1.9 Lumbar Radicular Pain and Radiculopathy Overview

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Questions and Answers

What is the common conservative approach for managing radiculopathy?

Regular use of opioids

Immediate surgical intervention

Complete bed rest for 6 weeks

Physiotherapy with a multimodal approach (correct)

What treatment approach is not recommended for clients with acute low back and sciatica?

Complete bed rest (correct)

Physiotherapy with manual therapy

Activity restrictions

Pain medication with NSAIDs

Which therapy aims to improve joint mobility and reduce pain in radiculopathy?

Pain neuroscience education

Acupuncture

McKenzie extension exercises (correct)

Combination of electrophysical agents

What is a potential side effect of using pain medications for radiculopathy management?

Epigastric pain Signup and view all the answers

When might surgical management be considered for radiculopathy cases?

When symptoms persist after 6 months of conservative management Signup and view all the answers

Which post-operative intervention is highlighted as integral in rehabilitation following spinal surgery for radiculopathy?

Post-operative physiotherapy Signup and view all the answers

What is the defining characteristic of radiculopathy?

Pain, weakness, or numbness in a specific distribution Signup and view all the answers

What is the prevalence of lumbar and sacral radiculopathy in adult individuals with low back pain?

3 to 5% Signup and view all the answers

Which diagnostic rule is considered evidence-based for radiculopathy?

Three out of four positive findings along with a positive SLR test Signup and view all the answers

What distinguishes radiculopathy from radicular pain?

Combination of sensory and motor symptoms Signup and view all the answers

What are typical symptoms associated with radicular pain?

Pain, paresthesia, and sensory loss Signup and view all the answers

How does radiculopathy differ from radicular pain in terms of symptoms?

Combination of sensory and motor symptoms Signup and view all the answers

Which of the following is not a common cause of lumbosacral radiculopathy?

Sensory loss in the affected region Signup and view all the answers

Which nerve root is associated with weakness in hip flexion and adduction, and quadriceps weakness?

L2/L3 Signup and view all the answers

Which radiculopathy is characterized by weakness in ankle dorsiflexion, toe extension, and hip abduction?

L5 Signup and view all the answers

What is a common clinical presentation of S1 radiculopathy?

Weakness in ankle plantar flexion Signup and view all the answers

What is considered a gold standard measure to confirm the presence of disc bulge and herniation?

CT myelography Signup and view all the answers

In individuals with radicular pain, what signs would not be evident?

Blurred vision Signup and view all the answers

Which age group is more commonly affected by lumbosacral radiculopathy according to Schoenfeld et al. (2012)?

Women in their 50s and 60s Signup and view all the answers

Which type of radiculopathy usually presents with posterior thigh, leg, and foot pain?

S1 radiculopathy Signup and view all the answers

What reflex is associated with L4 radiculopathy?

Patellar reflex Signup and view all the answers

What is the most common cause of radicular pain?

Intervertebral disc herniation Signup and view all the answers

Study Notes

Conservative Management of Radiculopathy

Common conservative approaches include physical therapy, pain management through medications, and activity modification.
Use of spinal manipulation and chiropractic care is generally not recommended for clients with acute low back pain and sciatica.

Goals of Therapy

Physical therapy aims to improve joint mobility and reduce pain associated with radiculopathy.

Pain Management Side Effects

Potential side effects of pain medications can include dependency, gastrointestinal issues, and cognitive effects.

Surgical Considerations

Surgical management may be considered for radiculopathy if conservative treatments fail or if there is significant neurological compromise.

Post-operative Rehabilitation

Early mobilization and physical therapy are integral in rehabilitation following spinal surgery for radiculopathy.

Definition and Prevalence

Radiculopathy is characterized by radiating pain or neurological deficits resulting from nerve root compression or irritation.
Prevalence of lumbar and sacral radiculopathy among adults with low back pain is significant, affecting a substantial portion of this demographic.

Diagnostic Criteria

The “straight leg raise test” is considered an evidence-based diagnostic rule for assessing radiculopathy.

Distinction Between Radiculopathy and Radicular Pain

Radiculopathy involves both pain and neurological deficits, whereas radicular pain primarily consists of pain without significant weakness or sensory loss.
Typical symptoms of radicular pain include sharp, shooting pain along the nerve's distribution, but without the neurological deficits indicative of radiculopathy.

Causes and Symptoms

Radiculopathy can result from herniated discs, spinal stenosis, tumors, or trauma.
Not all causes of lumbosacral radiculopathy are common; for example, infections are less prevalent.
L2-L3 nerve root involvement leads to weakness in hip flexion/adduction and quadriceps weakness.

Specific Root Characteristics

L5 radiculopathy is characterized by weakness in ankle dorsiflexion, toe extension, and hip abduction.
Common clinical presentation of S1 radiculopathy includes pain down the posterior aspect of the leg and diminished ankle reflex.

Imaging and Diagnosis

MRI is considered the gold standard for confirming disc bulge and herniation.
In radicular pain, signs of upper motor neuron lesions would not be evident.

Demographics and Pain Patterns

Lumbosacral radiculopathy most frequently affects individuals aged 30 to 50 years.
L5 radiculopathy typically presents with posterior thigh, leg, and foot pain.
L4 radiculopathy is associated with a diminished patellar reflex.

Common Causes of Pain

The most common cause of radicular pain is intervertebral disc herniation.

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Description

Learn about lumbar and sacral radiculopathy with this quiz. Explore the causes, symptoms, and prevalence of radicular pain in the lower back. Test your knowledge of disc displacement and its impact on intervertebral spaces.