By: Richard A. Owens, PT, MS, OCS, Cert. SHT, CWcHP, Cert DN
Low back pain is a common problem and affects an estimated 60% to 80% of people in the United States in some form during their lifetimes. Most occurrences of back pain improve within weeks with 90% of people completely getting better within 6 weeks. Only 1% to 2% of patients will require surgery. Of the total number of back pain patients, 5% to 10% eventually develop chronic low back pain, and approximately 1% may become disabled. Sometimes low back pain can be accompanied by pain into one or both legs. This is called radicular pain, and this pain can be much worse that the back pain itself.
Radiculopathy or radicular pain, radiates into the lower extremity (thigh, calf, and occasionally the foot) along the course of a specific spinal nerve root. It can manifest as mild tingling or numbness, but can also lead to excruciating burning and sharp shooting pains. Sciatica is one of the most common forms of this pain, and is directly caused by compression of an exiting nerve root in the lumbar spine. Two of the most common causes of radicular pain are a herniated disc with nerve root compression and foraminal stenosis (narrowing of the hole through which the spinal nerve exits due to bone spurs or arthritis - more common in the elderly). Radiculopathy can also cause mild to severe weakness in one or more of the muscles in the leg and can severely affect your ability to complete simple daily tasks or even walk normally.
The clinical diagnosis is usually arrived at through a combination of the patient's history, reported symptoms, as well as a physical exam. Imaging studies (X-ray, MRI, CT) are used to confirm the diagnosis and will usually show the impingement on the nerve root.
It is usually recommended that a course of conservative treatment such as physical therapy, medications, and selective spinal injections should be conducted for six to eight weeks. Physical Therapists are skilled medical practitioners trained in biomechanics and human anatomy. At your initial visit, a Physical Therapist will do a mechanical examination of your lower back to help determine the specific cause of your radicular symptoms and assist you in techniques to relieve the discomfort. From there he or she can develop a rehabilitation program designed around prevention and wellness including activity modification to assist the pain management physician in resolving your condition.
If conservative treatment does not alleviate the pain, or if the pain is severe, such as decompression surgery, such as laminectomy and/or discectomy/microdiscectomy may be recommended.
Professional Rehabilitation Services is a Physical Therapist owned Private Outpatient Physical Therapy Practice specializing in pain, orthopedics, balance and sports injuries with offices in Myrtle Beach and Pawleys Island, SC. For more information on this topic or to schedule a FREE 15 Minute Consultation please contact Brian Kinmartin, PT, DPT, MTC, OCS, STC, CWcHP, Cert. DN, at our Pawleys Island office at 843-235-0200, Richard A. Owens, PT, MS, OCS, Cert. SHT, CWcHP, Cert DN at our Myrtle Beach office at (843) 831-0163 or Richard DeFalco, DPT, OCS, CSCS, CWcHP, Cert. DN at our Myrtle Beach office at (843) 839-1300, or visit us at: www.prsrehabservices.com.