Expertise Details



LUMBAGO SCIATICA SYNDROME/ Intervertebral Disc Prolapse (IVDP).

• Lumbago is acute low backache.

• Sciatica is the neuralgic pain that starts in the back and radiates along the posterior aspect of lower limb to heel.


• Combination of lumbago with sciatica is invariably due to acute intervertebral disc protrusion in the lumbar region (L3-L4; L4-L5; L5-S l ).

• Other rare causes are the following:

• Metastasis

• Tumours

• Tuberculosis of spine

• Spinal canal stenosis


Clinical Features of lntervertebral Disc Prolapse (IVDP)


• Lumbago is localised low backache in the midline that increases on movements of spine or straining (like coughing, sneezing, etc.). There is associated paraspinal muscular spasm.

• Pain starts acutely, usually while attempting to lift weight in bent posture. Lumbago may or may not be associated with sciatica.


• Also known as lumbar radicular pain.

• Occurs due to irritation of a spinal root compressed by the protruded disc close to the intervertebral foramen.

• Pain is shooting, burning or shock-like in character. It maybe continuous or brought on by spinal movements and straining.

• Patient prefers to lie down on his sides with flexed lower limbs.

• Syndrome of pain may or may not be associated with symptoms of neurological deficit, which depends on the root involved.

• L4 root Weakness of invertors of foot, sensory impairment at L4 dermatome (inner aspect of leg) and depressed knee jerk

• LS root Weakness of extensor hallucis longus with sensory impairment at LS dermatome (outer aspect of leg and dorsum of foot)

• S1 root Weakness of plantar flexors of toes, foot and hamstrings with depressed ankle jerk and sensory impairment at S1 dermatome (outer aspect of foot)

• Positive straight leg raising (SLR) test is present.

• Large disc protrusions may cause bilateral, more extensive neurological deficit (cauda equina syndrome)



• Plain radiograph of lumbosacral spine:

   • Loss of lumbar lordosis

   • Scoliosis

   • Reduced intervertebral disc space

   • On most occasions, radiograph is normal

• CT scan shows the protruded disc. MRI is more sensitive and specific.



• Bed rest for 1-3 weeks; however, presently early return to daily activities is encouraged.



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