{"id":5863,"date":"2021-06-01T11:56:54","date_gmt":"2021-06-01T09:56:54","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=clinical_pattern&#038;p=5863"},"modified":"2024-03-04T12:02:52","modified_gmt":"2024-03-04T11:02:52","slug":"lumbar-radicular-syndrome","status":"publish","type":"clinical_pattern","link":"https:\/\/www.physiotutors.com\/clinical-patterns\/lumbar-radicular-syndrome\/","title":{"rendered":"Lumbar Radicular Syndrome"},"featured_media":5866,"template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":""},"tracking_tag":[2192],"class_list":["post-5863","clinical_pattern","type-clinical_pattern","status-publish","has-post-thumbnail","hentry","tracking_tag-lumbar-sij"],"acf":{"free_access":"unfree","app_link":"https:\/\/app.physiotutors.com\/add-ons\/678fa227-1815-44ed-85eb-6cff79001065","sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":5867,"background_image_alt_text":"Lumbar Radicular Syndrome"},"heading":"Lumbar Radicular Syndrome","subheading":"Lumbar Radicular Syndrome","content_editor":"","button_type":"internal_link","button_label":"","button_style":"button-one","button_internal_link":"","button_anchor":"","button_url":"","button_file":null,"label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Body Chart","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Background Information","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"History & Physical Examination","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Treatment","button_internal_link":null,"button_anchor":"section-number-6","button_url":"","button_file":null},{"button_type":"anchor","button_label":"References","button_internal_link":null,"button_anchor":"section-number-8","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"","button_style":"button-link-one","button_internal_link":"","button_anchor":"","button_url":"","button_file":null},"button_description":""},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">Body Chart<\/h2>"},"column_right":{"content_editor":"<img src=\"https:\/\/www.physiotutors.com\/wp-content\/uploads\/2021\/06\/Lumbar-Radicular-Syndrome-Pain-Diagram.png\" alt=\"Lumbar radicular syndrome pain diagram\" width=\"1240\" height=\"1112\" \/>\r\n<ul>\r\n \t<li><span lang=\"EN-US\">Pain radiating into the lower extremity in a quasi-segmental but not dermatomal distribution<\/span><\/li>\r\n \t<li><span lang=\"EN-US\">Leg pain more than back pain<\/span><\/li>\r\n<\/ul>"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">Background Information<\/h2>"},"column_right":{"content_editor":"<h3>Patient Profile<\/h3>\r\n<ul>\r\n \t<li>25 \u2013 60 years old<\/li>\r\n<\/ul>\r\n<h3>Pathophysiology<\/h3>\r\nCompression of nerve root within intervertebral foramen by tumor, HNP, vertebral body fracture or degenerative changes (e.g. stenosis through spondylophytes, spondylolysis, compression fracture)\r\nPeripheral nociceptive pain. Local inflammatory response common. Central sensitization possible due to prolonged high levels of pain\r\n<h3>Course<\/h3>\r\nConstant (acute).\r\n\r\nMild compression has a good prognosis with physiotherapy. Severe paresis requires surgical intervention with subsequent physiotherapy. Within the first 6 months, significant improvement in QoL possible.\r\nPsychosocial factors can negatively influence the prognosis.\r\nUsually rather lengthy course with good prognosis if patient receives proper education, shows good compliance and does not have any yellow flags"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">History &amp; Physical Examination<\/h2>"},"column_right":{"content_editor":"<h3>History<\/h3>\r\nInsignificant trauma in history (twisting, lifting); possibly recurrent or at least history of less severe low back pain episodes\r\n<ul>\r\n \t<li>Intense<\/li>\r\n \t<li>Deep<\/li>\r\n \t<li>Burning pain<\/li>\r\n \t<li>High intensity (acute) or varying intensity (subacute) VAS 5-10\/10<\/li>\r\n \t<li>Tingling\/numbness in lower extremity up to paresis<\/li>\r\n \t<li>More leg than back pain<\/li>\r\n \t<li>Central cord compression can lead to cauda equina syndrome<\/li>\r\n<\/ul>\r\n<h3>Physical Examination<\/h3>\r\n<strong>Inspection<\/strong>\r\nRelieving posture, typical shift or slight flexion\r\n\r\n<strong>Functional Assessment<\/strong>\r\nPain apparent in all movement directions; significant increase with additional compression of the nerve; patient can provoke pain with ease; typically during transfers or apparent during gait (limping)\r\n\r\n<strong>Passive Examination<\/strong>\r\nPPIVMs &amp; PPAVMs provoke pain on affected segment and segment above\/below; stiffness and hypertonus of paraspinal structures; muscle length tests: Rectus femoris, glutei, iliopsoas\u2026; in acute phase impossible due to pain\r\n\r\n<strong>Special Testing\r\n<\/strong>\r\n\r\n[embed]https:\/\/youtu.be\/CnITUzAD1SE[\/embed]\r\n\r\n[embed]https:\/\/youtu.be\/whb3Rknage0[\/embed]\r\n\r\n<strong>Neurodynamics<\/strong>\r\npositive\r\n\r\n<strong>Further Testing<\/strong>\r\n\r\n[embed]https:\/\/youtu.be\/ptO9ZvsUPDg[\/embed]\r\n\r\n[embed]https:\/\/youtu.be\/SzAyUsA25MQ[\/embed]\r\n\r\n[embed]https:\/\/youtu.be\/kFkRa17hlVc[\/embed]\r\n<h3>Differential Diagnosis<\/h3>\r\n<ol>\r\n \t<li>PEP<\/li>\r\n \t<li>Facetjoint hypomobility<\/li>\r\n \t<li>SI-Joint dysfunction<\/li>\r\n \t<li>coxarthrosis<\/li>\r\n \t<li>Spinal stenosis<\/li>\r\n<\/ol>\r\nConcerning cause of compression:\r\n<ol>\r\n \t<li>Tumor<\/li>\r\n \t<li>Vertebral fracture<\/li>\r\n \t<li>HNP<\/li>\r\n \t<li>Spondylolisthesis<\/li>\r\n<\/ol>"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">Treatment<\/h2>"},"column_right":{"content_editor":"<h3>Strategy<\/h3>\r\nDecrease pain in acute phase. Move into pain-free directionsSubacute phase: coordination, strength, endurance, and stability of trunk.Patient education\r\n<h3><strong>Interventions<\/strong><\/h3>\r\nAcute:\r\n<ul>\r\n \t<li>Treat surrounding structures and decrease compression<\/li>\r\n \t<li>Traction<\/li>\r\n \t<li>Movements into pain-free direction<\/li>\r\n \t<li>Infiltration<\/li>\r\n \t<li>Muscle relaxants\/NSAIDs<\/li>\r\n<\/ul>\r\nSubacute:\r\n<ul>\r\n \t<li>Trunk stability<\/li>\r\n \t<li>Motor control<\/li>\r\n \t<li>Neurodynamics<\/li>\r\n \t<li>Education on ergonomics<\/li>\r\n<\/ul>\r\n[embed]https:\/\/youtu.be\/ShM14BoX2WE[\/embed]"}},{"acf_fc_layout":"cta-big","heading":"Download the new Physiotutors App","subheading":"PHYSIOTUTORS APP","content_editor":"Are you ready for a learning revolution?\r\n\r\nExperience the Physiotutors content you love in our new app.","form_toggle":false,"form":"92","number_of_buttons":"one","button_1":{"button_1_button_type":"internal_link","button_1_button_label":"DOWNLOAD NOW","button_1_button_style":"button-two","button_1_button_internal_link":16662,"button_1_button_anchor":"","button_1_button_url":"","button_1_button_file":null},"button_2":{"button_2_button_type":"internal_link","button_2_button_label":"","button_2_button_style":"button-one : 1","button_2_button_internal_link":null,"button_2_button_anchor":"","button_2_button_url":"","button_2_button_file":null},"image":17728,"image_alt_text":"","overlay":false},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">References<\/h2>"},"column_right":{"content_editor":"<ol>\r\n \t<li>Wiesner, R. and P. Westerhuis, Klinische Muster in der manuellen Therapie. Vol.2 2013: Thieme.<\/li>\r\n \t<li>Scaia, V., D. Baxter, and C. Cook, The pain provocation-based straight leg raise test for diagnosis of lumbar disc herniation, lumbar radiculopathy, and\/or sciatica: a systematic review of clinical utility. J Back Musculoskelet Rehabil, 2012. 25(4): p.215-23.<\/li>\r\n \t<li>Tal-Akabi, A., Behinderung bei R\u00fcckenbeschwerden: Roland and Morris Disability Questionnaire (RMDQ), P. Oesch, Editor. 2010.<\/li>\r\n \t<li>Sullivan, M.J.L., Theoreticle perspectives on the relations between catastrophizing and pain, B. Thorn, Editor. 2001, The clinical journal of pain.<\/li>\r\n \t<li>Luomajoki, P.D.H., Artikel aus der Zeitschrift Physiopraxis: Wenn der Schmerz im Vordergrund steht. S2,\u00a0Abschnitt: Angst vor Schmerzen nehmen.<\/li>\r\n \t<li>Hahne, A.J., et al., Outcomes and adverse events from physiotherapy functional restoration for lumbar disc herniation with associated radiculopathy. Disabil Rehabil, 2011. 33(17-18): p. 1537-47.<\/li>\r\n \t<li>K., B., The Quality of life of lumbar radiculopathy patients under conservative treatment, T.-T. S., Editor. 2009, Vajosanit pregl. p. 807-12.<\/li>\r\n<\/ol>"}}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Lumbar Radicular Syndrome - Physiotutors<\/title>\n<meta name=\"description\" content=\"Learn about the diagnosis, prognosis and treatment of Lumbar Radicular Syndrome in our Clinical Pattern for Physiotutors Members\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.physiotutors.com\/clinical-patterns\/lumbar-radicular-syndrome\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Lumbar Radicular Syndrome - Physiotutors\" \/>\n<meta property=\"og:description\" content=\"Learn about the diagnosis, prognosis and treatment of Lumbar Radicular Syndrome in our Clinical Pattern for Physiotutors Members\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.physiotutors.com\/clinical-patterns\/lumbar-radicular-syndrome\/\" \/>\n<meta property=\"og:site_name\" content=\"Physiotutors\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/facebook.com\/physiotutors\" \/>\n<meta property=\"article:modified_time\" content=\"2024-03-04T11:02:52+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.physiotutors.com\/wp-content\/uploads\/2021\/06\/Lumbar-Radicular-Syndrome-Featured-Image.png\" \/>\n\t<meta property=\"og:image:width\" content=\"560\" \/>\n\t<meta property=\"og:image:height\" content=\"466\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@physiotutors\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.physiotutors.com\\\/clinical-patterns\\\/lumbar-radicular-syndrome\\\/\",\"url\":\"https:\\\/\\\/www.physiotutors.com\\\/clinical-patterns\\\/lumbar-radicular-syndrome\\\/\",\"name\":\"Lumbar Radicular Syndrome - 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