Lumbosacral radiculitis occurs when the inner portion or jelly of the disc herniates into the lumbar epidural space causing impingement onto the exiting nerves. The exiting nerves supply the skin and muscles of the leg along a dermatomal or myotomal pattern. Typically disc herniations do not cause back pain but more often cause burning pain in the leg. Typically the management of this condition is nonsurgical and symptoms will respond to physical therapy, oral nerve pain medications, and/or epidural injections. Red flag signs and symptoms in which further evaluation with a surgeon would be warranted include persistent pain, numbness, leg weakness, bowel or bladder incontinence, or numbness in the saddle region.
Lastly, back pain and pain in general can be very frustrating. It is normal to feel frustrated regarding your symptoms. In general, movement and exercise is healthy for the spine. Patients who begin avoiding activities and move less tend to experience more pain overall. Consider reading a book titled “End Back Pain Forever” by Norman Marcus which details the pain pathophysiology. The more you learn about generation of pain and its physiology, the more comfortable you will feel with your symptoms. You could also consider connecting with a Mindfulness teacher to help address pain symptoms. Often times stress can incite pain particularly in the back/neck and aggravate your symptoms. Mindfulness can be a useful tool to reduce stress and therefore reduce pain. Another great resource is www.retrainpain.org which provides 8 short modules to educate you on pain physiology.
The McKenzie method explores different positions and movements, how the patient performs them, and the response to these movements. Interpreting this information, the clinician determines which of the movements and posture becomes the treatment as well as the necessary exercise dosage. Further, it means that a position, movement or activity caused the pain to start. If a mechanical force caused the problem then it is logical that a mechanical force may be part of the solution. The MDT system is designed to identify the mechanical problem and develop a plan to correct or improve the mechanics and thus decrease or eliminate the pain and functional problems.
A lumbar RFA is a procedure that uses radio waves to stop the lumbar medial branch nerve from transmitting pain signals from the injured facet joint to the brain. The procedure calls for a needle to be inserted through the skin and guided with X-ray to the correct site overlying the medial branch nerve.