eMedicine Specialties > Sports Medicine > Spine

Lumbosacral Radiculopathy: Follow-up

Author: Gerard A Malanga, MD, Founder and Director, New Jersey Sports Medicine Institute; Director of Pain Management, Overlook Hospital; Director of Sports Medicine, Sports Medicine Fellowship Director, Mountainside Hospital; Clinical Chief, Rehabilitation Medicine and Electrodiagnosis, St Michael's Medical Center; Medical Director, Consultant, Horizon Healthcare Worker's Compensation Services, Blue Cross and Blue Shield Worker's Compensation
Coauthor(s): Charles J Buttaci, DO, PT, Pain Management, Northeast Orthopedics; Mariam Rubbani, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Union County Orthopedic Group
Contributor Information and Disclosures

Updated: Jan 6, 2009

Follow-up

Education

Individuals with lumbosacral radiculopathy need to have an understanding of the likely etiology of their pain. The examination findings of patients with acute LBP can often be suggestive, although no clinical or historical findings have been found to significantly correlate with confirmed pain generators.

Review the basic anatomy and biomechanics of the spine with the patient. Discuss the etiology of the patient's symptoms. Also discuss the treatment plan, including a description of the recommended imaging studies, medications, injections, and therapeutic exercises. Review proper posture, the biomechanics of the spine in the activities of daily living, and simple methods to reduce the patient's symptoms. These early and simple instructions enable the patient to become an active participant in the treatment as he or she progresses to a more comprehensive home exercise program.

Patients must understand that they are making a lifelong commitment to their maintenance exercise program, because the single most important risk factor for future episodes of back pain is a previous episode. Patient education should be considered an ongoing process that must be continually refined. Directed education should continue until the patient is independent in his or her maintenance exercise program.

Miscellaneous

Medicolegal Pitfalls

  • A pitfall is failure to recognize more serious medical conditions that may feature back pain.

    • All red-flag symptoms must be pursued for an etiology. Symptoms such as fever, weight loss, or chills may represent a more ominous condition, such as a tumor, and must be dealt with expeditiously to yield the best chance of improving the patient's health, if not to save the patient's life.
    • Failure to be aware of and to act on red flags could have serious medicolegal consequences.
    • Failure to recognize cauda equina syndrome or significant motor deficits could also have legal implications.
 


More on Lumbosacral Radiculopathy

Overview: Lumbosacral Radiculopathy
Differential Diagnoses & Workup: Lumbosacral Radiculopathy
Treatment & Medication: Lumbosacral Radiculopathy
Follow-up: Lumbosacral Radiculopathy
Multimedia: Lumbosacral Radiculopathy
References
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Further Reading

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Keywords

lumbosacral radiculopathy, back pain, sciatica, herniated disc, herniated disk, nucleus pulposus, pinched nerve, referred leg pain, acute low back pain, chronic low back pain, LBP, lumbosacral radicular syndrome, LRS, lumbosacral radiculitis, lumbosacral nerve root compression

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Contributor Information and Disclosures

Author

Gerard A Malanga, MD, Founder and Director, New Jersey Sports Medicine Institute; Director of Pain Management, Overlook Hospital; Director of Sports Medicine, Sports Medicine Fellowship Director, Mountainside Hospital; Clinical Chief, Rehabilitation Medicine and Electrodiagnosis, St Michael's Medical Center; Medical Director, Consultant, Horizon Healthcare Worker's Compensation Services, Blue Cross and Blue Shield Worker's Compensation
Gerard A Malanga, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, North American Spine Society, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.

Coauthor(s)

Charles J Buttaci, DO, PT, Pain Management, Northeast Orthopedics
Charles J Buttaci, DO, PT is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Osteopathic Association, American Osteopathic College of Physical Medicine and Rehabilitation, International Spine Intervention Society, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.

Mariam Rubbani, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Union County Orthopedic Group
Mariam Rubbani, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

Medical Editor

Andrew D Perron, MD, Residency Director, Department of Emergency Medicine, Maine Medical Center
Andrew D Perron, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Sports Medicine, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Henry T Goitz, MD, Fellowship Director, Sports Medicine, Department of Orthopedic Surgery, Henry Ford Hospital
Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Orthopaedic Society for Sports Medicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD, Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Sports Medicine Fellowship Director, Medical College of Wisconsin
Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa, and Wilderness Medical Society
Disclosure: Nothing to disclose.

 
 
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