Lumbar Radiculopathy: Proper Diagnosis Key to Effective Treatment of Back and Leg Pain

Physical Examination
You may be asked to stand, walk or lie down on the exam table during the physical examination. In a lying position, your physician will raise each of your legs to demonstrate flexibility and strength in your low back and legs. The following table is a summary for the examination performed and possible findings:

Diagnostic Studies
To further determine the source of your symptoms, and to confirm your diagnosis, your physician may request other tests such as an X-Ray or MRI (Magnetic Resonance Imaging).

MRI

X-RAY

An X-Ray is used to show the bony anatomy of the spine. In an X-Ray, the physician is looking for the alignment and integrity of the bony structures. Integrity in this sense means no degeneration in the bone structures.

An MRI produces images of the soft tissues of the spine. Using an MRI, the physician looks at the soft tissue structures such as the discs, ligaments, spinal cord, and spinal nerves. The physician looks at the integrity of the discs themselves for degeneration (dark in color because of loss of hydration), bulging or herniation (where the disc contents protrude into the spinal canal and compress the nerves or spinal cord). If there is a herniation present, the MRI helps the physician determine if the nerves are being pinched or smashed by the herniated disc.

Treatment
Low back pain with lumbar radiculopathy is often treated conservatively. This may include a combination of rest, medication, and a home exercise or structured physical therapy program.

Surgery may be recommended if symptoms persist after conservative treatment. These symptoms may include severe pain, increasing numbness, or weakness of the legs. The decision for surgical intervention is often made when conservative treatment has failed and the symptoms are interfering with your daily function causing lifestyle changes such as an inability to work or participate in the activities you enjoy.

Understanding Lumbar Radiculopathy
A combination of medical history, physical examination, and diagnostic testing helps your physician understand your symptoms. It is important for you as the patient to understand your symptoms, as well. Understanding your symptoms allows you to seek treatment when appropriate. Your family physician is an excellent source for initial assessment and treatment, followed by referral to a spine specialist when necessary.