If you have lower back pain, there could be several different things that are causing it. For instance, radiculopathy is one problem many people have in their vertebras. One way to help back pain is to go to a chiropractor, where they have chiropractic medicine and the like for painful issues. There are also cardiac rehabilitation centers that can help back pains. If you have radiculopathy, you should look very seriously into physical therapy. Radiculopathy refers to nerve irritation caused by damage to the disc between the vertebrae. This occurs because of degeneration of the outer ring of the disc, or because of traumatic injury, or both. As a result, the central softer portion of the disc can rupture through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column.
When nerves are irritated in the neck from degenerative disc disease, the condition is referred to as cervical radiculopathy. This can lead to painful burning or tingling sensations in the arms.
When nerves are irritated in the low back from degenerative disc disease, the condition is called lumbar radiculopathy and it often causes the commonly recognized "sciatica" pain that shoots down the lower extremity. This condition can be preceded by a localized low back aching. Sciatica pain can follow a "popping" sensation at onset 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, lumbar radiculopathy can be accompanied by incontinence of the bladder and/or bowels.
How is radiculopathy diagnosed?
Radiculopathy is suspected when the symptoms described above are noted. The doctor can sometimes detect signs of irritated nerves during the examination. For example, 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 the nerve irritation. The actual disc herniation can be detected with radiology testing, such as CAT or MRI scanning. For more information, please read the CAT Scanning and MRI Scanning articles.
The treatment of radiculopathy ranges from no surgical (medical) management to surgery. Medical management of radiculopathy includes patient education of the condition, 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 (producing a small hole in the bone of the spine surrounding the spinal cord), laminectomy (removal of the bony wall adjacent to the nerve tissues), by needle technique through the skin (percutaneous discectomy), disc- dissolving procedures (chemonucleolysis), and others.
