What is radiculitis and why does lower back pain occur?
Radiculitis, or radiculopathy, is a condition characterized by the compression or inflammation of spinal nerve roots. It most often manifests as acute or chronic pain that may radiate (spread) along the nerve path. The lumbar spine is the most vulnerable to the development of radiculitis because it bears a significant load. Typical symptoms include lower back pain that may radiate to the buttock, thigh, or lower leg, as well as numbness, tingling, or weakness in the affected limb.
Although radiculitis is often associated with herniated intervertebral discs, it can also be caused by other factors: osteochondrosis, spondylolisthesis, spinal canal stenosis, injuries, tumors, or inflammatory processes. It is important to understand that lower back pain is a symptom that can indicate a wide range of conditions, from relatively benign ones to those requiring immediate medical intervention.
Diagnosing lower back pain: when is thoroughness needed?
Accurate diagnosis is the cornerstone of successful treatment for lower back pain, especially when dealing with radiculitis or other complex conditions. The physician collects a detailed medical history and performs a physical examination, assessing reflexes, muscle strength, and sensitivity. To confirm the diagnosis and exclude other causes of pain, instrumental studies such as radiography, computed tomography (CT), or magnetic resonance imaging (MRI) may be ordered.
In some cases, especially with atypical symptoms or a lack of response to standard treatment, a more in-depth examination is required. For example, spinal infections caused by atypical mycobacteria can be difficult to diagnose and treat. They often require early and aggressive surgical intervention to remove affected tissues and restore spinal biomechanics, as well as prolonged antibiotic therapy. In such situations, close cooperation between a spine surgeon, an infectious disease specialist, and a general practitioner is crucial for successful infection control [6]. Such rare but serious causes of back pain underscore the need for thorough differential diagnosis.
Chronic pelvic pain in men, which can also radiate to the lower back, is another example of a condition with a wide spectrum of clinical manifestations and requires an interdisciplinary approach to diagnosis and treatment. This highlights that pain in the pelvic and lumbar regions can be caused by a multitude of factors, and its management is often fraught with challenges [8].
Approaches to treating radiculitis and chronic pain
Treatment for radiculitis usually begins with conservative methods aimed at reducing pain, relieving inflammation, and restoring function. These include:
- Pharmacotherapy: non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and analgesics. In some cases, corticosteroids may be used (orally or via injection).
- Physiotherapy: therapeutic exercise, massage, manual therapy, electrophoresis, magnetotherapy, and other procedures that help reduce pain and strengthen the muscular corset.
- Lifestyle modification: resting during the acute phase, avoiding provocative movements, correcting posture, and using orthopedic devices.
However, as mentioned, not all lower back pain is "ordinary" radiculitis. In cases where pain becomes chronic or is associated with more complex diseases, a more comprehensive and individualized approach is required. For example, in chronic pain, such as chronic pelvic pain which may also involve the lumbar region, management is often a complex task due to the diversity of clinical manifestations and the need for interdisciplinary involvement [8].
Promising directions and interdisciplinary collaboration
Beyond standard methods, researchers are constantly seeking new approaches to treating inflammatory and pain syndromes. For example, curcumin, the active component of Curcuma longa, is being actively studied in the context of treating various autoimmune diseases due to its anti-inflammatory properties. A systematic review and meta-analysis of 31 randomized controlled trials showed its potential in the therapy of 10 types of autoimmune diseases, including ankylosing spondylitis, which is an inflammatory disease of the spine and can cause chronic back pain [3]. Although this is not a direct treatment for radiculitis, research into such natural compounds opens new perspectives for managing the inflammatory components of back pain.
The importance of an interdisciplinary approach is not limited to rare infections or autoimmune conditions. For chronic lower back pain, including prolonged forms of radiculitis, the involvement of not only a neurologist or orthopedist is often required, but also a physiotherapist, rehabilitation specialist, psychologist, and sometimes pain management specialists. This approach allows for the consideration of all aspects of the patient's condition — physical, psychological, and social — and the development of the most effective treatment strategy. For example, in the treatment of atypical mycobacterial spinal infections, successful patient management requires close cooperation between a surgeon, an infectious disease specialist, and a general practitioner to ensure adequate treatment and disease control [6]. Similarly, for chronic pelvic pain, which can also manifest in the lower back, interdisciplinary interaction is the key to effective management [8].
Prevention and long-term management
To prevent radiculitis flare-ups and reduce the risk of developing chronic lower back pain, it is recommended to:
- Engage in regular physical activity aimed at strengthening back and abdominal muscles.
- Maintain a healthy weight.
- Maintain proper posture when sitting, standing, and lifting heavy objects.
- Avoid staying in one position for long periods.
- Seek medical attention promptly upon the appearance of the first symptoms of pain.
Long-term management of radiculitis often includes not only treating flare-ups but also constant work on strengthening the spine and maintaining its health. This may include regular therapeutic exercise, ergonomic correction of the workplace and lifestyle, as well as training in self-care methods and stress management, which can influence pain perception.
Sources
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- [2] Fischer, G., et al. (2021). Treatment of chronic hand and foot eczema. Clinical review from Australia/New Zealand. The Australasian Journal of Dermatology, 32(4), e221-e229. https://pubmed.ncbi.nlm.nih.gov/32776537/
- [3] Wang, Y., et al. (2022). Curcumin and Curcuma longa extract in the treatment of 10 types of autoimmune diseases: a systematic review and meta-analysis of 31 randomized controlled trials. Frontiers in Immunology, 13, 950821. https://pubmed.ncbi.nlm.nih.gov/35979355/
- [4] Ozen, S., et al. (2019). European consensus recommendations for the diagnosis and treatment of rare pediatric vasculitides – the SHARE initiative. Rheumatology (Oxford, England), 58(1), 108-119. https://pubmed.ncbi.nlm.nih.gov/30535249/
- [5] Gupta, V., et al. (2026). Myocardial infarction in a child with systemic lupus erythematosus. BMJ Case Reports, 19(1), e256860. https://pubmed.ncbi.nlm.nih.gov/41763661/
- [6] Al-Mohamadi, A., et al. (2024). Atypical mycobacterial spinal infections: assessment and treatment. Orthopedics, 47(1), e20-e24. https://pubmed.ncbi.nlm.nih.gov/38285551/
- [7] Strate, L. L., & Morris, A. M. (2019). Management of diverticulitis: a review of guidelines. The Medical Journal of Australia, 210(8), 363-368. https://pubmed.ncbi.nlm.nih.gov/31352692/
- [8] Shoskes, D. A., et al. (2025). Chronic pelvic pain in men: AUA Guideline: Part I. Approach to assessment and treatment. The Journal of Urology, 213(2), 299-307. https://pubmed.ncbi.nlm.nih.gov/40243110/
Please note: The information provided in this article is for reference purposes only and should not be used for self-diagnosis or self-treatment. Always consult a qualified medical professional for an accurate diagnosis and the prescription of appropriate treatment.