SIGNS AND SYMPTOMS

One of the most common symptoms of low back (lumbar) radiculopathy is radiating leg pain, a condition often referred to as sciatica (sciatic neuralgia). Sciatica is characterized by pain that radiates from your the low back or buttock into the legs and often to the feet. Lower extremity sensory complaints such as numbness and tingling are more common than muscle atrophy or weakness. Muscle weakness is usually a sign that the nerve dysfunction is more severe. Muscle weakness is not always obvious. Early symptoms of muscle weakness are more often associated with early muscle fatique during exertion rather than obvious weakness.

Mild radiculopathy may result in the skin becoming more sensitive (hyperesthesia) to touch along the area innervated by the involved spinal nerve root. Persistent and/or progressive signs and symptoms of radiculopathy are warning signs that the degree of neurological compromise is progressing.

Individuals with spinal nerve compromise commonly describe sensory symptoms such as pain, numbness, tingling in a distribution that corresponds to the level of spinal involvement.  The segmental levels of sensory innervation are referred to as dermatomes.  The sensory portion of the clinical evaluation should include assessment with pinprick, two-point discrimination, vibratory stimuli, and joint position testing.  Spinal nerve damage will result in decreased sensation radiating the corresponding area of skin (dermatome).  Spinal nerve root compromise is often associated with intermittent pain into the involved extremity.

CAUSES

There are many potential causes of spinal nerve root compromise with the intervertebral foramen (NF).  Common causes of nerve compression include disc bulge, disc herniation, enlargement of the facet joints, bone spurs, excessive vertebral movement (vertebral instability), as well as degenerative disc disease with loss of disc height and narrowing of the IVF.  Less common causes of nerve compromise in the NF include tumor, vein dilation, scar tissue, and hereditary abnormalities of the bone.  More than one cause may be present.

Chemicals leaking from injured spine tissues such as a degenerative herniated disc may spread and contact a spinal nerve root inducing inflammation.  The chemically-induced inflammation promotes swelling (edema) and nerve damage.  The signs and symptoms are similar to those of a compressed nerve. A spinal nerve can be compressed and inflamed at the same time.