Nerve irritation caused by damage to the discs between the vertebrae. Damage to the disc occurs because of degeneration (“wear and tear”) of the outer ring of the disc, traumatic injury, or both. As a result, the central softer portion of the disc can rupture (herniate) through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column. This rupture is what causes the commonly recognized pain of “sciatica” that shoots down the leg.
Sciatica can be preceded by a history of localized low back aching or it can follow a “popping” sensation and be accompanied by numbness and tingling. The pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, sciatica can be accompanied by incontinence of the bladder and/or bowels. Increased radiating pain when the lower extremity is lifted supports the diagnosis of lumbar radiculopathy. Nerve testing (EMG/electromyogram and NCV/nerve conduction velocity) of the lower extremities can be used to detect nerve irritation. The actual disc herniation can be detected with radiology testing, such as CAT or MRI scanning.
Treatment of lumbar radiculopathy ranges from medical management to surgery. Medical management includes patient education, medications to relieve pain and muscles spasm, cortisone injection around the spinal cord (epidural injection), physical therapy (heat, massage, ultrasound, electrical stimulation), and rest (not strict bed rest, but avoiding re-injury). With unrelenting pain, severe impairment of function, or incontinence (which can indicate spinal cord irritation), surgery may be necessary. The operation performed depends on the overall status of the spine, and the age and health of the patient. Procedures include removal of the herniated disc with laminotomy (a small hole in the bone of the lumbar spine surrounding the spinal cord), laminectomy (removal of the bony wall), by needle technique (percutaneous discectomy), and disc-dissolving procedures (chemonucleolysis).
- Lumbar spinal stenosis
A condition whereby either the spinal canal (central stenosis) or vertebral foramen (foraminal stenosis) becomes narrowed, leading to compression of the spinal nerves. Symptoms are pain in the lower back and weakness, numbness, pain, and loss of sensation in the legs. The most common cause of lumbar spinal stenosis is degenerative arthritis (osteoarthritis), but other […]
- Lumbar strain
A stretching injury to the ligaments, tendons, and/or muscles of the low back. The stretching incident results in microscopic tears of varying degrees in these tissues. Lumbar strain is one of the most common causes of low back pain. The injury can occur because of overuse, improper use, or trauma. It is classified as “acute” […]
- Lumbar vertebrae
The five vertebrae situated between the thoracic vertebrae and the sacral vertebrae in the spinal column. The lumbar vertebrae are represented by the symbols L1 through L5.
A luminous term referring to the channel within a tube such as a blood vessel or to the cavity within a hollow organ such as the intestine. Lumen is a luminous term because it is Latin for light, including the light that comes through a window. When a hollow organ is cut across, you can […]
The surgical removal of a small tumor, which may be benign or cancerous. In common use, lumpectomy refers especially to removal of a lump from the breast. Lumpectomy, often with chemotherapy or radiation therapy, can be an alternative to mastectomy in cases of nonmetastatic breast cancer.