What Is Lumbar Radiculopathy?
Lumbar radiculopathy is a condition caused by compression or inflammation of a nerve root in the lower back, often resulting in pain, numbness, tingling, or weakness that travels down the buttock, leg, or foot. When nerve root inflammation is present without significant nerve damage, the condition may be called lumbar radiculitis.
These conditions are frequently referred to as sciatica, especially when the sciatic nerve distribution is involved (commonly L4-S1 nerve roots).
Common Causes
Several spinal conditions can irritate or compress lumbar nerve roots:
Herniated or Bulging Discs - Disc material can press on nearby nerves.
Degenerative Disc Disease - Disc height loss reduces space and increases nerve root compression risk.
Lumbar Spinal Stenosis - Narrowing of the spinal canal or foraminal space due to aging or arthritis.
Facet Joint Arthropathy - Arthritic overgrowth can narrow the nerve pathways.
Spondylolisthesis - Vertebral slippage may stretch or compress nerve roots.
Trauma or Repetitive Strain - Injuries or chronic poor posture may aggravate nerve structures.
Symptoms
Low back pain that radiates to the hip, thigh, calf, or foot
Burning or electric shock-like pain in one leg
Numbness or tingling in a dermatomal pattern (e.g., outer thigh, big toe)
Muscle weakness in the affected leg or foot
Pain worsened by sitting, bending, or coughing
Relief when lying flat or walking with forward flexion
Non-Surgical Treatment Options
Conservative Management
Physical Therapy - Strengthens the core, improves posture, and reduces nerve irritation.
Medications - Includes NSAIDs, oral corticosteroids, muscle relaxants, or neuropathic agents (e.g., gabapentin).
Activity Modification - Avoiding activities that exacerbate pain and improving spine mechanics.
Heat/Ice Therapy & Support Braces - Used for short-term symptom control.
Interventional Pain Management Options
If conservative measures are not sufficient, minimally invasive interventional procedures can offer targeted relief:
Lumbar Epidural Steroid Injections (ESI) - Anti-inflammatory medication is injected into the epidural space to reduce nerve root inflammation and pain.
Selective Nerve Root Blocks - Pinpoints the affected nerve for both diagnostic and therapeutic purposes.
Transforaminal vs. Interlaminar ESI - Chosen based on the location and severity of compression.
Medial Branch Blocks & Radiofrequency Ablation (RFA) - Used if facet joint degeneration contributes to axial back pain along with radicular symptoms.
Minimally Invasive Discectomy or Endoscopic Decompression - Removes herniated disc material with minimal tissue disruption.
Spinal Cord Stimulation (SCS) - Considered for chronic cases or failed back surgery syndrome (FBSS).
When Is Surgery Needed?
Surgery may be recommended for patients who experience:
Severe or progressive motor weakness
Loss of bladder or bowel control (cauda equina syndrome)
Debilitating pain despite non-surgical treatments
Structural abnormalities requiring decompression
Surgical options may include:
Microdiscectomy
Laminectomy
Spinal Fusion (for instability or multi-level degeneration)
Conclusion
Lumbar radiculitis and radiculopathy are common causes of sciatica and lower extremity pain. Most cases can be successfully treated with a combination of physical therapy, medications, and interventional pain procedures. At Parkview Spine & Pain, we provide comprehensive, individualized care plans to help you return to the activities you love—pain-free.
👉 Schedule a consultation today to explore your treatment options.