Lumbar Radiculopathy Assessment: Difference between revisions
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Revision as of 05:13, 27 November 2023
Original Editor - User Name
Top Contributors - Jess Bell, Matt Huey and Wanda van Niekerk
Introduction[edit | edit source]
Causes of Radiculopathy[edit | edit source]
Assessment for Radiculopathy[edit | edit source]
Myotomes[edit | edit source]
Sensation[edit | edit source]
Patients may experience a change in sensation in their lower extremities with a lumbar radiculopathy. A common complaint with lumbar radiculopathy is numbness and tingling in the legs along a dermatomal pattern. Patients may also state they feel "weird" sensations in their lower extremities as well, such as the feeling of bugs crawling on them, tenderness, or "it doesn't feel right."
Light touch can be utilized to determine if sensation is altered.
- Have the patient in the supine or seated position
- Inform them what you will be doing. "I will be brushing along your legs in certain areas, let me know if it feels the same on both sides."
- Can have the patient close their eyes or obscure their view so they are not biased to the testing
- Use your fingertips or a cotton swab to apply a light touch to a dermatome.
- Test each side and compare if it feels the same.
| L1 | Greater trochanter |
|---|---|
| L2 | Front of thigh to knee |
| L3 | Anterior thigh and Knee, medial lower leg |
| L4 | Lateral thigh, medial leg, dorsum of foot, big toe |
| L5 | Posterior and lateral thigh, lateral aspect of leg, dorsum of foot, medial half of bottom of foot, toes 1-3 |
| S1 | Posterior thigh |
Deep Tendon Reflexes[edit | edit source]
Neurodynamics[edit | edit source]
Repeated Movement[edit | edit source]
The use of repeated movement testing is a hallmark of Mechanical Diagnosis and Therapy (MDT or the McKenzie Method). The goal with utilizing repeated movement testing, is to determine if the person is able to centralize their radicular symptoms. There is evidence that utilizing repeated movement testing can be both useful in the assessment and treatment for lumbar radiculopathy[1]. Repeated movement testing can be useful even if a patient is only experiencing symptoms in their lower extremity[2].
Several things must be considered when performing repeated movement:
- Direction. Often a mistake is only performing repeated extension.
- Loaded or unloaded. Standing is considered a loaded position of the lumbar spine whereas supine/prone is considered unloaded.
- Time and/or repetition. Another mistake that can be made is not giving enough time or the proper number of repetitions to exhaust a movement.
References[edit | edit source]
- ↑ Wetzel, F. T., & Donelson, R. (2003). The role of repeated end-range/pain response assessment in the management of symptomatic lumbar discs. The spine journal : official journal of the North American Spine Society, 3(2), 146–154. https://doi.org/10.1016/s1529-9430(02)00565-x
- ↑ osedale, R., Rastogi, R., Kidd, J., Lynch, G., Supp, G., & Robbins, S. M. (2020). A study exploring the prevalence of Extremity Pain of Spinal Source (EXPOSS). The Journal of manual & manipulative therapy, 28(4), 222–230. https://doi.org/10.1080/10669817.2019.1661706
