Lumbar Radiculopathy is the medical term for lower back pain and is one of the most common reasons that a person will consult a medical practitioner (Berry et al. 2019). Up to 40% of these people may also experience pain that travels down their leg.
Why do you feel pain in your leg?
The lumbar spine is made up of five large vertebrae connected by a joint called the facet joint. Found between each vertebra is an inter-vertebral disc that helps absorb forces and allows movement. At each level of the lumbar spine, a spinal nerve passes through a canal where it can then join with other spinal nerves and supply the leg with sensation and movement.
These spinal nerves can become affected by injury to surrounding structures causing compression or irritation of the nerve, and this can lead to pain being felt along the course of the nerve into the leg (Riley 2011).
- Direct damage to the nerve root
- Inflammation because of injury of a surrounding structure
- Lumbar disc injury or herniation
- Facet joint injury
• Narrowing of the canals around the nerve (stenosis)
• Stiff joints
• Tight muscles around the nerve that stop the nerve from moving freely
What are the symptoms of Lumbar Radiculopathy?
Most patients experience pain in the leg, but there are other symptoms (Berry et al. 2019), such as
- Shooting or burning type pain in the leg
- Numbness or tingling in the leg
- The painful leg may feel weaker
- Changes in your walking or balance
What is the Physiotherapy treatment for Lumbar Radiculopathy?
Medical practitioners encourage conservative, non-surgical management as the first line of treatment for most patients (Reddington et al. 2018). Your physiotherapist will provide a thorough assessment of your condition to understand what may be causing your pain and to determine the best, most specific treatments to help you.
Physiotherapy sessions may include:
- Education and advice – helping you to understand what is causing your symptoms and how you can work together to manage them.
- Joint mobilisations – to reduce stiffness and allow joints to move easily through full movement (Thakur et al. 2015, Shipton 2018).
- Soft tissue release – to return muscle and fascia to their original length and keep them flexible.
- Exercise – strengthening of muscle groups, especially the core and specific exercise depending on the cause of symptoms (Vijayaraj 2018, Zhou et al. 2014).
- Neural mobilisations – exercises that help to improve the nerve’s ability to move and glide amongst surrounding tissues (Adel 2011).
- Correcting ergonomics – addressing any activities at work or home that may contribute to your pain and correcting these (Kuijer et al. 2018).
- Adel, S.M., 2011. Efficacy of neural mobilization in treatment of low back dysfunctions. Journal of American Science, 7 (4), pages 566-573.
- Basson, A., Olivier, B., Ellis, R., Coppieters, M., Stewart, A. and Mudzi, W., 2017. The effectiveness of neural mobilization for neuro-musculoskeletal conditions: a systematic review and meta-analysis. journal of orthopaedic & sports physical therapy, 47(9), pp.593-615.
- Berry, J.A., Elia, C., Saini, H.S. and Miulli, D.E., 2019. A Review of Lumbar Radiculopathy, Diagnosis, and Treatment. Cureus, 11 (10).
- Das, S.M.S., Dowle, P. and Iyengar, R., 2018. Effect of spinal mobilization with leg movement as an adjunct to neural mobilization and conventional therapy in patients with lumbar radiculopathy: Randomized controlled trial. J Med Sci Res, 6 (1), pp.11-9.
- Kuijer, P.P.F., Verbeek, J.H., Seidler, A., Ellegast, R., Hulshof, C.T., Frings-Dresen, M.H. and Van der Molen, H.F., 2018. Work-relatedness of lumbosacral radiculopathy syndrome: Review and dose-response meta-analysis. Neurology, 91 (12), pp.558-564.
- Lin, J.H., Chiang, Y.H. and Chen, C.C., 2014. Lumbar radiculopathy and its neurobiological basis. World Journal of Anesthesiology, 3 (2), pp.162-173.
- Lipetz, J.S., 2002. Pathophysiology of inflammatory, degenerative, and compressive radiculopathies. Physical Medicine and Rehabilitation Clinics, 13 (3), pp.439-449.
- Reddington, M., Walters, S.J., Cohen, J., Baxter, S.K. and Cole, A., 2018. Does early intervention improve outcomes in the physiotherapy management of lumbar radicular syndrome? Results of the POLAR pilot randomised controlled trial. BMJ open, 8 (7), p.e021631.
- Riley, J.A., 2011. Manual therapy treatment of lumbar radiculopathy: A single case report. South African Journal of Physiotherapy, 67 (3), pp.41-45.
- Shipton, E.A., 2018. Physical therapy approaches in the treatment of low back pain. Pain and therapy, 7 (2), pp.127-137.
- Thakur, A., Mahapatra, R.K. and Mahapatra, R., 2015. Effect of Mulligan spinal mobilization with leg movement and shacklock neural tissue mobilization in lumbar radiculopathy: a randomised controlled trial. J Med Thesis, 3, pp.27-30.
- Vijayaraj, V., 2018. A comparative study between McKenzie technique and neural mobilization in chronic low back pain patients with radiculopathy. International Journal of Orthopaedics, 4 (2), pp.802-806.
- Zhou, L., Holder, E.K. and Leahy, H.P., 2014. Pathophysiology and Treatment of Discogenic and Radicular Lower Back Pain. Int J Phys Med Rehabil, 5, p.e107.