is caused by any source that compresses, pinches, or irritates the roots of the spinal nerves, leading to their inflammation. This can include an injury, such as a car accident, or a spine condition that develops over time such as bone spurs, tumors of the spine, cysts, or arthritis of the spine. Radiculopathy also can be caused by a narrowing of the spinal canal, known as spinal stenosis, or from intervertebral disc herniation, which can impinge on the space where nerve roots exit the spinal cord.

Risk factors for lumbar radiculopathy include:

  • Lifestyle: Patients who are overweight or have a sedentary lifestyle are at higher risk of developing lumbar pain.
  • Occupation: Jobs that require frequent bending, lifting, or twisting can lead to spinal conditions that cause radiculopathy, as can occupations that require long and frequent drives.
  • Age: Male patients are most at risk for lumbar radiculopathy in their 40s, while women are typically affected in their 50s and 60s.
  • Sex: Men are more likely to develop lumbar radiculopathy than women.
  • Smoking: Patients who smoke have a higher risk of lumbar radiculopathy.

Recognizing Symptoms

Common symptoms of lumbar radiculopathy are:

  • Low back pain
  • Muscle spasms around the lumbar area
  • Pain, numbness, tingling, or muscle weakness that travels into the buttocks, hip, groin, or leg

Sharp pain that radiates from a pinched nerve down into the buttocks and legs also is known as sciatica.

Diagnosing Lumbar Radiculopathy

Lumbar radiculopathy can be diagnosed by a neurosurgeon or orthopedic spine surgeon. They will begin by reviewing the patient’s medical history and documenting any symptoms. Next, they will conduct a physical examination to assess the back and spine and check reflexes. To isolate specifically what is causing the radiculopathy, they likely will use diagnostic imaging, such as an X-ray, magnetic resonance imaging (MRI), computer tomography (CT) scan, or EMG/NCV study.

A physiatrist is a specialist who performs electromyography (EMG), which is a test that measures electrical impulses in the muscles to check intrinsic muscle function. Often the physiatrist will also perform a nerve conduction study (NCS), which measures the integrity of the individual nerve’s ability to transmit electrical signaling to the muscles they innervate. This test can assess whether there is damage to the peripheral nerves or the more central nerve roots.

CNSO’s neurosurgeons, orthopedic surgeons, pain management doctors, and physiatrists use these diagnostic techniques to provide a treatment plan that will be successful. CNSO also often provides second opinions whenever patients need reassurance about the treatment options they are being offered.

Non-Surgical Treatments

CNSO takes a conservative approach to resolving lumbar radiculopathy. This requires a stepwise approach from least invasive pain management, such as stretching, strength, and conditioning using non-surgical interventions to provide symptom relief. Injections are offered if there is a lack of resolution and if the pain initially is so severe the patient is unable to participate in conditioning. Conservative treatment options available for lumbar radiculopathy are:

  • Activity modification: Resting and avoiding strenuous activities can help reduce pain, along with applying heat or ice to the affected area.
  • Pain medication: Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce pain and are readily available without a prescription.
  • Oral corticosteroids: Prescription steroid medications can help reduce inflammation around the affected nerve.
  • Physical therapy: Seeing a physical therapist can help a patient learn appropriate exercises and stretches to reduce muscle tension and pain caused by radiculopathy.
  • Epidural steroid injection: These injection treatments deliver anesthetic and corticosteroid medication to relieve radicular pain and decrease inflammation.
  • Chiropractic care: Spinal manipulation performed by a chiropractor may help relieve some of the irritation caused by a pinched nerve.

Surgical Options

Back surgery as a treatment for lumbar radiculopathy is recommended in cases where the cause of the symptoms is so severe and there is a failure of injections to relieve the discomfort. It can also be ideal if there begins to be evidence of weakness or loss of function. Surgical procedures that can treat radicular pain causes include:

Microdiscectomy

A microdiscectomy is a type of minimally invasive spine surgery that offers a small incision to remove part of a damaged intervertebral disc that is pressing upon the spinal cord or nerve roots. This small incision allows for rapid recovery including returning home on the same day of the surgery.

Laminectomy

The surgical name, laminectomy, stems from the word laminae, which is used to describe the bony arches located on the posterior portion of each vertebra. A laminectomy is the removal of a portion of the lamina. The amount of the lamina to be removed is dependent on the reason it needs to be removed. If the lamina is compression on the spinal cord or nerve roots, then the offending portion needs to be removed. This is called a decompressive laminectomy.

A small or large laminectomy may also be necessary to gain access to a portion of the vertebrae, nerve roots, or spinal cord. A laminectomy should only be performed by a neurosurgeon or fellowship-trained orthopedic spine surgeon.

Spinal Fusion

Fusion surgery may be necessary for patients with significant damage to the spine because of trauma, degenerative conditions such as osteoarthritis, or revision spine surgery. In this procedure, diseased bone or intervertebral discs are surgically removed, and then the spine is stabilized using a bone graft or a prosthetic. To hold the spine in the correct position and encourage new bone growth, the surgeon will place stabilization hardware, such as a titanium plate or pedicle screws.

Post-Surgery Recovery

A patient’s post-surgery recovery plan will depend on the type of procedure they had. Fusion surgery may require a day or two hospital stay whereas a laminectomy or microdiscectomy can go home the same day. After the procedure, the patient will have follow-up appointments at one week, three months, six months, and then at the one-year mark to track recovery. Postoperatively, physical therapy may be recommended to regain strength in the muscles in the lumbar spine and improve flexibility and range of motion.

Post-surgical pain or discomfort typically can be minimized with medication and gradually titrated off within one to two weeks. Patients can expect a gradual return to their normal activities after a few weeks or months depending on the number of levels of surgery and the health status of the patient before the surgery. Healthier patients recover more quickly.

Emerging Therapies

Newer therapies are being studied to help manage or decrease back pain, including lumbar radiculopathy, caused by many different sources. These include treatments such as:

  • Laser therapy: Low-level laser therapy (LLLT) may help relieve radiculopathy when used in combination with treatments such as physical therapy.
  • Platelet-rich plasma (PRP) injections: Because the platelets found in blood are rich in growth factors, they may help treat inflamed nerves by accelerating the body’s healing processes.
  • Regenerative medicine: Stem cell therapy may help relieve lumbar pain by releasing anti-inflammatory proteins.

While additional research is needed to better understand whether these treatments are effective, they may offer hope for new, minimally invasive treatment options for patients with radiculopathy.

Lifestyle Modifications for Managing Symptoms

Certain lifestyle changes can help manage the conditions that lead to lumbar radiculopathy, such as:

  • Maintaining a healthy weight
  • Exercise including strength training
  • Eating a nutrient-dense diet
  • Practicing stress reduction techniques
  • Using recommended exercises and stretches
  • Implementing ergonomic adjustments at work

A physical therapist, physiatrist, and pain management doctor can work with a patient to implement changes that decrease their risk of back pain caused by radiculopathy.

Coping With Chronic Lumbar Radiculopathy

Chronic back pain that does not respond to conservative treatments can be difficult to cope with and surgery may be the only solution. For patients unable or unwilling to consider a surgical solution, yet dealing with moderate or severe lumbar radiculopathy, it is helpful to keep physically active but guard against worsening the condition.

There are biomechanical techniques that may be helpful to cope with pain and discomfort. These may be taught via mental health resources in person at the CNSO Morristown office, an online community, or support groups. Additionally, adaptive devices and assistive technology such as walking aids or back braces are useful for helping patients recovering from a spinal deformity that causes lumbar radiculopathy.

Frequently Asked Questions About Lumbar Radiculopathy

Frequently asked questions from patients with lumbar radiculopathy include:

What Are the Primary Causes of Lumbar Radiculopathy?

Lumbar radiculopathy often is caused by degenerative disc disease, bone spurs, spinal stenosis, or trauma to the spine.

How is Lumbar Radiculopathy Diagnosed?

Lumbar radiculopathy typically is diagnosed with a physical examination, imaging tests, and if necessary, an EMG.

Are There Non-Surgical Treatment Options?

Lumbar radiculopathy often can be treated with non-surgical treatment methods, including rest, physical therapy, NSAIDS, prescription pain medication, and injection treatments.

What Is the Typical Recovery Period After Surgery?

Recovery timelines will vary by patient and procedure, but most patients can resume normal, non-strenuous activities by 4-6 weeks after most spine surgery.

Can Lumbar Radiculopathy Be Prevented?

While there is no definitive way to prevent lumbar radiculopathy, maintaining good posture and physical strength, can reduce stress on the spine and help lower the risk of conditions such as a herniated disc. Patients who work in occupations linked to a higher risk of back injuries should use proper form and lifting techniques. Furthermore, they must only lift a weight they are in condition to lift.

Is Physical Therapy Essential for Recovery?

Physical therapy may not be required for every patient, but it can shorten recovery times and help the body heal either to avoid surgery or to recover from surgery properly and expediently.

What Lifestyle Changes Can Help Manage Nerve Pain?

Eating a balanced diet high in anti-inflammatory foods, maintaining an active lifestyle, physical strength and conditioning, and practicing good posture can all help manage nerve pain.

Trust CNSO for Lumbar Radiculopathy Treatment

While lumbar radiculopathy can be painful and disruptive, there are many non-invasive treatment options. As with any condition that affects the spine, it is important to follow proper medical guidance from a neurosurgeon, orthopedic spine surgeon, pain management doctor, physiatrist, or physical therapist.

At CNSO, all these types of spine experts are accessible and patients can receive personalized and coordinated treatment plans from this team of experienced, award-winning spine specialists. With multiple locations throughout northern New Jersey, CNSO providers work in collaboration to support patients throughout their treatment journey. For more information or to schedule an appointment, contact CNSO today.

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