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Lumbar radicular pain.

Jay Govind1

  • 1Royal Newcastle Hospital, New South Wales. jaygovind@bigpond.com.au

Australian Family Physician
|July 16, 2004
PubMed
Summary

Lumbar radicular pain (LRP) stems from spinal nerve irritation, causing leg pain. Most cases resolve with analgesics, but epidural steroid injections or surgery may be needed for persistent or severe symptoms.

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Area of Science:

  • Neurology
  • Pain Medicine
  • Spinal Cord Medicine

Background:

  • Radicular pain originates from irritation of spinal nerve sensory roots or dorsal root ganglia.
  • Pathophysiology involves nerve root compression, mechanical stimulation, stretching, and inflammatory reactions.
  • Ectopic nerve impulses are generated, leading to pain perceived along the axon's distribution.

Purpose of the Study:

  • To discuss the clinical features of lumbar radicular pain (LRP).
  • To outline the assessment methods for LRP.
  • To describe the management strategies for LRP.

Main Methods:

  • Review of clinical features associated with lumbar radicular pain.
  • Discussion of diagnostic assessment techniques.
  • Analysis of conservative and interventional management options.

Main Results:

  • Lumbar radicular pain is characterized by sharp, shooting, or lancinating sensations in a narrow band down the leg.
  • Pain may be accompanied by radiculopathy (sensory/motor dysfunction) or referred pain.
  • Over 50% of LRP cases improve with simple analgesics.

Conclusions:

  • Transforaminal epidural steroid injections offer significant and lasting pain relief for LRP.
  • Surgical intervention is reserved for progressive neurological deficits or severe LRP unresponsive to conservative treatments.
  • Understanding LRP's clinical presentation and pathophysiology guides effective management.

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