Radicular back pain, commonly associated with conditions like herniated discs or sciatica, can be debilitating. This type of pain, caused by nerve irritation or compression, often radiates down the legs and significantly affects daily life. While conventional treatments like medication and surgery exist, a combination of osteopathic techniques and shockwave therapy offers a non-invasive, effective alternative. This guide explores radicular back pain, osteopathic approaches, and the role of shockwave therapy in treatment.
What is Radicular Back Pain?
Radicular back pain arises from nerve root compression or irritation in the spine, often causing sharp, shooting pain that radiates along the affected nerve’s pathway, typically into the legs.
In contrast, pseudoradicular pain stems from conditions such as facet joint involvement, piriformis syndrome, or other disorders. This pain is usually felt in the proximal dermatomes of the thigh as referred pain (Head’s zones). Unlike radicular pain, pseudoradicular lower back pain often lacks a clear underlying cause, with many cases classified as idiopathic.
Causes and Symptoms Explained
Radicular pain typically results from conditions like:
Herniated discs: When spinal discs bulge and press on nerve roots.
Spinal stenosis: Narrowing of the spinal canal.
Bone spurs or spondylolisthesis: Causing nerve compression.
Symptoms include:
Pain radiating from the lower back to the legs.
Tingling, numbness, or weakness in the legs.
Increased pain with activities like sitting or bending (Stafford et al., 2007).
How It Differs from Other Back Pain
The distinction between radicular and pseudoradicular lower back pain is clinically significant for both diagnosis and treatment. Radicular pain always involves a neuropathic component due to damage or irritation of peripheral nerves or nerve roots, whereas pseudoradicular pain may occur without such involvement and is often purely nociceptive. This difference is crucial for interpreting neurophysiologic examinations.
Radicular pain typically follows nerve pathways, making it more severe and often accompanied by neurological symptoms such as sensory loss or diminished reflexes. It is predominantly responsive to antidepressants and anticonvulsants. In contrast, pseudoradicular pain remains localized, similar to mechanical back pain, and responds better to nonsteroidal anti-inflammatory drugs (NSAIDs).
Diagnosis relies primarily on clinical features, with imaging used to rule out other causes or confirm the nature of the pain when uncertain. However, radiological abnormalities in the lumbar spine often show poor correlation with clinical symptoms, emphasising the importance of thorough clinical evaluation.
Osteopathic Approaches to Radicular Back Pain
Osteopaths focus on relieving pressure on the affected nerves, restoring alignment, and improving the overall function of the spine and surrounding tissues.
Techniques to Alleviate Nerve Compression
Osteopathic manual therapy involves techniques like:
Spinal mobilisation: Gently improving movement in the affected spinal segments.
Soft tissue therapy: Reducing tension in muscles that may be contributing to nerve compression.
Muscle energy techniques: Restoring balance and alignment in the spine.
By reducing nerve pressure, osteopaths not only alleviate pain but also enhance the body’s ability to heal itself (Chaitow, 2013).
The Importance of a Tailored Approach
Each case of radicular back pain is unique. Osteopaths assess posture, movement patterns, and lifestyle factors to create a personalized treatment plan. This ensures both symptom relief and long-term prevention of recurrence.
How Shockwave Therapy Addresses Radicular Pain
Shockwave therapy complements osteopathic care by targeting the underlying issues contributing to radicular pain.
Stimulating Tissue Regeneration Near Nerves
Shockwave therapy delivers high-energy acoustic waves to the affected area, stimulating blood flow and tissue repair. This is particularly effective for conditions like herniated discs, where it promotes healing around the compressed nerve (Notarnicola & Moretti, 2012).
Enhancing Pain Relief Through Non-Invasive Treatment
Shockwave therapy helps reduce inflammation and block pain signals, providing relief without medication or invasive procedures. For patients with chronic radicular pain, it offers a safe, evidence-based option for improving function and reducing discomfort (Wang et al., 2012).
Living with Radicular Pain: Tips for Relief
While professional treatment is essential, lifestyle adjustments can help manage radicular pain daily.
Managing Pain Day-to-Day
Stay active: Gentle exercises, like walking or swimming, can maintain mobility without worsening symptoms.
Ergonomics: Adjust your workstation to support proper posture.
Heat and cold therapy: Use heat to relax muscles and cold packs to reduce inflammation.
When to Seek Professional Help
If pain persists or worsens, or if you experience neurological symptoms like numbness or weakness, consult an osteopath. Early intervention can prevent further damage and speed up recovery.
Conclusion
Combining osteopathic techniques with shockwave therapy offers a powerful approach to managing radicular back pain. While osteopathy focuses on alleviating nerve compression and restoring alignment, shockwave therapy enhances healing and provides effective pain relief. Together, these treatments address the root cause of radicular pain, helping patients regain mobility and quality of life.
Jonathan Hall M.Ost, BAppSci (Human Biology), PGCertHSc (Acupuncture), GradDipHeal
Jonathan Hall is the founder and principal Osteopath at Movement Mechanics Osteopathy. Jonathan specialises in Shockwave Therapy and Western medical acupuncture. A fully qualified Osteopath registered with OCNZ, PNZ, PAANZ and ACC, Jonathan also founded Auckland Shockwave Therapy to help bring evidence-based Shockwave treatment to New Zealand using the industry-leading EMS Radial Shock Wave device.
Contact Us: hello@movementmechanics.nz
References
Chaitow, L. (2013). Clinical Application of Neuromuscular Techniques, Volume 1: The Upper Body. Elsevier Health Sciences.
Notarnicola, A., & Moretti, B. (2012). The biological effects of extracorporeal shockwave therapy (ESWT) on soft tissue. Muscles, Ligaments and Tendons Journal, 2(2), 33-37.
Stafford, M. A., Peng, P., & Hill, D. A. (2007). Sciatica: A review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. British Journal of Anaesthesia, 99(4), 461-473.
Wang, C. J., et al. (2012). Extracorporeal shockwave therapy for chronic plantar fasciitis. The American Journal of Sports Medicine, 40(3), 542-549.
Disclaimer: This content is for educational purposes and is not a substitute for professional medical advice.
© Movement Mechanics Osteopathy Auckland 2024. All rights reserved.
Comentários