Radiation-Induced Lumbosacral Plexopathy Treatment & Management
- Author: Rajesh R Yadav, MD; Chief Editor: Robert H Meier III, MD more...
Rehabilitation Program
Physical Therapy
Strengthening of lower extremity muscles, use of assistive devices for ambulation (eg, cane, walker), and gait training should be prescribed for patients with weakness and proprioceptive feedback loss. Use of orthotics also may be beneficial in certain individuals with lumbosacral plexopathy.
Occupational Therapy
The patient's ability to perform activities of daily living (ADL) should be assessed, and appropriate assistive device(s) should be prescribed as needed. In particular, safety with standing transfers may be impaired with more distal involvement. With more proximal involvement, sit-to-stand transfers also may be affected. Strengthening exercises, along with sensory reeducation techniques, may be employed.
Medical Issues/Complications
Treatment of postradiation plexopathy is symptomatic. For issues of pain, consider the use of nonopiate pharmacologic medications, such as tricyclic antidepressants or antiepileptic agents (eg, gabapentin, carbamazepine). The use of steroids and opiates, including methadone, can also be considered.
Other Treatment
Nonpharmacologic measures, such as transcutaneous electrical nerve stimulation (TENS), may be used for pain.
While not studied in patients with radiation-induced lumbosacral plexopathy, hyperbaric oxygen therapy has not led to the slowing or reversal of radiation-induced brachial plexopathy symptoms, although improvement was noted in warm sensory threshold.[14]
In a small population, partial recovery of motor function was noted in few patients treated with anticoagulant therapy for a period of 3-6 months.
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