Principles of diagnosis and non-surgical treatment of lumbar and sacral radiculopathy

Jūratė Kazlauskaitė1, Paulius Meškauskas1, Miglė Puodžiūnaitė2

1 Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicin, Kaunas, Lithuania

2 Lithuanian University of Health Sciences, Department of Family Medicine, Kaunas, Lithuania


Background. Lumbosacral radiculopathy is a condition, when the lumbar and sacral spinal nerve roots are irritated, compressed or otherwise damaged for various etiological reasons. Depending on the location and extent of damage to the spinal nerve roots, sensory and reflex disorders of the lower extremities may also occur. The increasing incidence of this disease especially in developed countries leads that lumbosacral radiculopathy is one of the most common cause of disability.

Aim. Tol review the main principles of diagnosis and non-surgical treatment of lumbosacral radiculopathy.

Results: It is important to collect a medical history, perform a consistent physical examination to differentiate the causes of radiculopathy, and rule out the symptoms of the red flag, which could signal an acute and special attention requiring disorder. Imaging techniques like magnetic resonance imaging, computed tomography, and myelography can also be used to confirm a diagnosis:. In cases of unclear radiological image, electromyography and electroneurography might be performed. Treatment of lumbosacral radiculopathy is a complex process that includes physiotherapy, manual therapy, kinesitherapy, and pharmacological treatment. If neurological symptoms progress, or there is no response to conservative treatment, surgical treatment may be appointed.

Conclusions. In order to prevent the progression of neurological symptoms and deterioration of the patient’s quality of life, the most important thing is timely and accurate diagnosis of lumbar and sacral radiculopathy. Neurodynamic tests are used during the physical examination. If necessary, neuroradiological or electroneurographic tests are performed. In the absence of contraindications, it is recommended to start the treatment with conservative measures.


Keywords: lumbosacral radiculopathy, neurodynamic test, radiculopathy pain syndrome, radiofrequency therapy, epidural steroid injection.