Around 80% of the population is plagued at one time or another by back pain, especially lower back pain. Associated leg pain (called lumbar radiculopathy or sciatica) happens less frequently. Pain could be debilitating and bothersome, restricting daily activities. Leg and back pain can result from a number of reasons, not all of which originate in your spinal column.
With the aim of this particular article, we’ll concentrate on lumbar radiculopathy, which refers to pain in the low extremities in a dermatomal pattern (see picture below). A dermatome is a special place in the lower extremity that’s nerves going from a particular lumbar nerve to it. Compaction of the origins of the spinal nerves in the lumbar region of the back causes this pain. Diagnosing leg and lower back pain begins with assessment and a detailed patient history.
Diagnosing Lower Back Pain and Sciatica
Your medical history helps the issue is understood by the physician. It is essential to be specific when answering medical questions linked to pain beginning but recalling every detail is often not critical. Keeping records of your medical history, including medical issues, medicines you’re taking and surgeries you have had in the past is helpful.
Seeing your leg and back pain, it may be helpful to keep the activities that aggravate your pain, a journal of your actions, when the pain began documenting and those who alleviate your symptoms. It’s also important to ascertain whether your back pain is than visa versa or your leg pain. If you are experiencing any numbness or weakness in your legs or any difficulty walking, maybe you are asked. Remember, understanding the reason for your issue is founded on the advice you supply.
Most of the individuals describe radicular pain as a burning or sharp pain that shoots down the leg. This is what many people call sciatica. This pain may or may not begin in the low back. Leg pain caused by nerve roots that are compressed normally has routines that are particular. These routines of pain is determined by the degree of the nerve being compressed. After reviewing your history, your physician will perform a physical examination. This will assist the doctor determine in case your symptoms are due to an issue that’s caused by spinal nerve root compression. To assist you understand the exam performed by your doctor lets pause to get an instant anatomy lesson.
Understanding the Anatomy of the Spine
The spine is comprised of 33 vertebrae (bones piled on top of each other in a “building-block” fashion) that have 4 distinct areas: cervical (neck), thoracic (upper/mid back), lumbar (low back), and sacrum (pelvis).
Discs are cushion-like tissues that separate most vertebrae and act as the back’s shock absorbing system. Eaach disk is comprised of a tough outer ring of fibers known as the annulus fibrosus, plus a soft gel-like center known as the nucleus pulposus.
There are 7 flexible cervical (neck) vertebrae that help to support the head. Twelve thoracic vertebrae attach to ribs. Next, are 5 lumbar vertebrae; they are large and carry nearly all the body weight. The sacral region helps disperse the body weight to the pelvis and hips.
The spinal cord is placed within the protective components of spinal canal. Spinal nerves exit the spinal canal through passageways between the vertebral bodies and branch from the spinal cord. The passageways are called neuroforamen. Nerves supply sensory (permitting you to touch and feel) and motor information (allowing the muscles to function) to the complete body.
In another article (click the Continue Reading link below), we discuss how your doctor determines what’s causing your lower back pain and sciatica, which is critical to the appropriate treatment strategy and symptom relief.
Comments by way of a Spine Specialist
Lumbar is a familiar problem that results when nerve roots are compressed or irritated. This excellent article discusses the basic anatomy and clinical manifestations of lumbar radiculopathy, which will be regularly referred to generically as sciatica. These symptoms can be due to a selection of causes such as disc bulges, degenerative narrowing of the space for the nerves (spinal stenosis or foraminal stenosis), spinal instability, deformity of the vertebrae, or herniated disc fragments outside the disc space.
In 70-80% of patients, sciatica is ephemeral, and works out with nonsurgical treatments for example anti-inflammatory drugs, physical therapy, exercise, spinal manipulation, or alternative nonsurgical modalities. Surgical intervention is required by a proportion of patients with sciatica in cases where nonsurgical treatments have failed to supply sufficient pain relief, and there is pathology [cause] that is present compressing the nerves. A tiny proportion of patients need urgent surgery. If an extremely large lumbar disk herniation causes serious nerve damage, with paralysis or acute bowel or bladder incontinence, then emergency surgery might be needed.—Curtis A. Dickman, MD
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By Dr. Alex Jimenez
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