We review the epidemiology, etiology, symptomatology, clinical presentation, anatomy, pathophysiology, workup, diagnosis, non-surgical and surgical management, postoperative care, outcomes, long-term management, and morbidity of lumbar radiculopathy. We review when outpatient conservative management is appropriate and "red flag" warning symptoms that would necessitate an emergency evaluation. Diagnostic modalities, including magnetic resonance imaging (MRI), computerized tomography (CT), contrast myelogram, electromyogram (EMG), and nerve conduction velocity (NCV), are involved in the diagnosis and decision-making are discussed. Treatment of lumbar radiculopathy requires a multimodal and multispecialty team. We review indications for the involvement of other professionals, including physical therapy (PT), occupational therapy (OT), physical and rehabilitation medicine (PMR), and pain management.
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http://dx.doi.org/10.7759/cureus.5934 | DOI Listing |
Introduction: Increased fatty infiltration of the paraspinal muscles (PM) has been recognized as a sign of decreased muscle quality in patients with degenerative disc disease. However, whether fatty infiltration is a consequence of a neurogenic process due to spinal nerve root compression has not yet been determined.
Objective: To investigate the correlation between fatty infiltration of the paraspinal muscles (PM) and neurogenic remodeling of motor unit action potentials (MUAPs) in patients with lumbar radiculopathy.
PLoS One
December 2024
Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran.
Background: Chronic low back pain (CLBP) is linked to reduced excitability in the primary motor (M1) and sensory (S1) cortices. Combining sensory-motor exercises with transcranial direct current stimulation (tDCS) to boost M1 and S1 excitability may improve treatment outcomes. This combined approach aligns with the neurophysiological mechanisms underlying CLBP and may target the neuroplastic changes induced by low back pain.
View Article and Find Full Text PDFInterv Pain Med
December 2024
Department of Physical Medicine and Rehabilitation, McGovern Medical School at UTHealth, Houston, TX, USA.
Interv Pain Med
December 2024
Department of Rehabilitation, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
A 78-year-old female with a remote history of L3-4 decompression and fusion presented with several months of low back and radicular leg pain. MRI revealed moderate L2-L3 spinal canal stenosis, ligamentum flavum infolding, moderate bilateral foraminal stenosis, and a grade I retrolisthesis. A right sided L2-L3 TFESI was performed using multiplanar fluoroscopic imaging with a subpedicular supraneural approach.
View Article and Find Full Text PDFHeliyon
December 2024
CBP Nonprofit (a spine research foundation), Eagle, ID, USA.
This prospective consecutive case series was conducted in 5 physiotherapy clinics in the UAE from January 2021-March 2023 to assess coronal lumbar spine radiographic parameters as a predictor of conservative therapy outcomes in patients suffering from low back and leg pain due to lumbar herniated nucleus pulposus (HNP). Ninety patients (mean age 44 yrs., 54 % male) with lumbar HNP underwent conservative therapy.
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