What is Lumbosacral Neuritis? Causes, Diagnosis, Treatment

Lumbosacral neuritis is the scientific term used to describe irritation to one of the nerves lining the spinal column in the region of the lower back (the lumbar region).

This area is packed particularly densely with fragile, essential structures, including nerves, blood vessels, muscles, discs (the soft pads in between each vertebra in the spinal column itself) and joints.

For this reason, when there is a pain in the lumbar area, it is critical to obtain the most accurate diagnosis so the appropriate treatment will be applied.

In this article, learn more about lumbosacral neuritis, what it is, what causes it, signs and symptoms, treatment options and possible routes to prevention.

Man having a back pain

What Is Lumbosacral Neuritis?

According to Health N Care, lumbosacral neuritis is a medical condition that occurs when one or more nerves located in the lumbar (lower back) region of the spinal column become irritated or otherwise compromised.(1)

The lumbar region includes five vertebra (named L1 through L5) plus the sacrum, one larger bone at the base of the spine that connects the spinal column to the pelvis.

Any of the nerves lining this segment of the spinal column can become irritated in their fibers or at the nerve root.

 

Causes of Lumbosacral Neuritis

According to Health and Living magazine, lumbosacral neuritis can arise due to a number of causes. This, of course, can make diagnosis more challenging.(2)

However, having an awareness of the major potential causes can serve as a useful tool in working towards the most accurate diagnosis.

 

Here is a list of some of the most common causes for lumbosacral neuritis:

» Herniated lumbar disc. WebMD outlines a number of names for the condition often called simply “herniated disc.”(3) A disc is the flexible, soft structure that sits in between each vertebra to keep them from rubbing against one another.

When the disc is compromised in some way, such as by slipping out of position, becoming compressed or rupturing, this is called “herniation,” or, alternately, ruptured disc or slipped disc.

» Compression. Compression can occur for a variety of reasons, including the presence of a spinal column tumor, the growth of a bone spur that presses down on the nerves or even pressure from nearby vertebra due to a herniated disc.

» Infection. Infection can arise as a result of a co-occurring condition such as HIV/AIDS, diphtheria, hepatitis and other serious infectious health issues. Infection can cause inflammation of the lumbar-area nerves.

»  Scar tissue. If there has been surgery in the lumbar area in the past, the presence of adhesions or simple scar tissue can cause compression, which can lead to inflammation and pain.

» Dietary imbalance. Deficiency in certain vitamins and minerals (specifically, the B vitamins, thiamine and niacin) can give rise to peripheral neuritis in the lumbar region, according to ePainAssist.(4)

» Exposure to systemic toxins. Dependency on alcohol or exposure to chemicals, drug or medication interactions or exposure to environmental toxins can all lead to lumbosacral neuritis.(5)

» Inflammation. Inflammation that arises from other health conditions, including cancer, diabetes, endocrine disease or hypothyroidism, can then put pressure on the lumbar spinal column nerves and lead to lumbosacral neuritis.

 

Symptoms

Human back

While the most commonly reported patient symptoms for individuals diagnosed with lumbosacral neuritis include lower back pain and shooting pains into the legs, from here symptoms will become more specific based on the exact diagnosis of the affected region (see more in the next section here).

Depending on the location and number of affected nerves and/or discs, symptoms can include any or all of the following:(1,2,4)

» Numbness.
» Tingling.
» Muscle weakness and/or atrophy in one muscle or a group of muscles.
» Inability to discern temperature changes (hot/cold).
» Inability to feel pressure or simple touch on the skin.
» Neuropathic pain.
» Sharp or burning pain.
» Chronic pain (day or night or both).
» Night-specific pain.
» Poor reflexes.
» Reduction in muscle mass.
» Reduced coordination and muscle control.

 

Diagnosing Lumbosacral Neuritis

Get PT reports that diagnosing lumbosacral neuritis definitively can be challenging.(6) Part of the reason for this is because specific tests are needed to determine exactly which nerve(s) and disc(s) may be affected.

Also, some nerves are very small and thin with a number of parts and can be difficult to isolate during testing.

There are two major types of nerves that run through the spinal column: sensory nerves and motor nerves. Sensory nerves are responsible for transmitting messages from the body’s extremities to the central nervous system (CNS).

Motor nerves, conversely, are responsible for transmitting messages from the CNS to the extremities.

Doctors test to confirm a diagnosis of one of the three different types of lumbosacral neuritis as follows:(1,4)

Lumbar mononeuritis

Lumbar mononeuritis has two sub-types: lumbar sensory nerve and lumbar motor nerve. The symptoms of each differ, although the affected region (lower back and lower extremities) remains the same for both.

Lumbar polyneuritis

Lumbar polyneuritis also has two types: lumbar sensory nerve inflammation and lumbar motor nerve inflammation. In each type, symptoms will differ but multiple lumbar regions will be affected for both.

Mixed nerve

With mixed nerve lumbosacral neuritis, both sensory and motor nerves are affected in one or several portions of the lumbar spine. Often the diagnosis here is simply “mixed neuritis.”

Diagnosing lumbosacral neuritis relies on several elements. The diagnostic process begins with a patient report of symptoms and a thorough physical exam, including reflex testing.

From here, a number of diagnostic tests can be prescribed depending on reported symptoms and results of the exam:

» CBC (complete blood count). Looks for vitamin/mineral and nutrient imbalances as well as overall blood composition.

» WBC (white blood cell count). Looks for increased white blood cells to indicate infection.

» EMG (electromyogram). Measures nerve conduction and nerve function.

» Nerve conduction. Attempts to isolate affected motor and/or sensory nerves.

» Nerve biopsy. Looks for neuropathy and nerve damage.

» MRI (magnetic resonance imaging). Looks for structural damage such as herniated disc, tumor, aneurysm, cancer and other possible triggers.

» X-ray. Looks for co-occurring conditions in the spinal column such as spinal stenosis (narrowing of the lumbar-area spinal column).

 

Treatment

Once a definitive diagnosis has been established, the treatment phase can begin. In general, there are three different treatment approaches: conservative, moderate and surgical.(4)

» Conservative. The conservative approach typically focuses on over-the-counter (OTC) or prescription medications and at-home helps, such as stretching, specific exercises and assistive devices such as lumbar cushions for use during sitting.

» Moderate. The moderate approach typically includes both medication and some form of physical therapy (PT), which may include alternatives such as acupuncture, chiropractic or other types of movement therapy.

» Surgical. The surgical approach will only be recommended when there are no other potential less invasive means of alleviating symptoms of lumbosacral neuritis.
Otherwise, the treatment will always be specific to the symptoms and causes for lumbosacral neuritis.

For example, if dietary/vitamin/mineral deficiencies are discovered, treatment will aim to correct those as quickly as possible through prescribing appropriate supplementation.

If testing discovers that a co-occurring condition, such as diabetes or an infection, is causing lumbosacral neuritis, treatment will focus on addressing that underlying condition.

 

If symptoms indicate a potential case of lumbosacral neuritis, it is important to follow these steps:

» Keep a daily log of specific symptoms, including times and durations.
» Make a list of all current medications and/or supplements (including vitamins).
» Schedule a medical exam with a qualified neurologist.
» Undergo diagnostic testing as needed to arrive at a specific diagnosis.
» Follow treatment recommendations until symptoms are alleviated.


References

(1)http://healthncare.info/7244-lumbosacralneuritis-definition-symptoms/
(2)http://www.healthandlivingmag.com/Lumbosacral_neuritis_symptoms_causes_and_treatments/
(3)http://www.webmd.com/back-pain/tc/herniated-disc-topic-overview
(4)https://www.epainassist.com/back-pain/lower-back-pain/lumbar-neuritis
(5)https://www.spineuniverse.com/conditions/back-pain/low-back-pain/does-drinking-alcohol-lead-lower-back-pain
(6)http://getpt.org/diagnosis/thoracic-or-lumbosacral-neuritis/