Acute lumbar syndrome

Acute lumbar syndrome is a condition of radicular leg pain, sometimes accompanied by low back pain which may be accompanied by a motor or sensory deficit.

Initial Diagnosis and Management

 * The initial diagnosis is clinical with the acute or subacute development of low back pain usually with sciatic pain following minimal low back trauma.


 * In patients under the age of 50, no x-ray or lab studies are necessary.


 * Over the age of 50, disc abnormalities are possible, but initial lumbar sacral spine series should be considered which might exclude bony structural abnormalities such as severe degenerative changes, osteoporosis with compression or metastatic involvement.


 * MRI and/or CT scan are not necessary to confirm the initial diagnosis of acute lumbar syndrome except when there is failure to respond to conservative therapy or there is development of neurologic deficit.


 * The initial objective of management is to reduce lumbar nerve root tension. Depending upon the severity, bed-rest or reduction of activity level for one to two weeks is indicated. Analgesics and muscle relaxants are usually helpful.