Lumbosacral radicular syndrome LRS / hernia nucleus pulposus (HNP) / herniated disc / sciatica

Lumbosacral radicular syndrome (LRS) is a collective term for the pain associated with compression of a nerve root in the back. This may be associated with loss of strength, pins and needles or loss of sensation in the leg. The most common cause of lumbosacral radicular syndrome is a back hernia.

A bundle of nerves runs through the vertebrae of the back. At each vertebra, a number of nerves exit the spine in the direction of various parts of the body. Among other functions, nerves ensure that we can control muscles and that pain signals from the entire body are transmitted to the brain.

With lumbosacral radicular syndrome, a nerve root becomes trapped or irritated at the point where the nerve leaves the spinal canal. This can cause the nerve to transmit signals less effectively. As lumbosacral radicular syndrome affects the nerves going to the legs, this syndrome causes problems with the legs as well as back pain. This results in less effective control of the muscles (loss of strength) and can cause distorted sensations (pain or pins and needles in the leg).

In 90% of cases, the symptoms are caused by a herniated disc. A prolapsed (or protruding)

Conservative management of lumbosacral radicular syndrome usually has favorable results with regards to the symptoms in the legs. However, the lower back symptoms may continue to exist to varying degrees. The treatment policy is aimed at alleviating the symptoms and waiting to see if the condition progresses favorably. Bed rest does not contribute to a faster recovery but can be helpful at times.

The physiotherapy treatment in the acute phase consists of providing advice on how to cope with the symptoms and stimulating movement. In addition, (non-weight-bearing) exercise therapy can be used to maintain the mobility of the lower back. For a hernia, it may be sensible to stretch the back (as far as the pain permits) during the first two weeks, in order to prevent further protrusion of the intervertebral disc. In later stages, specific strength training of the trunk and leg muscles can contribute significantly to preventing a recurrence of the symptoms.

Surgery will only be considered in severe cases. Paralysis forms a relative reason for rapid surgery. If acute surgery is not indicated, surgeons often review after 6 weeks to see if the conservative management is effective.

Take a look at the online exercise program here with exercises for lumbosacral radicular syndrome.

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